2024
Efficacy and utility of antifibrinolytics in pediatric spine surgery: a systematic review and network meta-analysis
Aghajanian S, Mohammadifard F, Kohandel Gargari O, Naeimi A, Bahadorimonfared A, Elsamadicy A. Efficacy and utility of antifibrinolytics in pediatric spine surgery: a systematic review and network meta-analysis. Neurosurgical Review 2024, 47: 177. PMID: 38644447, DOI: 10.1007/s10143-024-02424-x.Peer-Reviewed Original ResearchConceptsNetwork meta-analysisRate of complicationsBlood lossSpine surgeryEpsilon-aminocaproic acidMeta-analysisTranexamic acidEfficacy of antifibrinolyticsPediatric spine surgeryPerioperative blood lossReduce blood lossStandardized outcome dataRandomized clinical trialsStandard of carePerioperative bleedingTransfusion volumeTransfusion rateAntifibrinolytic agentsMassive transfusionPediatric patientsSafety profilePediatric surgeryProbability of efficacyAntifibrinolyticsClinical trials
2023
Treatment of intramedullary spinal cord tumors: a modified Delphi technique of the North American Spine Society Section of Spine Oncology.
Hersh A, Pennington Z, Lubelski D, Elsamadicy A, Dea N, Desai A, Gokaslan Z, Goodwin C, Hsu W, Jallo G, Krishnaney A, Laufer I, Lo S, Macki M, Mehta A, Ozturk A, Shin J, Soliman H, Sciubba D. Treatment of intramedullary spinal cord tumors: a modified Delphi technique of the North American Spine Society Section of Spine Oncology. Journal Of Neurosurgery Spine 2023, 40: 1-10. PMID: 37856379, DOI: 10.3171/2023.8.spine23190.Peer-Reviewed Original ResearchMeSH KeywordsDelphi TechniqueHumansHypesthesiaNeurosurgical ProceduresNorth AmericaSpinal Cord DiseasesSpinal Cord NeoplasmsTreatment OutcomeConceptsIntramedullary spinal cord tumorsSpinal cord tumorsTumor-specific characteristicsOperative candidacyCord tumorsResection strategyNew neurological deficitsGross total resectionT2 signal changeSet of patientsAreas of controversyIMSCT resectionFrail patientsChronic myelopathyChronic paraplegiaNeurological deficitsPreoperative symptomsTranscranial motorDelphi techniqueSurgical managementMild numbnessOperative managementSurgical interventionFurther resectionRare tumorOutcomes Following 2-Level Cervical Interventions with Cage-and-Plate, Zero-Profile, or Arthroplasty Constructs
Khalid S, Mirpuri P, Thomson K, Elsamadicy A, Massaad E, Deysher D, Khilwani H, Adogwa O, Shin J, Mehta A. Outcomes Following 2-Level Cervical Interventions with Cage-and-Plate, Zero-Profile, or Arthroplasty Constructs. World Neurosurgery 2023, 180: e607-e617. PMID: 37797683, DOI: 10.1016/j.wneu.2023.09.117.Peer-Reviewed Original ResearchConceptsAdditional surgeryCervical interventionsPlate constructZero-profileMedical complicationsAnterior cervical proceduresDisc height restorationPostoperative medical complicationsOutcomes of patientsCervical disc diseaseLogistic regression modelsCervical proceduresSecondary outcomesSurgical complicationsIndex interventionPrimary outcomeIndex procedureHeight restorationDisc diseasePatientsSurgeryArthroplastyMotion limitationArtificial discComplicationsAssessment of the impact of frailty on adverse surgical outcomes in patients undergoing surgery for intracranial tumors using modified frailty index: A systematic review and meta-analysis
Aghajanian S, Shafiee A, Ahmadi A, Elsamadicy A. Assessment of the impact of frailty on adverse surgical outcomes in patients undergoing surgery for intracranial tumors using modified frailty index: A systematic review and meta-analysis. Journal Of Clinical Neuroscience 2023, 114: 120-128. PMID: 37390775, DOI: 10.1016/j.jocn.2023.06.013.Peer-Reviewed Original ResearchMeSH KeywordsBrain NeoplasmsFrailtyHumansPostoperative ComplicationsRetrospective StudiesRisk AssessmentRisk FactorsTreatment OutcomeConceptsImpact of frailtyFrailty indexMFI scoreAdverse outcomesReoperation rateIntracranial tumorsNon-frail participantsAdverse surgical outcomesNeuro-oncological surgeryWeb of SciencePerioperative outcomesComplication rateIndependent predictorsSurgical outcomesWorse prognosisMean ageObservational studySurgical pathologyMixed-effects multilevel modelsPrimary analysisSystematic reviewNeurosurgical proceduresFrailtySurgical operationSurgery
