Should patients see their doctor's notes?

Giving patients access to their surgeons' notes is an almost unheard of practice and the idea generates uneasy feelings in the medical community. However, a recent study granted patients access to their primary care physician's notes and it had some surprising outcomes.

What would you do if a patient asked to view your notes on their care? The 1996 US Health Insurance Portability and Accountability Act made it a patient’s legal right to view and amend their records at any time. Many doctors balk at the idea, while some counsel patients to take an active approach. Read more...

Hypoxic conditions may help spinal cord injured

Atlanta, US.Researchers at Atlanta’s Emory University wanted to determine the effect of oxygen on movement and assembled 19 people with spinal cord injuries who could take at least one step unaided. Nine people were given hypoxia treatment 40 minutes per day for 5 days and at the end of the experiment were able to walk 3.8 seconds faster on a 10-meter walking test, increase their speed and gained endurance by 250% compared to the sham group. A Neurology editorial by AOSpine member Michael G Fehlings of the University of Toronto pondered the reason behind these results: “One question this research brings to light is how a treatment that requires people to take in low levels of oxygen can help movement, let alone in those with compromised lung function and motor abilities. A possible answer is that spinal serotonin, a neurotransmitter, sets off a cascade of changes in proteins that help restore connections in the spine.”

Brain surgery technique for spinal stenosis

Crawley, Australia.A procedure most commonly used during brain surgery has been found useful in determining which spinal segments were suffering from stenosis. Until now it has been difficult to figure out which segments required treatment with decompression surgery. Sedimentation sign (SedSign) involves measuring the pressure within the spinal canal by inserting a catheter containing a pressure sensor. It is a procedure that could even be completed before surgery. Professor Markus Melloh, of the Harry Perkins Institute of Medical Research and the University of Western Australia explains what they found: “The pressure at the stenosis level in patients with spinal stenosis was three times higher than at unaffected levels in this patient group and compared to the control group, which makes this technique a very promising diagnostic tool for patients with problems of the lumbar spine.” This technique could result in shorter operating times and fewer complications for patients.

Best time to perform spinal decompression surgery

Aylesbury, UK. There is some debate as to the best time to perform spinal decompression surgery after traumatic spinal cord injury (tSCI). The procedure can decrease swelling and increase blood flow to an injured spine. A meta-analysis of 18 studies looked at outcomes and timing of spinal surgery after tSCI and found support in six of the studies for “early” spinal surgery intervention when considering total motor score improvement, neurological improvement, and shorter hospital stay. Conducted by Joost van Middendorp, Allard Hosman, and Suhail Doi, researchers from the UK, Australia and the Netherlands, the study also noted that the support they found for early surgery lacks robustness and heterogeneity within and between studies. The authors suggested a number of approaches for future nonrandomized studies that may “diminish their susceptibility to bias”. “This timely article contributes additional data and discussion to the general topic of decompression surgery as an effective strategy to protect against traumatic SCI,” said W Dalton Dietrich, PhD, Deputy Editor of the Journal of Neurotrauma.

The Division of Spine Surgery at the Department of Orthopaedics and Traumatology, The University of Hong Kong

Well known for for its novel research and innovative approach to spine care the Division of Spine Surgery at the Department of Orthopaedics and Traumatology, The University of Hong Kong is a busy department offering a comprehensive range treatment options. A recognized AOSpine Reference Center since 2002, the division also offers international fellowships for further education. Read more...