2023
Emergency department visits within 90 days of lumbar discectomy
Ratnasamy P, Rudisill K, Caruana D, Kammien A, Grauer J. Emergency department visits within 90 days of lumbar discectomy. The Spine Journal 2023, 23: 1522-1530. PMID: 37356460, DOI: 10.1016/j.spinee.2023.06.384.Peer-Reviewed Original ResearchConceptsElixhauser Comorbidity IndexSurgical site painED visitsED utilizationLumbar discectomySite painUnderwent reoperationPatient factorsPostoperative weekPatient satisfactionPrimary diagnosisRisk factorsCSF leakHealth care resource utilizationHigher Elixhauser comorbidity indexExcess health care expendituresCommon primary diagnosisType of reoperationNerve root decompressionDay of surgeryEmergency department visitsPatient-level predictorsPosterior segmental instrumentationRisk of reoperationSpecific patient characteristicsSingle-level Anterior Cervical Discectomy and Fusion Results in Lower Five-year Revisions than Posterior Cervical Foraminotomy in a Large National Cohort
Jayaram R, Joo P, Gouzoulis M, Ratnasamy P, Caruana D, Grauer J. Single-level Anterior Cervical Discectomy and Fusion Results in Lower Five-year Revisions than Posterior Cervical Foraminotomy in a Large National Cohort. Spine 2023, 48: 1266-1271. PMID: 37339256, DOI: 10.1097/brs.0000000000004754.Peer-Reviewed Original ResearchMeSH KeywordsCervical VertebraeDiskectomyForaminotomyHumansRetrospective StudiesSpinal FusionTreatment OutcomeConceptsPosterior cervical foraminotomySingle-level ACDFSingle-level anterior cervical discectomyPerioperative adverse eventsAnterior cervical discectomyAdverse eventsCervical foraminotomyCervical discectomyRevision rateOdds ratioShort-term adverse eventsSimilar short-term outcomesKaplan-Meier survival analysisRetrospective cohort studySerious adverse eventsCervical disc diseaseFive-year ratesSurgical site infectionShort-term outcomesMultivariable logistic regressionLarge national cohortCumulative revision rateCervical reoperationPCF cohortCohort studyRheumatoid arthritis patients are at increased risk for adverse events following lumbar discectomy
Ratnasamy P, Rudisill K, Gouzoulis M, Kammien A, Grauer J. Rheumatoid arthritis patients are at increased risk for adverse events following lumbar discectomy. The Spine Journal 2023, 23: 990-996. PMID: 36990283, DOI: 10.1016/j.spinee.2023.03.012.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAntirheumatic AgentsArthritis, RheumatoidDiskectomyHumansReoperationRetrospective StudiesConceptsLumbar discectomy patientsAdverse eventsRheumatoid arthritisLumbar discectomyPatient ageDiscectomy patientsMinor adverse eventsRetrospective cohort studyLumbar spinal surgeryPatient's medication regimenElixhauser Comorbidity IndexExclusion of patientsRA medicationsComorbidity indexCohort studyMedication regimenPrior diagnosisPredictive factorsAdverse outcomesSubgroup analysisSpinal surgeryInfection diagnosisAutoinflammatory diseasesHigher oddsDiscectomyAnterior Cervical Discectomy and Fusion Outcomes in Patients With and Without Bariatric Surgery—Weight Loss Does Make a Difference
Joo P, Zhu J, Wilhelm C, Tang K, Day W, Moran J, Grauer J. Anterior Cervical Discectomy and Fusion Outcomes in Patients With and Without Bariatric Surgery—Weight Loss Does Make a Difference. Spine 2023, 48: 400-406. PMID: 36735637, DOI: 10.1097/brs.0000000000004580.Peer-Reviewed Original ResearchConceptsAnterior cervical discectomyBariatric surgeryMorbid obesityAdverse eventsCervical discectomyReoperation rateBS proceduresFive-Year Reoperation RatesRetrospective comparative cohort studyHistory of BSMinor adverse eventsNon-obese patientsAdverse event ratesComparative cohort studyElixhauser Comorbidity IndexKaplan-Meier analysisRisk of complicationsNon-obese controlsLength of stayACDF patientsElective ACDFComorbidity indexFusion patientsPulmonary embolismCohort study
2022
Cervical Disc Arthroplasty Usage Has Leveled Out From 2010 to 2021
