2024
Perioperative inpatient falls for anterior cervical discectomy and fusion patients are on the rise: Risk factors associated with this “never event”
Seddio A, Jabbouri S, Gouzoulis M, Vasudevan R, Halperin S, Varthi A, Rubio D, Grauer J. Perioperative inpatient falls for anterior cervical discectomy and fusion patients are on the rise: Risk factors associated with this “never event”. The Spine Journal 2024 PMID: 39631462, DOI: 10.1016/j.spinee.2024.11.018.Peer-Reviewed Original ResearchInpatient fallsLength of stayMultivariate logistic regressionAnterior cervical discectomyInpatient ACDFElixhauser Comorbidity IndexMultidisciplinary fall prevention programAnnual incidenceRisk factorsInpatient fall preventionFall prevention programsLogistic regressionNational sample of patientsCervical discectomyNational Quality ForumSocioeconomically disadvantaged patientsHistory of dementiaUnderweight body mass indexACDF patientsObese BMI >Posterior cervical proceduresBody mass indexMulti-level ACDFAdult patientsQuality ForumThe incidence, providers involved, and patient factors associated with diagnosis of specific lumbar spine pathology subsequent an initial nonspecific low back pain diagnosis
Seddio A, Jabbouri S, Gouzoulis M, Sanchez J, Day W, Varthi A, Rubio D, Grauer J. The incidence, providers involved, and patient factors associated with diagnosis of specific lumbar spine pathology subsequent an initial nonspecific low back pain diagnosis. The Spine Journal 2024 PMID: 39505011, DOI: 10.1016/j.spinee.2024.10.008.Peer-Reviewed Original ResearchLow back painPrimary care providersLow back pain diagnosisNS-LBPInternational Classification of DiseasesLumbar spine pathologyHistory of cancerSpecialty providersOpioid use disorderNonspecific low back painSpine pathologyBack pain diagnosisPCP providersFactors associated with diagnosisClassification of DiseasesUse disorderLBP managementLBP symptomsNational administrative databaseCare providersBack painFamily medicineAdult patientsProvider specialtyPain diagnosisSemaglutide utilization associated with reduced ninety-day postoperative complications following single-level posterior lumbar fusion for patients with type II diabetes
Seddio A, Gouzoulis M, Vasudevan R, Dhodapkar M, Jabbouri S, Varthi A, Rubio D, Grauer J. Semaglutide utilization associated with reduced ninety-day postoperative complications following single-level posterior lumbar fusion for patients with type II diabetes. The Spine Journal 2024 PMID: 39491749, DOI: 10.1016/j.spinee.2024.10.011.Peer-Reviewed Original ResearchSingle-level posterior lumbar fusionPosterior lumbar fusionSodium-glucose transport protein 2 inhibitorsAdverse eventsPostoperative complicationsT2DM patientsCurrent Procedural TerminologyElixhauser Comorbidity IndexED visitsLumbar fusionHospital readmissionEmergency departmentOdds of postoperative complicationsNinety-day postoperative complicationsImpact of semaglutideOdds of hospital readmissionMonths of surgeryRetrospective cohort studyPostoperative adverse eventsMinor adverse eventsType II diabetes mellitusRisk of type I errorDiagnosis of T2DMII diabetes mellitusYears of ageTrends in management of odontoid fractures 2010–2021
Gouzoulis M, Seddio A, Rancu A, Jabbouri S, Moran J, Varthi A, Rubio D, Grauer J. Trends in management of odontoid fractures 2010–2021. North American Spine Society Journal (NASSJ) 2024, 20: 100553. PMID: 39381260, PMCID: PMC11459689, DOI: 10.1016/j.xnsj.2024.100553.Peer-Reviewed Original ResearchOdontoid fracturesSurgical interventionPredictive factorsAdult patientsManagement of odontoid fracturesPosterior stabilizationMethods Adult patientsNon-clinical factorsRate of surgerySampled adult patientsYearly rateAnterior surgeryPosterior surgeryNonoperative careSurgical managementNonsurgical treatmentClinical factorsMale sexPosterior approachMultivariate analysisMedicare insuranceFracture managementSurgeryPatientsMidwest United StatesOutcomes following two-level Cervical Disc Arthroplasty Relative to two-level Anterior Cervical Discectomy.