2022
Geriatric relationship with inpatient opioid consumption and hospital outcomes after open posterior spinal fusion for adult spine deformity
Elsamadicy A, Sandhu M, Reeves B, Sherman J, Craft S, Williams M, Shin J, Sciubba D. Geriatric relationship with inpatient opioid consumption and hospital outcomes after open posterior spinal fusion for adult spine deformity. Clinical Neurology And Neurosurgery 2022, 224: 107532. PMID: 36436433, DOI: 10.1016/j.clineuro.2022.107532.Peer-Reviewed Original ResearchConceptsNon-routine dischargeHealthcare resource utilizationAdverse eventsGeriatric cohortMME useGeriatric patientsSpinal fusionSpine deformityMultivariate logistic regression analysisInpatient narcotic consumptionInpatient opioid consumptionInpatient opioid usePremier Healthcare DatabasePoor surgical outcomesPatient risk stratificationPosterior spinal fusionAdult spinal deformityAdult spine deformityICD-10-CM codesGreater proportionLogistic regression analysisGreater resource utilizationNon-Hispanic whitesOlder CohortOpioid consumptionAssociation of inpatient opioid consumption on postoperative outcomes after open posterior spinal fusion for adult spine deformity
Elsamadicy A, Sandhu M, Reeves B, Freedman I, Koo A, Jayaraj C, Hengartner A, Havlik J, Hersh A, Pennington Z, Lo S, Shin J, Mendel E, Sciubba D. Association of inpatient opioid consumption on postoperative outcomes after open posterior spinal fusion for adult spine deformity. Spine Deformity 2022, 11: 439-453. PMID: 36350557, DOI: 10.1007/s43390-022-00609-2.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAnalgesics, OpioidHumansInpatientsRetrospective StudiesSpinal FusionTreatment OutcomeConceptsAdult spinal deformityInpatient opioid useProportion of patientsOpioid useAdverse eventsHigher MMESpinal fusionHospital costsMME consumptionPostoperative outcomesDischarge dispositionHospital admissionRisk factorsMultivariate analysisLong-term opioid useMethodsA retrospective cohort studyHigh opioid useInpatient opioid consumptionOpioid-related disordersPremier Healthcare DatabasePostoperative adverse eventsPostoperative opioid useRetrospective cohort studyHealthcare resource utilizationNon-routine dischargeLeveraging HFRS to assess how frailty affects healthcare resource utilization after elective ACDF for CSM
Elsamadicy AA, Koo AB, Sarkozy M, David WB, Reeves BC, Patel S, Hansen J, Sandhu MRS, Hengartner AC, Hersh A, Kolb L, Lo SL, Shin JH, Mendel E, Sciubba DM. Leveraging HFRS to assess how frailty affects healthcare resource utilization after elective ACDF for CSM. The Spine Journal 2022, 23: 124-135. PMID: 35988878, DOI: 10.1016/j.spinee.2022.08.004.Peer-Reviewed Original ResearchConceptsHighest Hospital Frailty Risk ScoresHospital Frailty Risk ScoreCervical spondylotic myelopathyNon-routine discharge dispositionDischarge dispositionElective ACDFFrail patientsExtended LOSHospital costsHealth care resource utilizationNationwide Inpatient Sample databaseMultivariate stepwise logistic regressionFrailty Risk ScorePeri-operative protocolSeverity of frailtyTotal admission costLonger hospital stayRetrospective cohort studyAnterior cervical discectomyCervical spine pathologyHealthcare resource utilizationNon-routine dischargeHigh complication rateTotal hospital costsSignificant independent predictorsPredictors of survival and time to progression following operative management of intramedullary spinal cord astrocytomas