Ratnasamy P, Rudisill K, Maloy G, Grauer J. Cervical Disc Arthroplasty Usage Has Leveled Out From 2010 to 2021. Spine 2022, 48: e342-e348. PMID: 36728785, PMCID: PMC10300227, DOI: 10.1097/brs.0000000000004560.Peer-Reviewed Original ResearchConceptsSingle-level cervical disc arthroplastyCervical disc arthroplastyKaplan-Meyer survival analysisPredictive patient factorsCervical spine pathologySingle-level ACDFAnterior cervical discectomyAnterior cervical surgeryCervical spine surgerySpine reoperationCervical surgeryCervical discectomyPatient factorsPredictive factorsSpine surgeryACDFDisc arthroplastySpine pathologyEpidemiologic studiesOrthopaedic surgeonsCommercial insuranceSurvival analysisMultivariate analysisSurgeryYounger age
2021
Clinical outcomes following one-, two-, three-, and four-level anterior cervical discectomy and fusion: a national database study
Joo PY, Zhu JR, Kammien AJ, Gouzoulis MJ, Arnold PM, Grauer JN. Clinical outcomes following one-, two-, three-, and four-level anterior cervical discectomy and fusion: a national database study. The Spine Journal 2021, 22: 542-548. PMID: 34774751, DOI: 10.1016/j.spinee.2021.11.002.Peer-Reviewed Original ResearchConceptsOne-level casesAnterior cervical discectomyAdverse eventsReoperation rateACDF casesCervical discectomyProlonged lengthFour-level anterior cervical discectomyMultivariate analysisMinor adverse event rateFour-level ACDFNational database studyAdverse event ratesGreater odds ratioCommon surgical procedureLarge national databaseDysphagia ratesElective ACDFLarge comparative studiesComplication ratePatient characteristicsReadmission ratesClinical outcomesPearlDiver databasePosterior procedures
2019
Economic and Outcomes Analysis of Recalcitrant Cervical Radiculopathy: Is Nonsurgical Management or Surgery More Cost-Effective?
Rihn JA, Bhat S, Grauer J, Harrop J, Ghogawala Z, Vaccaro AR, Hilibrand AS. Economic and Outcomes Analysis of Recalcitrant Cervical Radiculopathy: Is Nonsurgical Management or Surgery More Cost-Effective? Journal Of The American Academy Of Orthopaedic Surgeons 2019, 27: 533-540. PMID: 30407977, DOI: 10.5435/jaaos-d-17-00379.Peer-Reviewed Original ResearchConceptsCervical epidural injectionsIncremental cost-effectiveness ratioEpidural injectionQuality-adjusted life yearsCervical radiculopathyCost-effectiveness ratioConservative managementPhysical therapyLife yearsAverage incremental cost-effectiveness ratioAnterior cervical diskectomyCervical injectionCervical diskectomyNonsurgical managementSurgical managementClinical effectivenessOutcome analysisTheoretical cohortAvoidance rateRadiculopathyCost-effective strategySuch injectionsSuccess rateACDFInjectionIncidence, Risk Factors, and Clinical Implications of Postoperative Hematoma Requiring Reoperation Following Anterior Cervical Discectomy and Fusion
Bovonratwet P, Fu MC, Tyagi V, Bohl DD, Ondeck NT, Albert TJ, Grauer JN. Incidence, Risk Factors, and Clinical Implications of Postoperative Hematoma Requiring Reoperation Following Anterior Cervical Discectomy and Fusion. Spine 2019, Publish Ahead of Print: &na;. PMID: 30247374, DOI: 10.1097/brs.0000000000002885.Peer-Reviewed Original ResearchConceptsAnterior cervical discectomyRisk factorsPostoperative hematomaCervical discectomyNational Surgical Quality Improvement Program databaseClinical implicationsPreoperative international normalized ratioQuality Improvement Program databaseDeep wound infectionHigh-risk patientsImprovement Program databaseDevelopment of hematomaInternational normalized ratioLarge cohort studyOccurrence of hematomaACDF patientsPreoperative anemiaVentilator requirementAnesthesiologists classificationPostoperative lengthCohort studyPerioperative periodCatastrophic complicationPrimary outcomeSubsequent complications
2018
Frequency and Acceptability of Adverse Events After Anterior Cervical Discectomy and Fusion
