CDE Detailed Report

Osteotomy has been performed to position the extremity for function. In cases of internal rotation contracture of the shoulder and/or forearm supination contracture, a de-rotational osteotomy is performed to position the arm and forearm for function, respectively (Coulet et al 2010); these are usually done as a precursor to or in combination with tendon transfers. Fusion has been performed to stabilize a joint to improve function. The most common joints that are fused are in the thumb (House, et al 1992;
Waters 1985).

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Choose all that apply. Recommend collection during acute hospital care. Document information on a continuing basis and check/update on discharge/death from review of medical charts. Add date stamp for when assessed. In previous trials and studies, information on surgical procedures has typically been documented in free text format, thus often precluding any meaningful analysis. We therefore propose the use of ICD-10 coding.

Tendon transfer for wrist extension has been performed to restore/augment active wrist extension. The primary procedure for restoration of wrist extension in SCI is transfer of the brachioradialis to radial wrist extensors (FridÉn 2005)

Osteotomy has been performed to position the extremity for function. In cases of internal rotation contracture of the shoulder and/or forearm supination contracture, a de-rotational osteotomy is performed to position the arm and forearm for function, respectively (Coulet et al 2010); these are usually done as a precursor to or in combination with tendon transfers. Fusion has been performed to stabilize a joint to improve function. The most common joints that are fused are in the thumb (House, et al 1992;
Waters 1985).

Tendon transfer for pinch and\or grasp has been performed to restore/augment active hand function. The procedures used to restore hand function vary (Keith 2012; FridÉn 2011; Zancolli 2002; House 1985; Waters 1985).

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This includes prescriptive bed-rest which usually involves more than 10 days of enforced bed-rest and does not include the normal recumbency which follows injury or surgery as a patient is slowly mobilized. The application of external spinal immobilization devices such as braces, casts, halo thoracic vests, etc. is also a specific spine intervention.

Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).

Osteotomy has been performed to position the extremity for function. In cases of internal rotation contracture of the shoulder and/or forearm supination contracture, a de-rotational osteotomy is performed to position the arm and forearm for function, respectively (Coulet et al 2010); these are usually done as a precursor to or in combination with tendon transfers. Fusion has been performed to stabilize a joint to improve function. The most common joints that are fused are in the thumb (House, et al 1992;
Waters 1985).

Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).

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Anterior surgical approaches include all anterior and lateral cervical approaches as well as any thoracic or lumbar approach that visualizes the vertebral body or inter-vertebral disk such as thoracotomy, thoracoscopy, thoracoplasty, thoraco-abdominal, retro-peritoneal, trans-peritoneal, or variations of lateral lumbar approaches. A posterior approach includes midline posterior incisions, paraspinal and Wiltse type incisions that expose the lamina, facet joints, and/or the transverse processes. Also included in posterior approaches are percutaneous or minimally invasive surgical techniques that enable insertion of spinal implants through stab incisions.

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Osteotomy has been performed to position the extremity for function. In cases of internal rotation contracture of the shoulder and/or forearm supination contracture, a de-rotational osteotomy is performed to position the arm and forearm for function, respectively (Coulet et al 2010); these are usually done as a precursor to or in combination with tendon transfers. Fusion has been performed to stabilize a joint to improve function. The most common joints that are fused are in the thumb (House, et al 1992;
Waters 1985).

Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).

Other surgical soft tissue reconstruction to improve arm/hand function such as tenodesis procedures (Treanor 1992; Waters 1985).

Most commonly, open reduction is performed through a posterior surgical approach, but may, on occasion such as the anterior cervical discectomy which is followed by a reduction of a facet dislocation, be performed through an anterior approach.

Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).

An FES system has been implanted in the upper extremity to restore stimulated arm and/or hand movement (Kilgore et al 2008; Peckham et al 2001; Mulcahey et al 1997).

This variable is used to document each of the level(s) of spinal fusion or instrumentation. For a single fused motion segment injury, such as a C5-6 anterior fusion and plating, both the cephalic and caudal of the two adjacent vertebrae are identified and separated by a dash (-). The prefix "v" references the fact that we are referring to a spinal column level (vertebral level) and helps distinguish the spinal column injury level from the neurological level. The cervical region is represented by vC00-vC07. The occiput is considered to be the most cephalic vertebral level and is designated by vC00. The thoracic region is represented by vT01-vT12.

Osteotomy has been performed to position the extremity for function. In cases of internal rotation contracture of the shoulder and/or forearm supination contracture, a de-rotational osteotomy is performed to position the arm and forearm for function, respectively (Coulet et al 2010); these are usually done as a precursor to or in combination with tendon transfers. Fusion has been performed to stabilize a joint to improve function. The most common joints that are fused are in the thumb (House, et al 1992;
Waters 1985).

When a surgical procedure is performed it may or may not include the insertion of instrumentation to stabilize vertebral levels and may or may not involve a formal fusion procedure with or without insertion of local or distantly harvested structural or non-structural bone graft or substitutes. This variable encompasses any and all of the above in one single data point. This variable orders and assigns numbers to each region of the spine which has undergone a spinal instrumentation or fusion procedure beginning with the most cephalic region that has been instrumented and fused and progressing to the most caudal fused region regardless of which level of spinal column injury is the most severe or significant injury or which injury may or may not contribute to the patient's neurological
injury. If a patient has had a vC5-6 anterior fusion and also a vT12 to vL2 posterior instrumentation, then each of these non-contiguous instrumented and fused regions would receive a numerical score beginning with 1 for the vC5-6 fusion and 2 for the vT12-vL2 instrumentation.