2024
A 10-year perspective on the question of whether surgeries for adolescent idiopathic scoliosis are “one and done”?
Gouzoulis M, Joo P, Jeong S, Jabbouri S, Moran J, Zhu J, Grauer J. A 10-year perspective on the question of whether surgeries for adolescent idiopathic scoliosis are “one and done”? Spine Deformity 2024, 12: 903-908. PMID: 38555557, DOI: 10.1007/s43390-024-00858-3.Peer-Reviewed Original ResearchConceptsAdolescent idiopathic scoliosisIdiopathic scoliosisRisk factorsAssociated with male sexTime of surgeryLong-term outcomesYear follow-upMultivariate regressionMonths to 2Reoperation incidenceReoperation ratePSF patientsExcellent outcomesPediatric surgeonsReoperationMale sexFollow-upStudy cohortPatient characteristicsPatient counselingSurgeryConclusionsThe current studyInterquartile rangeScoliosis fusionResultsIn total
2023
Do Children With Medicaid Insurance Have Increased Revision Rates 5 Years After Posterior Spinal Fusions?
Moore H, Patibandla S, McClung A, Grauer J, Sucato D, Wise C, Johnson M, Rathjen K, McIntosh A, Ramo B, Brooks J. Do Children With Medicaid Insurance Have Increased Revision Rates 5 Years After Posterior Spinal Fusions? Journal Of Pediatric Orthopaedics 2023, 43: 615-619. PMID: 37694695, DOI: 10.1097/bpo.0000000000002504.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentChildComorbidityHumansInsurance CoverageMedicaidRetrospective StudiesScoliosisSpinal FusionUnited StatesConceptsPosterior spinal fusionAdolescent idiopathic scoliosisMedicaid insurancePrivate insuranceRevision surgerySpinal fusionInternational ClassificationBaseline medical comorbiditiesKaplan-Meier analysisLog-rank testSegmental spinal instrumentationLong fusion constructsBaseline comorbiditiesIndependent t-testIndex surgeryMedical comorbiditiesPostoperative complicationsCause revisionCohort studyNinth RevisionAIS patientsRevision codesPrimary diagnosisHigh prevalenceMedicaid patientsSingle-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 studyDecline in Separate Incision Autograft for Spine Surgery Over the Past Decade: A Fading “gold standard”
Rudisill K, Ratnasamy P, Maloy G, Grauer J. Decline in Separate Incision Autograft for Spine Surgery Over the Past Decade: A Fading “gold standard”. Journal Of The American Academy Of Orthopaedic Surgeons 2023, 31: 938-944. PMID: 37332184, DOI: 10.5435/jaaos-d-22-01029.Peer-Reviewed Original ResearchConceptsElixhauser Comorbidity IndexSurgeon specialtySpinal fusionComorbidity indexSmoking statusGold standardIliac crest autograftPatient ageIndependent predictorsPatient factorsNonsurgical factorsCrest autograftSpine surgeryBone graftingSpine fusionIliac crestBone graftAutograftYounger ageSurgeryInsurance factorsSpinal boneCommon procedureInsurance plansAgeWeight loss makes the difference: perioperative outcomes following posterior lumbar fusion in patients with and without weight loss following bariatric surgery
Dhodapkar M, Halperin S, Joo P, Maloy G, Jeong S, Rubio D, Grauer J. Weight loss makes the difference: perioperative outcomes following posterior lumbar fusion in patients with and without weight loss following bariatric surgery. The Spine Journal 2023, 23: 1506-1511. PMID: 37302416, DOI: 10.1016/j.spinee.2023.06.002.Peer-Reviewed Original ResearchConceptsHistory of BSPosterior lumbar fusionElixhauser Comorbidity IndexMorbid obesityBariatric surgeryAdverse eventsWeight lossReadmission ratesLumbar fusionSingle-level posterior lumbar fusionImpact of BSRetrospective case-control studyPrior bariatric surgeryMinor adverse eventsLevel posterior lumbar fusionTime of surgeryMultivariable logistic regressionCase-control studyHistory of infectionSignificant weight lossMO categoryMorbidly obesityPLF patientsComorbidity indexPerioperative outcomesResponse to a letter to the editor regarding, “Effects of anode position on pedicle screw testing during lumbosacral spinal fusion surgery”
