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 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 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 ResearchMeSH KeywordsBariatric SurgeryCervical VertebraeCohort StudiesDiskectomyHumansObesity, MorbidPostoperative ComplicationsRetrospective StudiesSpinal FusionConceptsAnterior 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 studyIs There Utility to Requiring Spine MRI Pre-authorizations? Pre-authorizations
Kebaish K, Galivanche A, Mercier M, Varthi A, Rubin L, Grauer J. Is There Utility to Requiring Spine MRI Pre-authorizations? Pre-authorizations. Clinical Spine Surgery A Spine Publication 2023, 36: 186-189. PMID: 36728293, DOI: 10.1097/bsd.0000000000001422.Peer-Reviewed Original ResearchMeSH KeywordsCervical VertebraeHumansInsuranceMagnetic Resonance ImagingPrior AuthorizationRetrospective StudiesConceptsSpine magnetic resonance imagingMagnetic resonance imagingSpine centerAcademic spine centerRetrospective cohort studySignificant increased oddsMultivariate logistic regressionPatient undergoing treatmentEventual dispositionInsurance carriersCohort studyIncreased oddsCommercial insurance carriersMRI requestsMRI ordersUndergoing treatmentBACKGROUND DATAGreater oddsPreauthorization processCommercial insuranceResonance imagingSpine scansLogistic regressionPreauthorizationScans
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 ResearchMeSH KeywordsAgedArthroplastyCervical VertebraeDiskectomyHumansIntervertebral Disc DegenerationMedicareNeckSpinal FusionTreatment OutcomeUnited StatesConceptsSingle-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 ResearchMeSH KeywordsCervical VertebraeDiskectomyHumansPostoperative ComplicationsReoperationRetrospective StudiesSpinal FusionTreatment OutcomeConceptsOne-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 ResearchMeSH KeywordsCervical VertebraeForaminotomyHumansPostoperative ComplicationsRadiculopathyReoperationRetrospective StudiesSpinal FusionTreatment OutcomeConceptsSingle-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 ResearchMeSH KeywordsBiomechanical PhenomenaCervical VertebraeHumansLumbar VertebraeRadiologistsRange of Motion, ArticularSpinal FusionSpondylosis
2020
Underweight patients are at just as much risk as super morbidly obese patients when undergoing anterior cervical spine surgery
Ottesen TD, Malpani R, Galivanche AR, Zogg CK, Varthi AG, Grauer JN. Underweight patients are at just as much risk as super morbidly obese patients when undergoing anterior cervical spine surgery. The Spine Journal 2020, 20: 1085-1095. PMID: 32194246, PMCID: PMC7380546, DOI: 10.1016/j.spinee.2020.03.007.Peer-Reviewed Original ResearchConceptsAnterior cervical spine surgeryBody mass indexCervical spine surgeryNational Surgical Quality Improvement Program databaseSuper morbidly obese patientsQuality Improvement Program databaseWorld Health Organization categoriesMorbidly obese patientsImprovement Program databaseObese patientsAdverse eventsAdverse outcomesSpine surgeryUnderweight patientsPostoperative infectionProgram databaseSurgeons National Surgical Quality Improvement Program databaseMultivariate analysisAnterior cervical spine proceduresOverweight/obese categoriesThirty-day adverse eventsHigher body mass indexLower body mass indexAdverse outcome categoriesNormal BMI patients
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 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
Outpatient 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 complicationsResource utilization for non-operative cervical radiculopathy: Management by surgeons versus non-surgeons
Chung SH, Bohl DD, Paul JT, Rihn JA, Harrop JS, Ghogawala Z, Hilibrand AS, Grauer JN. Resource utilization for non-operative cervical radiculopathy: Management by surgeons versus non-surgeons. Clinical Neurology And Neurosurgery 2017, 158: 98-102. PMID: 28501759, DOI: 10.1016/j.clineuro.2017.04.024.Peer-Reviewed Original ResearchConceptsNon-operative careCervical radiculopathyCervical Spine Research SocietyPhysical therapy visitsNon-operative treatmentPrivate practiceTherapy visitsCervical injectionPhysician visitsChiropractic visitsAverage patientSurgeonsSurgeon's estimateVisitsRadiculopathyPatientsCareResearch SocietyResource utilizationHybrid groupDifferences 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 managementThree-Dimensional Isotropic MRI of the Cervical Spine
Fu MC, Buerba RA, Neway WE, Brown JE, Trivedi M, Lischuk AW, Haims AH, Grauer JN. Three-Dimensional Isotropic MRI of the Cervical Spine. Clinical Spine Surgery A Spine Publication 2016, 29: 66-71. PMID: 26889989, DOI: 10.1097/bsd.0b013e3182a355e5.Peer-Reviewed Original ResearchFactors Affecting Length of Stay and Complications After Elective Anterior Cervical Discectomy and Fusion
Gruskay JA, Fu M, Basques BA, Bohl DD, Buerba RA, Webb ML, Grauer JN. Factors Affecting Length of Stay and Complications After Elective Anterior Cervical Discectomy and Fusion. Clinical Spine Surgery A Spine Publication 2016, 29: e34-e42. PMID: 24525748, DOI: 10.1097/bsd.0000000000000080.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedCervical VertebraeDatabases, FactualDecompression, SurgicalElective Surgical ProceduresFemaleHumansIntervertebral Disc DisplacementLength of StayMaleOrthopedicsOutcome Assessment, Health CarePostoperative ComplicationsRetrospective StudiesSeverity of Illness IndexSex FactorsUnited StatesConceptsLength of stayElective anterior cervical discectomyExtended LOSAnterior cervical discectomyAge 65 yearsMajor complicationsExtended surgery timeMultivariate analysisPreoperative anemiaPreoperative factorsCervical discectomySurgery timeNational Surgical Quality Improvement Project databaseSurgeons National Surgical Quality Improvement Project databaseAverage LOSOrgan space infectionVenous thrombotic eventsACS-NSQIP databaseFactors Affecting LengthLarge database analysisACDF proceduresASA scorePerioperative factorsPerioperative variablesPostoperative complications