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 ResearchMeSH KeywordsAgedDiskectomyEmergency Service, HospitalFemaleHumansLumbar VertebraeMaleMedicarePainRetrospective StudiesUnited StatesConceptsElixhauser 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 characteristicsResponse 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 Letters
2022
Effects 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 evaluationAdverse 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
Current 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 FusionSpondylosisLong-term Corticosteroid Use Independently Correlates With Complications After Posterior Lumbar Spine Surgery.
Kebaish KJ, Galivanche AR, Varthi AG, Ottesen TD, Rubin LE, Grauer JN. Long-term Corticosteroid Use Independently Correlates With Complications After Posterior Lumbar Spine Surgery. Orthopedics 2021, 44: 172-179. PMID: 34039214, DOI: 10.3928/01477447-20210416-01.Peer-Reviewed Original ResearchConceptsLong-term corticosteroid usePosterior lumbar spine surgeryPosterior lumbar surgeryLumbar spine surgeryPerioperative adverse outcomesCorticosteroid useAdverse eventsLumbar surgerySpine surgeryPropensity matchingAdverse outcomesNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseMinor adverse eventsEffect of immunosuppressionImprovement Program databaseLong-term corticosteroidsSerious adverse eventsBody mass indexMultiple surgical specialtiesAnesthesiologists classComparable patientsPerioperative outcomesSurgical factorsMore patients
2020
High, 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
Patient-related Factors and Perioperative Outcomes Are Associated with Self-Reported Hospital Rating after Spine Surgery.
Mets EJ, Mercier MR, Hilibrand AS, Scott MC, Varthi AG, Grauer JN. Patient-related Factors and Perioperative Outcomes Are Associated with Self-Reported Hospital Rating after Spine Surgery. Clinical Orthopaedics And Related Research® 2019, 478: 643-652. PMID: 31389897, PMCID: PMC7145058, DOI: 10.1097/corr.0000000000000892.Peer-Reviewed Original ResearchConceptsOverall hospital experienceMultivariate logistic regression analysisPatient-related factorsAdverse eventsHospital ratingSpine surgeryLogistic regression analysisPerioperative outcomesPatient factorsQuality of careSurgical variablesHospital experienceHCAHPS scoresHCAHPS surveyPatient demographicsAnnual reimbursementAnesthesiologists class IIMinor adverse eventsNumerous patient factorsOnly surgical factorMajor adverse eventsSpine surgery populationSingle academic institutionHospital Consumer AssessmentPotential confounding variables
2018
Thromboembolic Events After Traumatic Vertebral Fractures
Samuel AM, Diaz-Collado PJ, Gala RJ, Webb ML, Lukasiewicz AM, Basques BA, Bohl DD, Kim HJ, Grauer JN. Thromboembolic Events After Traumatic Vertebral Fractures. Spine 2018, 43: 1289-1295. PMID: 29538240, DOI: 10.1097/brs.0000000000002634.Peer-Reviewed Original ResearchConceptsVenous thromboembolism eventsTraumatic vertebral fracturesVertebral fracturesSpinal cord injuryOdds ratioCord injuryRisk factorsNational Trauma Data Bank Research Data SetLonger inpatient lengthPulmonary embolism eventsDeep vein thrombosisHigh-energy injuriesVertebral fracture patientsLength of stayAdditional risk factorsMultivariate logistic regressionSuch adverse outcomesOverall rateThromboembolism eventsHospital courseThromboembolic eventsFracture patientsVein thrombosisLonger LOSTrauma patientsSystematic Changes in the National Surgical Quality Improvement Program Database Over the Years Can Affect Comorbidity Indices Such as the Modified Frailty Index and Modified Charlson Comorbidity Index for Lumbar Fusion Studies