Grauer J, Frenkel M, Callahan B. Response to a letter to the editor regarding, “Effects of anode position on pedicle screw testing during lumbosacral spinal fusion surgery”. The Spine Journal 2023, 23: 626. PMID: 36963915, DOI: 10.1016/j.spinee.2023.01.003.Commentaries, Editorials and LettersAnterior 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 ageEffects of anode position on pedicle screw testing during lumbosacral spinal fusion surgery
Amick M, Ottesen TD, O'Marr J, Frenkel MY, Callahan B, Grauer JN. Effects of anode position on pedicle screw testing during lumbosacral spinal fusion surgery. The Spine Journal 2022, 22: 2000-2005. PMID: 35843532, DOI: 10.1016/j.spinee.2022.07.090.Peer-Reviewed Original ResearchMeSH KeywordsElectrodesHumansLumbar VertebraePedicle ScrewsProspective StudiesReproducibility of ResultsSpinal FusionConceptsPedicle screwsLumbosacral fusionPedicle screw stimulationProspective cohort studySpinal fusion surgeryLumbosacral pedicle screwsSafe screw placementCohort studyFusion surgeryOutcome measuresBACKGROUND DATAScrew stimulationClinical practiceClinical thresholdGluteal musclesScrew placementSurgical fieldSafe placementPatientsScrewsStimulationSuch implantsCurrent studyPlacementFormal evaluationMarfan syndrome and adolescent idiopathic scoliosis patients have similar 90-day postoperative outcomes and 5-year reoperation rates after spinal deformity surgery
Joo PY, Caruana DL, Gouzoulis MJ, Moore HG, Zhu JR, Ameri B, Grauer JN. Marfan syndrome and adolescent idiopathic scoliosis patients have similar 90-day postoperative outcomes and 5-year reoperation rates after spinal deformity surgery. Spine Deformity 2022, 10: 1169-1174. PMID: 35362940, DOI: 10.1007/s43390-022-00501-z.Peer-Reviewed Original ResearchConceptsAdolescent idiopathic scoliosisMarfan syndromeReoperation rateAIS patientsOdds ratioMFS patientsFive-Year Reoperation RatesNinety-day outcomesMinor adverse eventsMultivariate odds ratiosPosterior spinal fusionSpinal deformity surgeryComorbidity indexAdverse eventsDeformity surgeryAdministrative databasesRelative riskSpinal fusionIdiopathic scoliosisPatientsRepresentative sampleAgeOutcomesSexReadmissionAdverse Events After Posterior Lumbar Fusion Are Not Sufficiently Characterized With 30-day Follow-up: A Database Study
Kammien AJ, Zhu JR, Gillinov SM, Gouzoulis MJ, Grauer JN. Adverse Events After Posterior Lumbar Fusion Are Not Sufficiently Characterized With 30-day Follow-up: A Database Study. Journal Of The American Academy Of Orthopaedic Surgeons 2022, 30: 528-533. PMID: 35234736, DOI: 10.5435/jaaos-d-21-01121.Peer-Reviewed Original ResearchConceptsPosterior lumbar fusionTime of diagnosisAdverse eventsLumbar fusionIndividual adverse outcomesNinety-day ratesAcute kidney injurySurgical site infectionUrinary tract infectionSpecific adverse eventsMultiple adverse eventsPLF patientsKidney injuryCardiac eventsTract infectionsVenous thromboembolismPostoperative periodSite infectionAdverse outcomesPatient counselingAdministrative data setsDatabase studyDay 0Time pointsInterquartile rangeUnderweight 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 infection
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 proceduresAmbulatory Single-level Posterior Cervical Foraminotomy for Cervical Radiculopathy
Bovonratwet P, Retzky JS, Chen AZ, Ondeck NT, Samuel AM, Qureshi SA, Grauer JN, Albert TJ. Ambulatory Single-level Posterior Cervical Foraminotomy for Cervical Radiculopathy. Clinical Spine Surgery A Spine Publication 2021, 35: e306-e313. PMID: 34654773, DOI: 10.1097/bsd.0000000000001252.Peer-Reviewed Original ResearchConceptsSingle-level posterior cervical foraminotomyPosterior cervical foraminotomyCervical radiculopathyInpatient proceduresCervical foraminotomyPerioperative complicationsAmbulatory proceduresSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseQuality Improvement Program databasePropensity scoreRetrospective cohort comparison studyImprovement Program databaseSurgical site infectionCohort comparison studyHospital lengthPain controlPerioperative outcomesPostoperative complicationsThromboembolic eventsWound complicationsNSQIP databasePatient characteristicsSite infectionIndividual complicationsCurrent concepts of spondylosis and posterior spinal motion preservation for radiologists