Wilson JR, Radcliff K, Schroeder G, Booth M, Lucasti C, Fehlings M, Ahmad N, Vaccaro A, Arnold P, Sciubba D, Ching A, Smith J, Shaffrey C, Singh K, Darden B, Daffner S, Cheng I, Ghogawala Z, Ludwig S, Buchowski J, Brodke D, Wang J, Lehman RA, Hilibrand A, Yoon T, Grauer J, Dailey A, Steinmetz M, Harrop JS. Frequency and Acceptability of Adverse Events After Anterior Cervical Discectomy and Fusion. Clinical Spine Surgery A Spine Publication 2018, 31: e270-e277. PMID: 29708891, DOI: 10.1097/bsd.0000000000000645.Peer-Reviewed Original ResearchConceptsAnterior cervical discectomyAdverse eventsCervical discectomyPrimary specialtyPractice locationAdjacent segment diseaseSpinal cord injuryUS surgeonsWrong-level surgeryFuture quality improvementComplication eventsAcceptable complicationsUncommon complicationEsophageal injuryLevel surgeryCord injurySegment diseaseSpine surgerySurgeon experienceOrthopaedic surgeonsSurgeons' opinionsComplicationsDiscectomyMajority of respondentsSurgeonsLonger Operative Time Is Associated With Increased Adverse Events After Anterior Cervical Diskectomy and Fusion: 15-Minute Intervals Matter.
Ondeck NT, Bohl DD, McLynn RP, Cui JJ, Bovonratwet P, Singh K, Grauer JN. Longer Operative Time Is Associated With Increased Adverse Events After Anterior Cervical Diskectomy and Fusion: 15-Minute Intervals Matter. Orthopedics 2018, 41: e483-e488. PMID: 29708570, DOI: 10.3928/01477447-20180424-02.Peer-Reviewed Original ResearchConceptsAnterior cervical diskectomyOperative timeAdverse eventsCervical diskectomyPerioperative outcomesSurgical durationSurgeons National Surgical Quality Improvement ProgramNational Surgical Quality Improvement ProgramSurgical Quality Improvement ProgramIndividual adverse outcomesPostoperative adverse eventsLonger operative timeGreater operative timeQuality Improvement ProgramUnplanned intubationHospital stayBaseline characteristicsVenous thromboembolismHospital readmissionAdverse outcomesPatient variablesAmerican CollegeAnesthetic effectSurgical pathologyPhysiologic stressMissing data treatments matter: an analysis of multiple imputation for anterior cervical discectomy and fusion procedures
Ondeck NT, Fu MC, Skrip LA, McLynn RP, Cui JJ, Basques BA, Albert TJ, Grauer JN. Missing data treatments matter: an analysis of multiple imputation for anterior cervical discectomy and fusion procedures. The Spine Journal 2018, 18: 2009-2017. PMID: 29649614, DOI: 10.1016/j.spinee.2018.04.001.Peer-Reviewed Original ResearchConceptsSevere adverse eventsNational Surgical Quality Improvement ProgramAnterior cervical discectomyAdverse eventsPreoperative anemiaPreoperative hypoalbuminemiaPreoperative albuminCervical discectomyHospital readmissionAdverse outcomesComplete case analysisSurgical Quality Improvement ProgramAdverse outcome variablesOne-level ACDFPreoperative laboratory valuesBody mass indexFusion proceduresMultiple imputationLogistic regression analysisQuality Improvement ProgramPreoperative hematocritPostoperative outcomesRetrospective reviewMass indexLaboratory valuesDiscrepancies in the Definition of “Outpatient” Surgeries and Their Effect on Study Outcomes Related to ACDF and Lumbar Discectomy Procedures
Bovonratwet P, Webb ML, Ondeck NT, Gala RJ, Nelson SJ, McLynn RP, Cui JJ, Grauer JN. Discrepancies in the Definition of “Outpatient” Surgeries and Their Effect on Study Outcomes Related to ACDF and Lumbar Discectomy Procedures. Clinical Spine Surgery A Spine Publication 2018, 31: e152-e159. PMID: 29351096, DOI: 10.1097/bsd.0000000000000615.Peer-Reviewed Original ResearchConceptsACDF patientsLumbar discectomy patientsDiscectomy procedureDiscectomy patientsSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseACS-NSQIP databaseAnterior cervical discectomyImprovement Program databaseSame-day dischargePossibility of patientsCervical discectomyOutpatient statusRetrospective studyOutpatient surgeryAdverse outcomesOutpatient settingOutpatient procedureProgram databaseBACKGROUND DATADay dischargeAmerican CollegeACDFOutpatients