Ratnasamy P, Gouzoulis M, Jabbouri S, Varthi A, Grauer J. Outcomes following two-level Cervical Disc Arthroplasty Relative to two-level Anterior Cervical Discectomy. Spine 2024 PMID: 39190404, DOI: 10.1097/brs.0000000000005131.Peer-Reviewed Original ResearchCervical disc arthroplasty patientsFive-year survivalCervical disc arthroplastyPostoperative adverse eventsSpine reoperationTwo-level cervical disc arthroplastyAdverse eventsACDF patientsPatient ageElixhauser Comorbidity IndexTreatment optionsMultivariate analysisDegenerative cervical spine pathologyTwo-level surgeryCervical spine pathologyTwo-level ACDFAnterior cervical discectomyNovel treatment optionsMinor adverse eventsCervical discectomyNo significant differenceSpine pathologyACDFReoperationComorbidity indexRobotic-Assisted Versus Navigation-Assisted Posterior Lumbar Fusion
Gouzoulis M, Seddio A, Winter A, Jabbouri S, Zhu J, Rubio D, Varthi A, Grauer J. Robotic-Assisted Versus Navigation-Assisted Posterior Lumbar Fusion. Spine 2024, 49: 1483-1487. PMID: 38717329, DOI: 10.1097/brs.0000000000005032.Peer-Reviewed Original ResearchPosterior lumbar fusionLumbar fusionAdverse eventsLevel posterior lumbar fusionsCPT codesKaplan-Meier survival analysisRate of reoperationNavigation-assisted surgeryRobotic-assisted casesNavigation-assistedMinor adverse eventsPerioperative adverse eventsMultivariate logistic regressionICD-10 procedure codeRobotic cohortRobotic assistanceSpinal navigationReoperation rateAnterior fusionElixhauser Comorbidity IndexPearlDiver databaseNo significant differenceIncremental advantageAdverse outcomesComorbidity indexGeriatric Vertebral Compression Fracture: A Database Study Characterizing Use and Trends for Prescribed Thoracic/Lumbar Orthoses.
Halperin S, Dhodapkar M, Moran J, Jeong S, Grauer J, Varthi A. Geriatric Vertebral Compression Fracture: A Database Study Characterizing Use and Trends for Prescribed Thoracic/Lumbar Orthoses. Global Spine Journal 2024, 21925682241238672. PMID: 38546972, DOI: 10.1177/21925682241238672.Peer-Reviewed Original ResearchCompression fracturesFractures associated with osteoporosisVertebral compression fracturesMultivariate logistic regressionIndicator of infectionPearlDiver databaseIndependent predictorsTreatment algorithmInclusion criteriaFemale sexLogistic regressionT5-L5Geographic regionsFracture managementFracture levelNational databasePatientsExclusion criteriaYounger ageBraceNon-clinicalCharacterized useOrthosesDatabaseFracture
2023
Ninety day adverse events following single level posterior lumbar interbody fusion in patients with sickle cell disease
Dhodapkar M, Halperin S, Saifi C, Whang P, Grauer J, Varthi A. Ninety day adverse events following single level posterior lumbar interbody fusion in patients with sickle cell disease. The Spine Journal 2023, 24: 807-811. PMID: 38081460, DOI: 10.1016/j.spinee.2023.11.025.Peer-Reviewed Original ResearchPosterior lumbar interbody fusionSingle-level posterior lumbar interbody fusionSickle cell diseaseElixhauser Comorbidity IndexAdverse eventsPostoperative outcomesInterbody fusionOdds ratioCell diseaseDays adverse eventsMinor adverse eventsPostoperative adverse eventsPerioperative adverse eventsSevere adverse eventsCohort of patientsED visit ratesEmergency department visitsMultivariable logistic regressionNational administrative databaseRetrospective database studyLumbar interbody fusionSingle level posteriorComorbidity indexPLIF patientsAdult patientsLumbar Laminotomy: Variables Affecting 90-day Overall Reimbursement