Shultz BN, Ottesen TD, Ondeck NT, Bovonratwet P, McLynn RP, Cui JJ, Grauer JN. Systematic Changes in the National Surgical Quality Improvement Program Database Over the Years Can Affect Comorbidity Indices Such as the Modified Frailty Index and Modified Charlson Comorbidity Index for Lumbar Fusion Studies. Spine 2018, 43: 798-804. PMID: 28922281, DOI: 10.1097/brs.0000000000002418.Peer-Reviewed Original ResearchConceptsNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseCharlson Comorbidity IndexImprovement Program databaseComorbidity indexFrailty indexNSQIP databaseProgram databaseSurgeons National Surgical Quality Improvement Program databaseElective posterior lumbar fusionModified Charlson Comorbidity IndexModified Frailty IndexAdverse postoperative outcomesRetrospective cohort studyMean American SocietyMean ASA scorePosterior lumbar fusionAnesthesiologists (ASA) scoreASA scoreCohort studyPostoperative outcomesLumbar fusionBACKGROUND DATAAmerican CollegePatientsComparison of 30-Day Complications Between Navigated and Conventional Single-level Instrumented Posterior Lumbar Fusion
Bovonratwet P, Nelson SJ, Ondeck NT, Geddes BJ, Grauer JN. Comparison of 30-Day Complications Between Navigated and Conventional Single-level Instrumented Posterior Lumbar Fusion. Spine 2018, 43: 447-453. PMID: 28700450, DOI: 10.1097/brs.0000000000002327.Peer-Reviewed Original ResearchConceptsPosterior lumbar fusionOperative timeLumbar fusionHospital lengthWound infectionSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseShorter mean hospital lengthQuality Improvement Program databaseScrew placementRadiation exposureContamination/infectionLower blood transfusionRetrospective cohort comparison studyMean hospital lengthMost adverse eventsImprovement Program databaseInstrumented posterior lumbar fusionInstrumented lumbar fusionSurgeon radiation exposureCohort comparison studyPotential confounding factorsPedicle screw placementPerioperative complicationsPerioperative outcomesDiscrepancies 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 CollegeACDFOutpatientsDifferent 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 databaseTotal Disc Arthroplasty Versus Anterior Interbody Fusion in the Lumbar Spine Have Relatively a Few Differences in Readmission and Short-term Adverse Events
Shultz BN, Wilson AT, Ondeck NT, Bovonratwet P, McLynn RP, Cui JJ, Grauer JN. Total Disc Arthroplasty Versus Anterior Interbody Fusion in the Lumbar Spine Have Relatively a Few Differences in Readmission and Short-term Adverse Events. Spine 2018, 43: e52-e59. PMID: 28723873, DOI: 10.1097/brs.0000000000002337.Peer-Reviewed Original ResearchConceptsAnterior lumbar interbody fusionTotal disc arthroplastyAdverse eventsBlood transfusionOperative timeInterbody fusionRisk factorsSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseShort-term adverse eventsQuality Improvement Program databaseShort-term clinical outcomesLong-term functional outcomeLumbar total disc arthroplastySerious adverse eventsImprovement Program databaseAnterior interbody fusionIndividual adverse eventsStand-alone Anterior Lumbar Interbody FusionGeneral health outcomesPotential risk factorsLumbar interbody fusionMultivariate Poisson regressionPerioperative outcomesPostoperative length
2017
Outpatient elective posterior lumbar fusions appear to be safely considered for appropriately selected patients
