The Effect of the Stopping Elderly Accidents, Deaths, and Injuries Program on Falls Prevention in Neurosurgical Patients.

ABSTRACT: BACKGROUND: Despite the negative consequences of falls among neurosurgery patients in acute care settings, there is a lack of high-quality evidence for successful fall prevention programs. This study was conducted to evaluate the effectiveness of the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) program on falling prevention compared with routine falling protocol in neurosurgical patients in Jordan. METHODS: A prospective quasi-experimental design was used in this study. The sample comprised 70 neurosurgical patients from a major university-affiliated hospital in Jordan. The study sample was assigned into a control group (35 patients) and an intervention group (35 patients). A demographics questionnaire, and different fall risk screening tools and tests were used in this study as recommended by the STEADI program. RESULTS: Multivariate analysis of variance results showed a significant effect ( P = .001) of the STEADI program on the linear combination of outcome measures. Independent samples t tests further confirmed the program's effectiveness, with statistically significant mean differences in most outcome measures between the intervention and control groups post intervention. After implementing the study intervention, participants in the intervention group had a statistically significant lower risk for falls. CONCLUSION: The findings indicate potential effectiveness in improving neurosurgery patients' outcomes and reducing the risk of falls. Implementing the study recommendations can enhance patient safety and promote evidence-based fall prevention interventions in neurosurgery patients.

Posterior cervical decompressive laminectomy and lateral mass screw fixation.

OBJECTIVE: To review the results and complications of cervical decompressive laminectomy and lateral mass screw fixation. METHODS: This retrospective study was carried out between October 2006 and January 2010 at King Abdullah University Hospital, Irbid, Jordan. Over 40 months, 405 lateral mass screws were placed in 50 patients aged 22-65 years (17 females, and 33 males) for variable cervical pathologies including degenerative disease, trauma, and neoplasm. All cases were performed with a polyaxial screw/rod construct. Most patients had 14 mm length and 3.5 mm diameter screws placed. The screw location was evaluated by postoperative plain x-ray and CT. The facet joint, foraminal and foramen transversarium violation were also assessed. RESULTS: All screws were placed using the Anderson or Sekhon methods. No patients experienced neural or vascular injury as a result of screw position. One patient needed screw repositioning. Three patients experienced superficial wound infection. Five patients experienced pain around the shoulder of C5 distribution that subsided over time. No patients had screw pullouts or symptomatic adjacent segment disease. Postoperative CT scanning showed no compromise of the foramen transversarium or neural foramen in the vast majority of the patients. CONCLUSION: Lateral mass screw stabilization is a safe and effective surgical technique. This study exhibits the safety and effectiveness of lateral mass fixation for a variety of subaxial cervical spine disease.