Halperin S, Dhodapkar M, Gouzoulis M, Laurans M, Varthi A, Grauer J. Lumbar Laminotomy: Variables Affecting 90-day Overall Reimbursement. Journal Of The American Academy Of Orthopaedic Surgeons 2023, 32: 265-270. PMID: 38064482, DOI: 10.5435/jaaos-d-23-00365.Peer-Reviewed Original ResearchPostoperative adverse eventsAdverse eventsInsurance typePostoperative emergency department visitsPostoperative emergency departmentEmergency department visitsElixhauser Comorbidity IndexMultivariable linear regression modelsMultivariable linear regressionHealthcare deliveryIndications of traumaPostoperative readmissionsComorbidity indexInfectious diagnosisConservative treatmentPerioperative dataDepartment visitsEmergency departmentOutpatient surgeryLarge cohortSpinal proceduresExclusion criteriaDiskectomyOverall reimbursementCommon procedure
2022
Demographic and economic trends in vertebral fracture surgeries throughout the United States
Beschloss AM, Taghlabi KM, Rodriguez DA, Lee N, Gupta S, Bondar K, Lombardi JM, Varthi A, Faraji A, Saifi C. Demographic and economic trends in vertebral fracture surgeries throughout the United States. North American Spine Society Journal (NASSJ) 2022, 12: 100175. PMID: 36281323, PMCID: PMC9587355, DOI: 10.1016/j.xnsj.2022.100175.Peer-Reviewed Original ResearchFracture surgeryNational Inpatient SampleVertebral fracturesHospital costsRelevant public health concernHealth care utilizationHigh-impact traumaRate of fracturesPublic health concernValue-based careInpatient mortalityPatient ageSurgical treatmentCare utilizationHospital chargesMean ageInpatient SampleInsurance typeMortality rateSurgeryDemographic dataSuch fracturesMore surgeonsUnderlying causeHealth concernComparison of postoperative outcomes in patients with and without osteoporosis undergoing single-level anterior cervical discectomy and fusion
Kammien AJ, Galivanche AR, Joo PY, Elaydi A, Whang P, Saifi C, Grauer JN, Varthi A. Comparison of postoperative outcomes in patients with and without osteoporosis undergoing single-level anterior cervical discectomy and fusion. North American Spine Society Journal (NASSJ) 2022, 12: 100174. PMID: 36299450, PMCID: PMC9589019, DOI: 10.1016/j.xnsj.2022.100174.Peer-Reviewed Original ResearchSingle-level anterior cervical discectomyAnterior cervical discectomyAdverse eventsCervical discectomySingle-level ACDF proceduresSurgical planningComorbidity-matched patientsPerioperative adverse eventsSingle-level ACDFLog-rank analysisLong-term outcomesNational administrative databaseSetting of osteoporosisACDF proceduresConcomitant proceduresPatient characteristicsPostoperative outcomesGraft subsidenceOsteoporosis groupBony unionPatient counselingPatient counsellingAdministrative databasesReoperationExclusion criteriaIn-hospital complications after cervical fusion in cases with versus without cerebral palsy
Galivanche AR, Gillinov SM, Mercier MR, Schneble CA, Varthi AG, Grauer JN, Frumberg DB. In-hospital complications after cervical fusion in cases with versus without cerebral palsy. North American Spine Society Journal (NASSJ) 2022, 12: 100167. PMID: 36132746, PMCID: PMC9483629, DOI: 10.1016/j.xnsj.2022.100167.Peer-Reviewed Original ResearchMinor adverse eventsCerebral palsyHospital complicationsAdverse eventsCervical fusionNational Inpatient Sample databaseMultiple logistic regression modelHospital adverse eventsCervical spine pathologyCervical fusion surgeryRetrospective cohort designMultiple logistic regressionLogistic regression modelsHospital mortalityMore comorbiditiesHospital morbidityHospital stayPerioperative outcomesPreoperative variablesPropensity matchingSurgical interventionFusion surgeryCohort designSpine pathologyCervical pathologyA comparison of in-hospital outcomes after elective anterior cervical discectomy and fusion in cases with and without Parkinson's Disease