Hersh AM, Antar A, Pennington Z, Aygun N, Patel J, Goldsborough E, Porras JL, Elsamadicy AA, Lubelski D, Wolinsky JP, Jallo GI, Gokaslan ZL, Lo SL, Sciubba DM. Predictors of survival and time to progression following operative management of intramedullary spinal cord astrocytomas. Journal Of Neuro-Oncology 2022, 158: 117-127. PMID: 35538385, DOI: 10.1007/s11060-022-04017-4.Peer-Reviewed Original ResearchMeSH KeywordsAstrocytomaHumansNeurosurgical ProceduresProgression-Free SurvivalRetrospective StudiesSpinal Cord NeoplasmsTreatment OutcomeConceptsProgression-free survivalPredictors of survivalHigh tumor gradeResection extentTumor gradePoor survivalIntramedullary spinal cord astrocytomasPost-operative neurologic deficitsSingle comprehensive cancer centerTumor progression/recurrencePre-operative presentationPreoperative back painSpinal cord astrocytomasKaplan-Meier curvesProgression/recurrenceStandard of careComprehensive cancer centerLong-term survivalPurposeSurgical resectionBowel dysfunctionChemotherapy regimensNeurologic deficitsIntramedullary astrocytomasPatient demographicsComplete resectionHigher Hospital Frailty Risk Score is associated with increased complications and healthcare resource utilization after endovascular treatment of ruptured intracranial aneurysms
Koo AB, Elsamadicy AA, Renedo D, Sarkozy M, Sherman J, Reeves BC, Havlik J, Antonios J, Sujijantarat N, Hebert R, Malhotra A, Matouk C. Higher Hospital Frailty Risk Score is associated with increased complications and healthcare resource utilization after endovascular treatment of ruptured intracranial aneurysms. Journal Of NeuroInterventional Surgery 2022, 15: 255-261. PMID: 35292571, PMCID: PMC8931798, DOI: 10.1136/neurintsurg-2021-018484.Peer-Reviewed Original ResearchConceptsHospital Frailty Risk ScoreNon-routine dischargeLength of stayFrailty Risk ScoreHealthcare resource utilizationTotal hospital costsEndovascular treatmentIntracranial aneurysmsAdverse eventsHospital costsRisk scoreHighest Hospital Frailty Risk ScoresMean LOSNational Inpatient Sample databaseMean total hospital costMultivariate logistic regression analysisImpact of frailtyRetrospective cohort studyICD-10-CM codesLogistic regression analysisRegression analysisMultivariate regression analysisCohort studyDischarge dispositionPatient demographics
2021
Effects of preoperative nutritional status on complications and readmissions after posterior lumbar decompression and fusion for spondylolisthesis: A propensity-score analysis
Elsamadicy AA, Havlik J, Reeves BC, Koo AB, Sherman J, Lo SL, Shin JH, Sciubba DM. Effects of preoperative nutritional status on complications and readmissions after posterior lumbar decompression and fusion for spondylolisthesis: A propensity-score analysis. Clinical Neurology And Neurosurgery 2021, 211: 107017. PMID: 34781222, DOI: 10.1016/j.clineuro.2021.107017.Peer-Reviewed Original ResearchConceptsUnplanned readmissionAdverse eventsSpine surgerySurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseOccurrence of AEsPreoperative serum albumin levelQuality Improvement Program databaseMultivariate logistic regression analysisPosterior lumbar decompressionPreoperative nutritional statusHigh rateImprovement Program databaseRetrospective cohort studySerum albumin levelSignificant independent predictorsEffects of malnutritionLogistic regression analysisPropensity score analysisPropensity-score matchingMalnourished cohortMalnourished patientsPerioperative complicationsPostoperative complicationsLumbar decompressionUtility of expanded anterior column resection versus decompression-alone for local control in the management of carcinomatous vertebral column metastases undergoing adjuvant stereotactic radiotherapy