2017
Of 20,376 Lumbar Discectomies, 2.6% of Patients Readmitted Within 30 Days
Webb ML, Nelson SJ, Save A, Cui J, Lukasiewicz AM, Samuel AM, Diaz-Collado PJ, Bohl DD, Ondeck NT, McLynn RP, Grauer JN. Of 20,376 Lumbar Discectomies, 2.6% of Patients Readmitted Within 30 Days. Spine 2017, 42: 1267-1273. PMID: 27926671, DOI: 10.1097/brs.0000000000002014.Peer-Reviewed Original ResearchConceptsSurgical site infectionLumbar discectomyThromboembolic eventsHospital readmissionSite infectionSurgical variablesCommon reasonSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseCauses of readmissionHigher American SocietyImprovement Program databaseRetrospective cohort studyDay of surgeryQuality-based reimbursementQuality improvement initiativesPearson chi-squareAnesthesiologists classPostoperative painPatient demographicsCohort studyOperative timeAffordable Care ActRisk factorsOutpatient Anterior Cervical Discectomy and Fusion is Associated With Fewer Short-term Complications in One- and Two-level Cases
Fu MC, Gruskay JA, Samuel AM, Sheha ED, Derman PB, Iyer S, Grauer JN, Albert TJ. Outpatient Anterior Cervical Discectomy and Fusion is Associated With Fewer Short-term Complications in One- and Two-level Cases. Spine 2017, 42: 1044-1049. PMID: 28697092, DOI: 10.1097/brs.0000000000001988.Peer-Reviewed Original ResearchConceptsOutpatient anterior cervical discectomyAnterior cervical discectomyTwo-level ACDFPostdischarge complicationsPostoperative complicationsPostoperative morbidityRisk factorsCervical discectomyACDF casesOutpatient procedureOutpatient casesInpatient casesNational Surgical Quality Improvement Program databasePropensity-adjusted multivariable logistic regressionsQuality Improvement Program databaseCharlson Comorbidity IndexChronic steroid useOne-level ACDFOverall unadjusted rateGreater comorbidity burdenHigher American SocietyImprovement Program databaseIndependent risk factorRetrospective cohort studyShort-term complicationsDifferences in Short-Term Outcomes Between Primary and Revision Anterior Cervical Discectomy and Fusion
Basques BA, Ondeck NT, Geiger EJ, Samuel AM, Lukasiewicz AM, Webb ML, Bohl DD, Massel DH, Mayo BC, Singh K, Grauer JN. Differences in Short-Term Outcomes Between Primary and Revision Anterior Cervical Discectomy and Fusion. Spine 2017, 42: 253-260. PMID: 28207667, DOI: 10.1097/brs.0000000000001718.Peer-Reviewed Original ResearchConceptsRevision anterior cervical discectomyAnterior cervical discectomySurgical site infectionACDF proceduresRevision proceduresAdverse eventsPostoperative lengthThromboembolic eventsCervical discectomySite infectionBlood transfusionOperative timeNational Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement Program databaseQuality Improvement Program databaseOperating roomImprovement Program databaseMinor adverse eventsRetrospective cohort studySevere adverse eventsShort-term morbidityRisk of readmissionAverage operative timeShort-term outcomesMultiple adverse outcomes
2016
Most 30-day Readmissions After Anterior Cervical Discectomy and Fusion Are Not Due to Surgical Site-Related Issues
Samuel AM, Fu MC, Toy JO, Lukasiewicz AM, Webb ML, Bohl DD, Basques BA, Albert TJ, Grauer JN. Most 30-day Readmissions After Anterior Cervical Discectomy and Fusion Are Not Due to Surgical Site-Related Issues. Spine 2016, 41: 1801-1807. PMID: 27398892, DOI: 10.1097/brs.0000000000001775.Peer-Reviewed Original ResearchConceptsAnterior cervical discectomyCommon reasonElective ACDFCervical discectomyNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseAdequate postoperative managementHemorrhage/hematomaPreoperative medical optimizationCauses of readmissionCervical spine pathologyDays of dischargeHigher American SocietyImprovement Program databaseSurgical site infectionCareful patient selectionQuality-based reimbursementAnesthesiologists classMedical optimizationMost readmissionsNSQIP databasePostoperative daySite infectionPatient selectionPostoperative managementPreoperative Nutritional Status as an Adjunct Predictor of Major Postoperative Complications Following Anterior Cervical Discectomy and Fusion