Galivanche AR, Schneble CA, David WB, Mercier MR, Kammien AJ, Ottesen TD, Saifi C, Whang PG, Grauer JN, Varthi AG. A comparison of in-hospital outcomes after elective anterior cervical discectomy and fusion in cases with and without Parkinson's Disease. North American Spine Society Journal (NASSJ) 2022, 12: 100164. PMID: 36304443, PMCID: PMC9594612, DOI: 10.1016/j.xnsj.2022.100164.Peer-Reviewed Original ResearchMinor adverse eventsSerious adverse eventsAnterior cervical discectomyAdverse eventsParkinson's diseaseElective ACDFComorbidity burdenCervical discectomyMedical complicationsPD casesElective anterior cervical discectomyNational Inpatient Sample databaseGreater riskAssociation of PDCervical degenerative pathologyPostoperative medical complicationsLogistic regression modelsHospital complicationsHospital outcomesComplication rateSurgical complicationsUnmatched populationACDF casesSurgical interventionComorbidity variablesCorrelation of Patient Reported Satisfaction With Adverse Events Following Elective Posterior Lumbar Fusion Surgery: A Single Institution Analysis
Mercier MR, Galivanche AR, McLean R, Kammien AJ, Toombs CS, Rubio DR, Varthi AG, Grauer JN. Correlation of Patient Reported Satisfaction With Adverse Events Following Elective Posterior Lumbar Fusion Surgery: A Single Institution Analysis. North American Spine Society Journal (NASSJ) 2022, 12: 100160. PMID: 36118954, PMCID: PMC9478916, DOI: 10.1016/j.xnsj.2022.100160.Peer-Reviewed Original ResearchPosterior lumbar fusion surgeryLumbar fusion surgeryAdverse eventsHCAHPS surveyPLF surgeryFusion surgerySelf-reported patient satisfactionPostoperative adverse eventsRetrospective cohort analysisPost-discharge careSingle-institution analysisHospital Consumer AssessmentPatient satisfaction metricsCorrelation of patientsHCAHPS survey dataTop-box responsesPLF patientsSurvey response ratePatient satisfactionSingle institutionHospital experiencePatients' perceptionsHospital careCohort analysisPatientsUnderweight patients are the highest risk body mass index group for perioperative adverse events following stand-alone anterior lumbar interbody fusion
Ottesen TD, Galivanche AR, Greene JD, Malpani R, Varthi AG, Grauer JN. Underweight patients are the highest risk body mass index group for perioperative adverse events following stand-alone anterior lumbar interbody fusion. The Spine Journal 2022, 22: 1139-1148. PMID: 35231643, DOI: 10.1016/j.spinee.2022.02.012.Peer-Reviewed Original ResearchConceptsBody mass indexNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseAnterior lumbar interbody fusionObese class 1Improvement Program databaseClass 2 patientsAdverse eventsUnderweight patientsBMI categoriesAdverse outcomesBMI spectrumInterbody fusionProgram databaseTwo-level anterior lumbar interbody fusionSurgeons National Surgical Quality Improvement Program databaseMultivariate analysisThirty-day adverse eventsWorld Health Organization categoriesBody mass index groupsPostoperative adverse eventsRetrospective cohort studyPerioperative adverse eventsNormal-weight subjectsPost-operative infectionCharacteristics, Management, and Outcomes of Patients With Osteosarcoma: An Analysis of Outcomes From the National Cancer Database
Ottesen TD, Shultz BN, Munger AM, Sibindi C, Yurter A, Varthi AG, Grauer JN. Characteristics, Management, and Outcomes of Patients With Osteosarcoma: An Analysis of Outcomes From the National Cancer Database. JAAOS Global Research And Reviews 2022, 6: e22.00009. PMID: 35192571, PMCID: PMC8865506, DOI: 10.5435/jaaosglobal-d-22-00009.Peer-Reviewed Original ResearchConceptsLikelihood of deathDistant metastasisKaplan-Meier survival curvesNational Cancer DatabaseOutcomes of patientsPoor prognostic signMultivariate Cox analysisMeier survival curvesAnalysis of outcomesPatient characteristicsCox analysisPrognostic signSurgical excisionMale sexPatient survivalPatient numbersCancer DatabasePatient variablesTumor managementPrimary siteTumor typesSurvival curvesTreatment dataOsteosarcomaPatients
2021
COVID-positive ankle fracture patients are at increased odds of perioperative surgical complications following open reduction internal fixation surgery