Pennington Z, Pairojboriboon S, Chen X, Sacino A, Elsamadicy AA, de la Garza Ramos R, Patel J, Elder BD, Kleinberg LR, Sciubba DM, Redmond KJ, Lo SL. Utility of expanded anterior column resection versus decompression-alone for local control in the management of carcinomatous vertebral column metastases undergoing adjuvant stereotactic radiotherapy. The Spine Journal 2021, 22: 835-846. PMID: 34718175, DOI: 10.1016/j.spinee.2021.10.016.Peer-Reviewed Original ResearchMeSH KeywordsAgedDecompressionFemaleHumansMaleMiddle AgedRadiosurgeryRadiotherapy, AdjuvantRetrospective StudiesSpinal NeoplasmsSpineTreatment OutcomeConceptsStereotactic body radiotherapyLong-term local controlLocal recurrenceLocal controlAnterior columnTumor pathologyCommon primary tumor typesSingle comprehensive cancer centerAdjuvant stereotactic radiotherapySpinal column metastasesVertebral Column MetastasesRetrospective cohort studyLocal control ratePrimary tumor typeLocal tumor recurrenceComprehensive cancer centerKaplan-Meier functionInvasive surgical techniquesEpidural removalAdjuvant radiotherapySurgical debulkingCohort studyDisease resectionSpinal metastasesTumor involvementRamifications of Postoperative Dysphagia on Health Care Resource Utilization Following Elective Anterior Cervical Discectomy and Interbody Fusion for Cervical Spondylotic Myelopathy
Elsamadicy AA, Koo AB, David WB, Freedman IG, Reeves BC, Ehresman J, Pennington Z, Sarkozy M, Laurans M, Kolb L, Shin JH, Sciubba DM. Ramifications of Postoperative Dysphagia on Health Care Resource Utilization Following Elective Anterior Cervical Discectomy and Interbody Fusion for Cervical Spondylotic Myelopathy. Clinical Spine Surgery A Spine Publication 2021, 35: e380-e388. PMID: 34321392, DOI: 10.1097/bsd.0000000000001241.Peer-Reviewed Original ResearchConceptsHealth care resource utilizationCervical spondylotic myelopathyElective anterior cervical discectomyPostoperative dysphagiaRetrospective cohort studyAnterior cervical discectomySpondylotic myelopathyNonroutine dischargeHospital stayCervical discectomyCohort studyRisk factorsOdds ratioHigher total costsICD-10-CM diagnosisSignificant independent risk factorsNationwide Inpatient Sample databaseMultivariate stepwise logistic regressionLonger hospital LOSLonger hospital stayIndependent risk factorPatient risk factorsStepwise logistic regressionPaucity of dataHospital LOSIndependent Association of Obesity and Nonroutine Discharge Disposition After Elective Anterior Cervical Discectomy and Fusion for Cervical Spondylotic Myelopathy
Koo AB, Elsamadicy AA, Sarkozy M, David WB, Reeves BC, Hong CS, Boylan A, Laurans M, Kolb L. Independent Association of Obesity and Nonroutine Discharge Disposition After Elective Anterior Cervical Discectomy and Fusion for Cervical Spondylotic Myelopathy. World Neurosurgery 2021, 151: e950-e960. PMID: 34020060, DOI: 10.1016/j.wneu.2021.05.022.Peer-Reviewed Original ResearchConceptsCervical spondylotic myelopathyNonroutine discharge dispositionAnterior cervical discectomyElective anterior cervical discectomyDischarge dispositionSpondylotic myelopathyCervical discectomyElective ACDFComplication rateNational Inpatient Sample databaseElective spine surgeryOverall complication ratePrevalence of obesityShort-term outcomesLength of stayHospital bed sizeMultivariate regression analysisHealth care coverageMore comorbiditiesNonroutine dischargeDischarge weightIndependent predictorsElixhauser comorbiditiesGreater proportionPrimary diagnosisImpact of race on outcomes and healthcare utilization following spinal fusion for adolescent idiopathic scoliosis
Elsamadicy AA, Koo AB, David WB, Freedman IG, Kundishora AJ, Hong CS, Sarkozy M, Sciubba DM, Kahle KT, DiLuna M. Impact of race on outcomes and healthcare utilization following spinal fusion for adolescent idiopathic scoliosis. Clinical Neurology And Neurosurgery 2021, 206: 106634. PMID: 33979695, DOI: 10.1016/j.clineuro.2021.106634.Peer-Reviewed Original ResearchConceptsPosterior spinal fusionPostoperative complicationsAdolescent idiopathic scoliosisPatient demographicsIdiopathic scoliosisAdolescent patientsSpine surgerySpinal fusionBlack cohortBaseline patient demographicsRate of complicationsMajority of patientsPosterior spine surgeryPosterior spinal surgeryMedian total costBaseline comorbiditiesHospital stayDischarge dispositionInpatient managementPostoperative outcomesBlood transfusionPrimary outcomeFemale patientsHealthcare utilizationHispanic patientsSystematic review of charged-particle therapy for chordomas and sarcomas of the mobile spine and sacrum.