Fu MC, Buerba RA, Grauer JN. Preoperative Nutritional Status as an Adjunct Predictor of Major Postoperative Complications Following Anterior Cervical Discectomy and Fusion. Clinical Spine Surgery A Spine Publication 2016, 29: 167-172. PMID: 25310390, DOI: 10.1097/bsd.0000000000000181.Peer-Reviewed Original ResearchConceptsNational Surgical Quality Improvement ProgramMajor postoperative complicationsPreoperative nutritional statusAnterior cervical discectomySurgical outcomes databaseSerum albumin concentrationPreoperative hypoalbuminemiaPostoperative complicationsNutritional statusAdjunct predictorCervical discectomyACDF casesOutcomes DatabaseAlbumin concentrationAlbumin measurementSurgical Quality Improvement ProgramMultivariable logistic regression modelHigher ASA classPreoperative albumin measurementsHigh-risk patientsPreoperative serum albuminMultiple medical comorbiditiesPreoperative risk assessmentAdjusted odds ratioStrong independent predictor
2015
Two-level Anterior Cervical Discectomy and Fusion
Samuel AM, Grauer JN, Rihn JA, Labrum JT. Two-level Anterior Cervical Discectomy and Fusion. Clinical Spine Surgery A Spine Publication 2015, 28: 349-351. PMID: 26579588, DOI: 10.1097/bsd.0000000000000338.Peer-Reviewed Original ResearchMyelopathy Is Associated With Increased All-Cause Morbidity and Mortality Following Anterior Cervical Discectomy and Fusion
Lukasiewicz AM, Basques BA, Bohl DD, Webb ML, Samuel AM, Grauer JN. Myelopathy Is Associated With Increased All-Cause Morbidity and Mortality Following Anterior Cervical Discectomy and Fusion. Spine 2015, 40: 443-449. PMID: 25599286, DOI: 10.1097/brs.0000000000000785.Peer-Reviewed Original ResearchMeSH KeywordsAdultCervical VertebraeCohort StudiesDatabases, FactualDiskectomyFemaleHumansIntervertebral Disc DegenerationLength of StayLogistic ModelsMaleMiddle AgedOperative TimeQuality ImprovementRetrospective StudiesSocieties, MedicalSpinal Cord DiseasesSpinal DiseasesSpinal FusionSurvival RateTreatment OutcomeUnited StatesConceptsBaseline patient characteristicsAnterior cervical discectomyAdverse eventsACDF proceduresCervical discectomyCervical myelopathyPatient characteristicsSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseMultivariate analysisQuality Improvement Program databaseSerious adverse eventsCervical spine pathologyImprovement Program databaseSevere adverse eventsMultivariate logistic regressionCommon surgical procedureCause morbidityRetrospective cohortSurgical characteristicsPatient factorsHigh morbidityDifferent morbiditiesPatient counselingDiagnosis codes
2014
Comparison of the lumbar disc herniation patients randomized in SPORT to 6,846 discectomy patients from NSQIP: demographics, perioperative variables, and complications correlate well
Golinvaux NS, Bohl DD, Basques BA, Yacob A, Grauer JN. Comparison of the lumbar disc herniation patients randomized in SPORT to 6,846 discectomy patients from NSQIP: demographics, perioperative variables, and complications correlate well. The Spine Journal 2014, 15: 685-691. PMID: 25499208, DOI: 10.1016/j.spinee.2014.12.008.Peer-Reviewed Original ResearchConceptsSpine Patient Outcomes Research TrialElective lumbar discectomyDiscectomy patientsPerioperative factorsLumbar discectomyClinical trialsNational Surgical Quality Improvement Program databaseSuperficial wound infection rateQuality Improvement Program databaseLumbar disc herniation patientsHigher body mass indexTotal wound complicationsRetrospective cohort studyDeep wound infectionImprovement Program databaseStatistical differenceWound infection rateAverage operative timeDisc herniation patientsBody mass indexNational patient sampleNinth Revision codesRandomized clinical trialsLength of stayResearch trials