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 ForumOutcomes 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 indexAnterior cervical decompression and fusion at one and two levels: trends and factors associated with structural allograft versus synthetic cages
Kim L, Grauer J. Anterior cervical decompression and fusion at one and two levels: trends and factors associated with structural allograft versus synthetic cages. North American Spine Society Journal (NASSJ) 2024, 17: 100310. PMID: 38390524, PMCID: PMC10882181, DOI: 10.1016/j.xnsj.2024.100310.Peer-Reviewed Original ResearchCage useAnterior cervical decompressionAnterior cervical discectomyStructural allograftSynthetic cageLevel ACDFCervical decompressionACDF casesCervical discectomyClinical predictorsAdult patientsClinical factorsACDFAnterior plateFemale sexImplant choiceMultivariate analysisAllograftProvider specialtyCare algorithmOlder ageDecompressionNon-clinical
2023
Single-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 ResearchConceptsPosterior 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 studyAnterior 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 ageComparison 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 criteriaA 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 variablesEmergency department visits within 90 days of single-level anterior cervical discectomy and fusion
Kammien AJ, Galivanche AR, Gouzoulis MJ, Moore HG, Mercier MR, Grauer JN. Emergency department visits within 90 days of single-level anterior cervical discectomy and fusion. North American Spine Society Journal (NASSJ) 2022, 10: 100122. PMID: 35637647, PMCID: PMC9144013, DOI: 10.1016/j.xnsj.2022.100122.Peer-Reviewed Original ResearchED visitsPostoperative week 1ED utilizationPredictive factorsSurgical siteWeek 1Single-level anterior cervical discectomySingle-level ACDF proceduresElixhauser comorbidity index scoreCommon postoperative issuesPrimary ED diagnosisComorbidity Index scoreAnterior cervical discectomyHigh-risk patientsSingle-level ACDFEmergency department visitsDay of surgeryMultivariate logistic regressionIntegrated care pathwayHealthcare spendingPostoperative readmissionsACDF proceduresCervical discectomyPatient ageDepartment visitsFour-level anterior versus posterior cervical fusions: Perioperative outcomes and five-year reoperation rates Outcomes after four-level anterior versus posterior cervical procedures
Joo PY, Jayaram RH, McLaughlin WM, Ameri B, Kammien AJ, Arnold PM, Grauer JN. Four-level anterior versus posterior cervical fusions: Perioperative outcomes and five-year reoperation rates Outcomes after four-level anterior versus posterior cervical procedures. North American Spine Society Journal (NASSJ) 2022, 10: 100115. PMID: 35392022, PMCID: PMC8980614, DOI: 10.1016/j.xnsj.2022.100115.Peer-Reviewed Original ResearchPosterior cervical fusionFour-level ACDFAdverse eventsReoperation rateCervical fusionOdds ratioMinor adverse eventsMultilevel cervical pathologyPosterior cervical proceduresRate of dysphagiaFive-year incidencePerioperative adverse eventsAnterior cervical discectomyHigher reoperation rateLength of stayGreater odds ratioRisk/benefit considerationsPosterior approach proceduresTimes lower oddsCervical reoperationCervical proceduresCervical discectomyPerioperative outcomesPosterior proceduresACDF cases
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 proceduresHigh‐Entry Vertebral Artery Variant during Anterior Cervical Discectomy and Fusion
Moran J, Kahan JB, Schneble CA, Johnson MH, Chan SM, Grauer JN, Rubio DR. High‐Entry Vertebral Artery Variant during Anterior Cervical Discectomy and Fusion. Case Reports In Orthopedics 2021, 2021: 8105298. PMID: 34341694, PMCID: PMC8325584, DOI: 10.1155/2021/8105298.Peer-Reviewed Case Reports and Technical NotesAnterior cervical discectomyVertebral arteryCervical discectomyCervical spineTransverse foramenC4-C5 disc herniationIatrogenic vascular injuryRight vertebral arteryAnterior surgical approachSevere canal stenosisProper surgical planningNeural foraminal stenosisCanal stenosisAnterior approachArtery variantForaminal stenosisDisc herniationPreoperative imagingExcellent outcomesSurgical approachVascular injuryCase reportAnatomic variantsRoutine MRITransverse foramina
2020
Perioperative Outcomes in 17,947 Patients Undergoing 2-Level Anterior Cervical Discectomy and Fusion Versus 1-Level Anterior Cervical Corpectomy for Treatment of Cervical Degenerative Conditions: A Propensity Score Matched National Surgical Quality Improvement Program Analysis