Bovonratwet P, Ottesen TD, Gala RJ, Rubio DR, Ondeck NT, McLynn RP, Grauer JN. Outpatient elective posterior lumbar fusions appear to be safely considered for appropriately selected patients. The Spine Journal 2017, 18: 1188-1196. PMID: 29155341, DOI: 10.1016/j.spinee.2017.11.011.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAmbulatory Surgical ProceduresBlood TransfusionCohort StudiesDatabases, FactualElective Surgical ProceduresFemaleHumansInpatientsLumbar VertebraeMaleMiddle AgedPatient ReadmissionPatient SelectionPostoperative ComplicationsPropensity ScoreQuality ImprovementRetrospective StudiesSpinal FusionYoung AdultConceptsPosterior lumbar fusionPerioperative complicationsPostoperative complicationsNSQIP databaseInterbody fusionLumbar fusionNational Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement Program databaseElective posterior lumbar fusionQuality Improvement Program databasePropensity score-matched comparisonLower blood transfusionMost perioperative complicationsPostoperative adverse eventsRetrospective cohort comparison studyImprovement Program databaseRate of readmissionCareful patient selectionCohort comparison studyPotential confounding factorsInpatient cohortPLF casesHospital lengthPerioperative courseSelect patientsOf 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 factorsAccess of Patients With Lumbar Disc Herniations to Spine Surgeons
Anandasivam NS, Wiznia DH, Kim CY, Save AV, Grauer JN, Pelker RR. Access of Patients With Lumbar Disc Herniations to Spine Surgeons. Spine 2017, 42: 1179-1183. PMID: 27902558, DOI: 10.1097/brs.0000000000002005.Peer-Reviewed Original ResearchConceptsLumbar disc herniationMedicaid insuranceSpine surgeonsAppointment success rateDisc herniationInsurance typePatient accessPrivate insuranceMedicaid expansionProspective cohort studyDifferent insurance typesSuccess rateAccess of patientsCohort studyAffordable Care ActBACKGROUND DATAPatientsSpine careLumbar discAcceptance of insuranceReferralMedicaid eligibilitySurgeonsMedicaidCare ActPredicting Postoperative Morbidity and Readmission for Revision Posterior Lumbar Fusion
Basques BA, Ibe I, Samuel AM, Lukasiewicz AM, Webb ML, Bohl DD, Grauer JN. Predicting Postoperative Morbidity and Readmission for Revision Posterior Lumbar Fusion. Clinical Spine Surgery A Spine Publication 2017, 30: e770-e775. PMID: 27280782, DOI: 10.1097/bsd.0000000000000391.Peer-Reviewed Original ResearchConceptsMinor adverse eventsSevere adverse eventsInsulin-dependent diabetesAdverse eventsPosterior lumbar fusionLumbar fusionRisk factorsASA classificationOperative timeSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseMultivariate analysisBody mass index 25Quality Improvement Program databaseImprovement Program databaseRetrospective cohort studySpecific risk factorsAnesthesiologists classificationBMI 30Postoperative complicationsPostoperative morbidityCohort studyPatient characteristicsSicker patientsAdverse outcomesDiscriminative ability of commonly used indices to predict adverse outcomes after poster lumbar fusion: a comparison of demographics, ASA, the modified Charlson Comorbidity Index, and the modified Frailty Index
Ondeck NT, Bohl DD, Bovonratwet P, McLynn RP, Cui JJ, Shultz BN, Lukasiewicz AM, Grauer JN. Discriminative ability of commonly used indices to predict adverse outcomes after poster lumbar fusion: a comparison of demographics, ASA, the modified Charlson Comorbidity Index, and the modified Frailty Index. The Spine Journal 2017, 18: 44-52. PMID: 28578164, DOI: 10.1016/j.spinee.2017.05.028.Peer-Reviewed Original ResearchConceptsPosterior lumbar fusionPerioperative adverse outcomesNational Surgical Quality Improvement ProgramCharlson Comorbidity IndexComorbidity indexAdverse outcomesAdverse eventsFrailty indexLumbar fusionSurgeons National Surgical Quality Improvement ProgramElective posterior lumbar fusionAnesthesiologists Physical Status Classification SystemDiscriminative abilitySurgical Quality Improvement ProgramPhysical Status Classification SystemAdverse outcome variablesDemographic factorsInfectious adverse eventsOutcome variablesPatient comorbidity indexPredictive demographic factorsMinor adverse eventsSevere adverse eventsBody mass indexHigh-level care