Porrino J, Rao A, Moran J, Wang A, Grauer J, Haims A, Kani K. Current concepts of spondylosis and posterior spinal motion preservation for radiologists. Skeletal Radiology 2021, 50: 2169-2184. PMID: 34131792, DOI: 10.1007/s00256-021-03840-6.Peer-Reviewed Original Research
2020
Local antibiotics in posterior lumbar fusion procedures for neuromuscular scoliosis: a case for their use
Ondeck NT, Ondeck MA, Bovonratwet P, Albert TJ, Grauer JN. Local antibiotics in posterior lumbar fusion procedures for neuromuscular scoliosis: a case for their use. The Spine Journal 2020, 21: 664-670. PMID: 33347970, DOI: 10.1016/j.spinee.2020.12.004.Peer-Reviewed Original ResearchConceptsSurgical site infectionPosterior spinal fusionNeuromuscular scoliosisLocal antibioticsIntraoperative antibioticsStudy populationRisk of SSIOccurrence of SSIReduced surgical site infectionsHigh-risk patient populationPosterior lumbar fusion proceduresAdverse outcome variablesIncreased overall riskHigh-risk patientsOverall study populationRisk patient populationPatient demographic factorsEntire study populationLumbar fusion proceduresIntrawound antibioticsNMS patientsRenal complicationsRisk patientsPediatric patientsRetrospective reviewUse of intraoperative navigation for posterior spinal fusion in adolescent idiopathic scoliosis surgery is safe to consider
Moore HG, Samuel AM, Burroughs PJ, Pathak N, Tuason DA, Grauer JN. Use of intraoperative navigation for posterior spinal fusion in adolescent idiopathic scoliosis surgery is safe to consider. Spine Deformity 2020, 9: 403-410. PMID: 33025389, DOI: 10.1007/s43390-020-00218-x.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentChildHumansKyphosisOperative TimeScoliosisSpinal FusionSurgical Navigation SystemsTreatment OutcomeConceptsAdolescent idiopathic scoliosisNon-navigated patientsPerioperative adverse outcomesPosterior spinal fusionUse of navigationPosterior fusionAdverse outcomesSpinal fusionShort-term adverse eventsPost-operative hospital stayAdolescent idiopathic scoliosis surgeryStereotactic navigationNon-navigated casesNSQIP-Pediatric databaseThirty-day outcomesYear of procedureLonger operative timeIdiopathic scoliosis surgeryLength of stayIntraoperative navigationNational pediatric databaseHospital stayPerioperative outcomesAdverse eventsPediatric patientsHigh, As Well As Low, Preoperative Platelet Counts Correlate With Adverse Outcomes After Elective Posterior Lumbar Surgery.
Malpani R, Gala RJ, Adrados M, Galivanche AR, Clark MG, Mercier MR, Pathak N, Mets EJ, Grauer JN. High, As Well As Low, Preoperative Platelet Counts Correlate With Adverse Outcomes After Elective Posterior Lumbar Surgery. Spine 2020, 45: 349-356. PMID: 32045405, DOI: 10.1097/brs.0000000000003248.Peer-Reviewed Original ResearchConceptsPosterior lumbar surgeryPreoperative platelet countLow platelet countPlatelet countLumbar surgeryAdverse outcomesAdverse eventsHospital lengthNational Surgical Quality Improvement Program databaseLow preoperative platelet countPreoperative low platelet countQuality Improvement Program databaseHigh platelet groupLonger hospital lengthLumbar surgery patientsPerioperative adverse outcomesMinor adverse eventsPostoperative adverse eventsImprovement Program databaseRetrospective cohort studyHigher platelet countsLarger patient populationPostoperative complicationsCohort studyPlatelet group
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