Mercier MR, Galivanche AR, Brand JP, Pathak N, Medvecky MJ, Varthi AG, Rubin LE, Grauer JN. COVID-positive ankle fracture patients are at increased odds of perioperative surgical complications following open reduction internal fixation surgery. PLOS ONE 2021, 16: e0262115. PMID: 34972190, PMCID: PMC8719674, DOI: 10.1371/journal.pone.0262115.Peer-Reviewed Original ResearchConceptsCOVID-positive patientsAnkle fracture surgeryPerioperative adverse eventsAdverse eventsAnkle fracture patientsFracture surgeryFracture patientsOperative interventionAnkle fracturesPropensity matchingCOVID statusOpen reduction internal fixation surgeryPerioperative adverse outcomesPerioperative surgical complicationsMinor adverse eventsPostoperative adverse eventsSerious adverse eventsChronic kidney diseaseCOVID-19 Research DatabaseLong-term outcomesInternal fixation surgeryBasis of agePropensity-score matchingPostoperative complicationsNegative patients
2018
Different Fusion Approaches for Single-level Lumbar Spondylolysis Have Similar Perioperative Outcomes
Gala RJ, Bovonratwet P, Webb ML, Varthi AG, Daubs MD, Grauer JN. Different Fusion Approaches for Single-level Lumbar Spondylolysis Have Similar Perioperative Outcomes. Spine 2018, 43: e111-e117. PMID: 28591074, DOI: 10.1097/brs.0000000000002262.Peer-Reviewed Original ResearchConceptsTransforaminal lumbar interbody fusionAnterior lumbar interbody fusionPosterior spinal fusionPerioperative adverse eventsAdverse eventsLong-term outcomesLumbar interbody fusionLumbar spondylolysisPerioperative outcomesOperative timeSurgical approachFusion groupInterbody fusionSurgeons National Surgical Quality Improvement databaseNational Surgical Quality Improvement databasePerioperative adverse event ratesSimilar long-term outcomesPropensity scoreMinor adverse eventsPrevious cohort studiesSerious adverse eventsSimilar perioperative outcomesAdverse event ratesIndividual adverse eventsQuality improvement database
2016
Is Outpatient Total Hip Arthroplasty Safe?
Nelson SJ, Webb ML, Lukasiewicz AM, Varthi AG, Samuel AM, Grauer JN. Is Outpatient Total Hip Arthroplasty Safe? The Journal Of Arthroplasty 2016, 32: 1439-1442. PMID: 28065622, DOI: 10.1016/j.arth.2016.11.053.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedArthroplasty, Replacement, HipBlood TransfusionDatabases, FactualFemaleHumansInpatientsLength of StayLogistic ModelsMaleMiddle AgedMultivariate AnalysisOutpatientsPatient DischargePatient ReadmissionPatient SafetyPoisson DistributionPostoperative ComplicationsPropensity ScoreQuality ImprovementRegression AnalysisRetrospective StudiesYoung AdultConceptsOutpatient total hip arthroplastyTotal hip arthroplastyAdverse eventsPropensity scoreSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseGeneral health outcome measuresDays adverse eventsImprovement Program databaseMultivariate Poisson regressionHealth outcome measuresHospital dischargePostoperative dayBlood transfusionExtended LOSTHA patientsPotential confoundersInpatient proceduresProgram databaseRelative riskHip arthroplastyOutcome measuresSafety dataStudy groupPerioperative Outcomes After Cervical Laminoplasty Versus Posterior Decompression and Fusion
Varthi AG, Basques BA, Bohl DD, Golinvaux NS, Grauer JN. Perioperative Outcomes After Cervical Laminoplasty Versus Posterior Decompression and Fusion. Clinical Spine Surgery A Spine Publication 2016, 29: e226-e232. PMID: 25310393, DOI: 10.1097/bsd.0000000000000183.Peer-Reviewed Original ResearchConceptsMultilevel cervical pathologyBaseline patient characteristicsCervical laminoplastyShort-term outcomesPosterior decompressionLaminoplasty patientsFusion patientsCervical decompressionAdverse eventsPatient characteristicsCervical pathologySurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databasePropensity-adjusted multivariate analysisQuality Improvement Program databaseWorse short-term outcomesCharlson Comorbidity IndexPosterior cervical decompressionRetrospective cohort studyImprovement Program databaseLength of stayBivariate logistic regressionAnesthesiologists (ASA) scoreComorbidity indexPerioperative outcomes