2024
Semaglutide utilization associated with reduced ninety-day postoperative complications following single-level posterior lumbar fusion for patients with type II diabetes
Seddio A, Gouzoulis M, Vasudevan R, Dhodapkar M, Jabbouri S, Varthi A, Rubio D, Grauer J. Semaglutide utilization associated with reduced ninety-day postoperative complications following single-level posterior lumbar fusion for patients with type II diabetes. The Spine Journal 2024 PMID: 39491749, DOI: 10.1016/j.spinee.2024.10.011.Peer-Reviewed Original ResearchSingle-level posterior lumbar fusionPosterior lumbar fusionSodium-glucose transport protein 2 inhibitorsAdverse eventsPostoperative complicationsT2DM patientsCurrent Procedural TerminologyElixhauser Comorbidity IndexED visitsLumbar fusionHospital readmissionEmergency departmentOdds of postoperative complicationsNinety-day postoperative complicationsImpact of semaglutideOdds of hospital readmissionMonths of surgeryRetrospective cohort studyPostoperative adverse eventsMinor adverse eventsType II diabetes mellitusRisk of type I errorDiagnosis of T2DMII diabetes mellitusYears of ageInflammatory bowel disease is associated with greater odds of complications following posterior lumbar fusion and further amplified for patients exposed to biologics
Seddio A, Katsnelson B, Smith-Voudouris J, Gouzoulis M, Day W, Jabbouri S, Vasudevan R, Rubio D, Grauer J. Inflammatory bowel disease is associated with greater odds of complications following posterior lumbar fusion and further amplified for patients exposed to biologics. North American Spine Society Journal (NASSJ) 2024, 100574. DOI: 10.1016/j.xnsj.2024.100574.Peer-Reviewed Original ResearchPosterior lumbar fusionInflammatory bowel diseaseOdds ratioNational Inpatient SampleElixhauser Comorbidity IndexLumbar fusionBowel diseaseKaplan-Meier survival analysisEmergency departmentInflammatory bowel disease patientsLog-rank testMinor adverse eventsNon-IBD patientsIn-hospital dataMultivariate logistic regressionAssociated with greater oddsElevated odds ratiosReoperation rateSurgical complicationsSpine surgeryInferior outcomesPearlDiver databasePost-discharge outcomesAdult patientsAdverse eventsP116. National trends and risk factors for new-onset depression following posterior lumbar fusion
Day W, Gouzoulis M, Zhu J, Seddio A, Fourman M, Grauer J. P116. National trends and risk factors for new-onset depression following posterior lumbar fusion. The Spine Journal 2024, 24: s119. DOI: 10.1016/j.spinee.2024.06.138.Peer-Reviewed Original ResearchNew-onset depressionPosterior lumbar fusionNational administrative claims databaseSingle-level posterior lumbar fusionRisk factorsDevelopment of new-onset depressionAdministrative claims databasePostoperative complicationsLumbar fusionNational trendsFactors associated with patientsClaims databaseAggregate patient dataAdult patientsTarget risk mitigation strategiesMultivariate logistic regressionPsychiatric risk factorsPotential risk factorsElixhauser Comorbidity IndexPercentage of patientsHigher oddsCase-controlAlcohol/drug abuseDiagnosis of tumorsLogistic regression100. Semaglutide associated with improved postoperative outcomes following single-level posterior lumbar fusion for patients with type II diabetes
Seddio A, Gouzoulis M, Vasudevan R, Dhodapkar M, Jabbouri S, Zhu J, Rubio D, Grauer J. 100. Semaglutide associated with improved postoperative outcomes following single-level posterior lumbar fusion for patients with type II diabetes. The Spine Journal 2024, 24: s52-s53. DOI: 10.1016/j.spinee.2024.06.543.Peer-Reviewed Original ResearchSingle-level posterior lumbar fusionPosterior lumbar fusionSodium-glucose transport protein 2 inhibitorsImpact of semaglutideHospital readmissionPostoperative outcomesElixhauser Comorbidity IndexED visitsT2DM patientsCurrent Procedural TerminologyEmergency departmentLumbar fusionAdverse eventsOdds of hospital readmissionOutcome measures IncidenceRisk of type I errorInferior postoperative outcomesDiagnosis of T2DMMonths of surgeryYear of surgeryRetrospective cohort studyMinor adverse eventsType II diabetes mellitusMatched 1:4Management of diabetesOne- versus Three-- Level Fusion in Patients Undergoing Multilevel Lumbar Decompression: Relative Perioperative Risks and Five-year Revisions.
