{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:52:42Z","timestamp":1786125162208,"version":"build-2736575974"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2021,10,11]],"date-time":"2021-10-11T00:00:00Z","timestamp":1633910400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurosurg.","NEUROS"],"abstract":"Abstract<\/jats:title>\n \n BACKGROUND<\/jats:title>\n Few studies have assessed the impact of overlapping surgery during different timepoints of neurosurgical procedures.<\/jats:p>\n <\/jats:sec>\n \n OBJECTIVE<\/jats:title>\n To evaluate the impact of overlap before the critical portion of surgery on short-term patient outcomes following lumbar fusion.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n \n In total, 3799 consecutive patients who underwent single-level, posterior-only lumbar fusion over 6 yr (2013-2019) at an academic hospital system were retrospectively studied. Outcomes included 30-d emergency department (ED) visit, readmission, reoperation, mortality, overall morbidity, and overall morbidity\/surgical complications. Duration of overlap that occurred before the critical portion of surgery was calculated as a percentage of total beginning operative time. Univariate logistic regression was used to assess the impact of incremental 1% increases in the duration of overlap within the whole population and patients with beginning overlap. Subsequently, univariate analysis was used to compare exact matched patients with the least (bottom 40%) and most amounts of overlap (100% beginning overlap). Coarsened exact matching was used to match patients on key demographic factors, as well as attending surgeon. Significance was set at a\n P<\/jats:italic>\n -value <\u00a0.05.\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n Increased duration of beginning overlap was associated with a decrease in 30-d ED visit (\n P<\/jats:italic>\n \u00a0=\u00a0.03) within all patients with beginning overlap, but not within the whole population undergoing lumbar fusion. Duration of beginning overlap was not associated with any other short-term morbidity or mortality outcome in either the whole population or patients with beginning overlap.\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSION<\/jats:title>\n Increased duration of overlap before the critical step of surgery does not predict adverse short-term outcomes after single-level, posterior-only lumbar fusion.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/neuros\/nyab360","type":"journal-article","created":{"date-parts":[[2021,9,8]],"date-time":"2021-09-08T07:41:57Z","timestamp":1631086917000},"page":"1052-1061","source":"Crossref","is-referenced-by-count":5,"title":["Overlap Before the Critical Step of Lumbar Fusion Does Not Lead to Increased Short-Term Morbidity"],"prefix":"10.1227","volume":"89","author":[{"given":"Ali S","family":"Farooqi","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Austin J","family":"Borja","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald K E","family":"Detchou","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Glauser","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlyn","family":"Shultz","sequence":"additional","affiliation":[{"name":"McKenna EpiLog Fellowship in Population Health at the University of Pennsylvania, Philadelphia, Pennsylvania, USA"},{"name":"The West Chester Statistical Institute and Department of Mathematics, West Chester University, West Chester, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott D","family":"McClintock","sequence":"additional","affiliation":[{"name":"The West Chester Statistical Institute and Department of Mathematics, West Chester University, West Chester, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil R","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA"},{"name":"McKenna EpiLog Fellowship in Population Health at the University of Pennsylvania, Philadelphia, Pennsylvania, 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