Galivanche AR, Gala R, Bagi PS, Boylan AJ, Dussik CM, Coutinho PD, Grauer JN, Varthi AG. Perioperative Outcomes in 17,947 Patients Undergoing 2-Level Anterior Cervical Discectomy and Fusion Versus 1-Level Anterior Cervical Corpectomy for Treatment of Cervical Degenerative Conditions: A Propensity Score Matched National Surgical Quality Improvement Program Analysis. Neurospine 2020, 17: 871-878. PMID: 33401865, PMCID: PMC7788425, DOI: 10.14245/ns.2040134.067.Peer-Reviewed Original ResearchBody mass indexCervical degenerative conditionsAnterior cervical corpectomyAnterior cervical discectomyOperative timeFunctional statusCervical corpectomyAdverse eventsCervical discectomyNational Surgical Quality Improvement Program analysisNational Surgical Quality Improvement Program databaseDegenerative conditionsQuality Improvement Program databasePropensity scoreMultivariate logistic regression analysisAnesthesiologists physical status classificationMinor adverse eventsSerious adverse eventsImprovement Program databasePhysical status classificationShorter operative timeHigher functional statusMultivariate logistic regressionLogistic regression analysisASA PS classification
2019
Safety of Outpatient Single-level Cervical Total Disc Replacement
Bovonratwet P, Fu MC, Tyagi V, Ondeck NT, Albert TJ, Grauer JN. Safety of Outpatient Single-level Cervical Total Disc Replacement. Spine 2019, Publish Ahead of Print: &na;. PMID: 30247372, DOI: 10.1097/brs.0000000000002884.Peer-Reviewed Original ResearchConceptsSingle-level cervical total disc replacementCervical total disc replacementSingle-level ACDFPerioperative complicationsTotal disc replacementPerioperative outcomesOutpatient settingDisc replacementNational Surgical Quality Improvement Program databaseSingle-level anterior cervical discectomyQuality Improvement Program databasePropensity scoreRetrospective cohort comparison studyPatient baseline characteristicsAdverse event profileAnterior cervical discectomyImprovement Program databasePerioperative adverse eventsRate of readmissionLength of stayCohort comparison studyHospital stayAdverse eventsBaseline characteristicsCervical discectomyIncidence, 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 respondentsSurgeonsMissing 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
Results of Database Studies in Spine Surgery Can Be Influenced by Missing Data
Basques BA, McLynn RP, Fice MP, Samuel AM, Lukasiewicz AM, Bohl DD, Ahn J, Singh K, Grauer JN. Results of Database Studies in Spine Surgery Can Be Influenced by Missing Data. Clinical Orthopaedics And Related Research® 2017, 475: 2893-2904. PMID: 27896677, PMCID: PMC5670041, DOI: 10.1007/s11999-016-5175-7.Peer-Reviewed Original ResearchMeSH KeywordsComorbidityData AccuracyData CollectionData MiningDatabases, FactualDecision Support TechniquesHumansLength of StayLogistic ModelsMultivariate AnalysisOdds RatioOperative TimeOrthopedic ProceduresPostoperative ComplicationsPredictive Value of TestsProcess Assessment, Health CareRetrospective StudiesRisk AssessmentRisk FactorsSpinal DiseasesSpineTime FactorsTreatment OutcomeUnited StatesConceptsACS-NSQIP databaseAdverse eventsPreoperative laboratory valuesRisk factorsSpine surgeryOperating room timeLaboratory valuesSpine studiesACS-NSQIPDatabase studyRoom timeReference rangeQuality Improvement Program databasePerioperative laboratory valuesVariable reference rangesAnterior cervical discectomyImprovement Program databaseMost risk factorsLength of stayLarge database studiesDifferent risk factorsEffect sizeCervical discectomyMedical comorbiditiesGreater effect sizeGeneral Health Adverse Events Within 30 Days Following Anterior Cervical Discectomy and Fusion in US Patients: A Comparison of Spine Surgeons’ Perceptions and Reported Data for Rates and Risk Factors
Ondeck NT, Bohl DD, Bovonratwet P, Geddes BJ, Cui JJ, McLynn RP, Samuel AM, Grauer JN. General Health Adverse Events Within 30 Days Following Anterior Cervical Discectomy and Fusion in US Patients: A Comparison of Spine Surgeons’ Perceptions and Reported Data for Rates and Risk Factors. Global Spine Journal 2017, 8: 345-353. PMID: 29977718, PMCID: PMC6022956, DOI: 10.1177/2192568217723017.Peer-Reviewed Original ResearchPostoperative adverse eventsNational Surgical Quality Improvement ProgramAnterior cervical discectomyPatient risk factorsAdverse eventsRisk factorsCervical discectomyPatient factorsSurgical Quality Improvement ProgramSpine surgeons’ perceptionOccurrence of complicationsSurgeons' perceptionsNational dataQuality improvement initiativesQuality Improvement ProgramElective ACDFAccuracy of surgeonsACDF proceduresPerioperative complicationsRetrospective reviewUS patientsNSQIP dataProspective dataSurgeon's assessmentSuch complications