Pennington Z, Ehresman J, Elsamadicy AA, Shin JH, Goodwin CR, Schwab JH, Sciubba DM. Systematic review of charged-particle therapy for chordomas and sarcomas of the mobile spine and sacrum. Neurosurgical FOCUS 2021, 50: e17. PMID: 33932924, DOI: 10.3171/2021.2.focus201059.Peer-Reviewed Original ResearchConceptsDisease-free survivalProgression-free survivalDisease-specific survivalOverall survivalLocal controlMobile spineLong-term local controlAcute toxicityManagement of sarcomasEn bloc resectionCharged-particle therapyUse of protonsFull-text screeningDefinitive radiotherapyAdjuvant radiationDefinitive radiationSurgical cohortSurgical groupPrimary sarcomaUnresectable tumorsBloc resectionNegative marginsRadiation toxicityConventional radiotherapyHigh risk
2020
Impact of Preoperative Anemia on Outcomes After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis
Elsamadicy AA, Freedman IG, Koo AB, David WB, Havlik J, Kundishora AJ, Hong CS, Sciubba DM, Kahle KT, DiLuna M. Impact of Preoperative Anemia on Outcomes After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis. World Neurosurgery 2020, 146: e214-e224. PMID: 33091648, DOI: 10.1016/j.wneu.2020.10.074.Peer-Reviewed Original ResearchConceptsPosterior spinal fusionAdolescent idiopathic scoliosisPreoperative anemiaAnemic cohortHospital stayReadmission ratesIndependent predictorsSpinal fusionIdiopathic scoliosisNational Surgical Quality Improvement Program Pediatric databaseSurgeons National Surgical Quality Improvement Program Pediatric databaseUnplanned reoperation rateLonger hospital stayRetrospective cohort studyThirty-day outcomesLonger operative timeLonger lengthPostoperative complicationsReoperation rateCohort studyDischarge dispositionComplication ratePediatric patientsTransfusion eventsOperative timePredictors of Extended Length of Stay Following Treatment of Unruptured Adult Cerebral Aneurysms: A Study of The National Inpatient Sample
Koo AB, Elsamadicy AA, Lin IH, David WB, Sujijantarat N, Santarosa C, Cord BJ, Zetchi A, Hebert R, Bahrassa F, Malhotra A, Matouk CC. Predictors of Extended Length of Stay Following Treatment of Unruptured Adult Cerebral Aneurysms: A Study of The National Inpatient Sample. Journal Of Stroke And Cerebrovascular Diseases 2020, 29: 105230. PMID: 33066916, DOI: 10.1016/j.jstrokecerebrovasdis.2020.105230.Peer-Reviewed Original ResearchMeSH KeywordsAgedComorbidityDatabases, FactualEndovascular ProceduresFemaleHospital CostsHumansInpatientsIntracranial AneurysmLength of StayMaleMicrosurgeryMiddle AgedOutcome and Process Assessment, Health CarePatient AdmissionPostoperative ComplicationsQuality Indicators, Health CareRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeUnited StatesConceptsLOS cohortExtended LOSMultivariate logistic regressionUnruptured cerebral aneurysmsCerebral aneurysmsPreadmission comorbiditiesInpatient complicationsHospital stayMore patientsOdds ratioUnruptured aneurysmsHealthcare costsMultiple patient-specific factorsLogistic regressionOverall complication rateHospital-level factorsNon-routine dischargePatient-level factorsNational Inpatient SamplePatient-specific factorsOverall healthcare costsChoice of procedureIndex admissionPostoperative complicationsComplication ratePosterior Reversible Encephalopathy Syndrome Caused by Induced Hypertension to Treat Cerebral Vasospasm Secondary to Aneurysmal Subarachnoid Hemorrhage
Elsamadicy AA, Koo AB, Reeves BC, Sujijantarat N, David WB, Malhotra A, Gilmore EJ, Matouk CC, Hebert R. Posterior Reversible Encephalopathy Syndrome Caused by Induced Hypertension to Treat Cerebral Vasospasm Secondary to Aneurysmal Subarachnoid Hemorrhage. World Neurosurgery 2020, 143: e309-e323. PMID: 32721559, DOI: 10.1016/j.wneu.2020.07.135.Peer-Reviewed Original ResearchMeSH KeywordsFemaleHumansHypertensionMiddle AgedPosterior Leukoencephalopathy SyndromeSubarachnoid HemorrhageTreatment OutcomeVasospasm, IntracranialConceptsPosterior reversible encephalopathy syndromeSystolic blood pressure goalBlood pressure goalsReversible encephalopathy syndromeAneurysmal subarachnoid hemorrhageSubarachnoid hemorrhageEncephalopathy syndromeCerebral vasospasmClinical statusFluid-attenuated inversion recovery hyperintensityMiddle cerebral artery syndromeAcute-onset headachePossible ischemic eventsClinical examination findingsInversion recovery hyperintensityPatient's clinical statusTransient clinical improvementArtery aneurysm ruptureMiddle cerebral arteryLevel of arousalMagnetic resonance imagingDigital subtraction angiographyInduced hypertensionClinical improvementIschemic eventsPre-operative headaches and obstructive hydrocephalus predict an extended length of stay following suboccipital decompression for pediatric Chiari I malformation
Elsamadicy AA, Koo AB, David WB, Kundishora AJ, Hong CS, Sarkozy M, Kahle KT, DiLuna M. Pre-operative headaches and obstructive hydrocephalus predict an extended length of stay following suboccipital decompression for pediatric Chiari I malformation. Child's Nervous System 2020, 37: 91-99. PMID: 32519127, DOI: 10.1007/s00381-020-04688-2.Peer-Reviewed Original ResearchConceptsPediatric CM-I patientsExtended LOSMultivariate logistic regressionCM-I patientsObstructive hydrocephalusSurgical decompressionSuboccipital decompressionElectrolyte disordersRisk factorsHeadache symptomsHospital-level risk factorsLogistic regressionChiari malformation type IPediatric Chiari I malformationPost-operative complicationsImpact of patientChiari I malformationRisk-adjusted LOSYoung childrenAdmission comorbiditiesMethodsThe KidsPediatric CMHospital stayPatient comorbiditiesPatient demographicsInfluence of gender on discharge disposition after spinal fusion for adult spine deformity correction
Elsamadicy AA, Freedman IG, Koo AB, David WB, Lee M, Kundishora AJ, Kuzmik GA, Gorrepati R, Hong CS, Kolb L, Laurans M, Abbed K. Influence of gender on discharge disposition after spinal fusion for adult spine deformity correction. Clinical Neurology And Neurosurgery 2020, 194: 105875. PMID: 32388244, DOI: 10.1016/j.clineuro.2020.105875.Peer-Reviewed Original ResearchConceptsDischarge dispositionSpine deformity correctionSpinal fusionFemale cohortMale cohortDeformity correctionElective spine fusion surgeryNon-routine discharge dispositionNationwide Inpatient Sample databaseSpine surgical careSurgical site hematomaNon-routine dischargeElective spinal fusionICD-9 codesSpine fusion surgeryInfluence of genderPostoperative MIPostoperative UTIHospital staySite hematomaHospital factorsIndependent predictorsMale patientsFemale patientsFusion surgery