Ratnasamy P, Gouzoulis M, Jabbouri S, Rubio D, Grauer J. One- versus Three-- Level Fusion in Patients Undergoing Multilevel Lumbar Decompression: Relative Perioperative Risks and Five-year Revisions. Spine 2024 PMID: 39190416, DOI: 10.1097/brs.0000000000005130.Peer-Reviewed Original ResearchOne-level fusionLumbar decompressionThree-level fusionPostoperative adverse eventsAdverse eventsOdds ratioElixhauser Comorbidity IndexPatient ageFive-year survivalOdds of perioperative complicationsLumbar decompression patientsPerioperative complicationsDecompression patientsPerioperative riskFusion patientsSpinal reoperationLumbar fusionReoperationComorbidity indexMultivariate analysisPatientsClinical interestDecompressionFusion levelsOddsRate and risk factors for inpatient falls following single-level posterior lumbar fusion: A national registry study
Gouzoulis M, Jabbouri S, Seddio A, Moran J, Day W, Ratnasamy P, Grauer J. Rate and risk factors for inpatient falls following single-level posterior lumbar fusion: A national registry study. North American Spine Society Journal (NASSJ) 2024, 20: 100549. PMID: 39318705, PMCID: PMC11417567, DOI: 10.1016/j.xnsj.2024.100549.Peer-Reviewed Original ResearchPosterior lumbar fusionSingle-level posterior lumbar fusionInpatient fallsOdds ratioLumbar fusionFall prevention programsIncidence of secondary injuryNational sample of patientsRisk factorsDecreased odds ratioPatient variablesPotential patient outcomesMultivariate logistic regressionNational registry studySample of patientsPrevention programsInpatient costsMedicaid insuranceActive deliriumAlcohol use disorderMethods Adult patientsSpinal pathologyOutcome metricsCommercial insuranceNational sampleRobotic-Assisted Versus Navigation-Assisted Posterior Lumbar Fusion
Gouzoulis M, Seddio A, Winter A, Jabbouri S, Zhu J, Rubio D, Varthi A, Grauer J. Robotic-Assisted Versus Navigation-Assisted Posterior Lumbar Fusion. Spine 2024, 49: 1483-1487. PMID: 38717329, DOI: 10.1097/brs.0000000000005032.Peer-Reviewed Original ResearchPosterior lumbar fusionLumbar fusionAdverse eventsLevel posterior lumbar fusionsCPT codesKaplan-Meier survival analysisRate of reoperationNavigation-assisted surgeryRobotic-assisted casesNavigation-assistedMinor adverse eventsPerioperative adverse eventsMultivariate logistic regressionICD-10 procedure codeRobotic cohortRobotic assistanceSpinal navigationReoperation rateAnterior fusionElixhauser Comorbidity IndexPearlDiver databaseNo significant differenceIncremental advantageAdverse outcomesComorbidity indexCefazolin Alone Versus Cefazolin with Tobramycin or Gentamicin as Intraoperative Antibiotic Prophylaxis for Single-Level Posterior Lumbar Fusion
Dhodapkar M, Jeong S, Halperin S, Rubio D, Li M, Grauer J. Cefazolin Alone Versus Cefazolin with Tobramycin or Gentamicin as Intraoperative Antibiotic Prophylaxis for Single-Level Posterior Lumbar Fusion. JAAOS Global Research And Reviews 2024, 8: e24.00082. PMCID: PMC11068128, DOI: 10.5435/jaaosglobal-d-24-00082.Peer-Reviewed Original ResearchSingle-level posterior lumbar fusionPosterior lumbar fusionSurgical site infectionElixhauser Comorbidity IndexLumbar fusionAntibiotic prophylaxisAdverse outcomesAntibiotic prophylaxis regimenAntibiotic prophylaxis regimensIntraoperative antibiotic prophylaxisRevision ratePerioperative antibiotic prophylaxisPostoperative adverse outcomesPosterior lumbar fusion patientsMultivariate logistic regressionProphylaxis regimensProphylaxis regimenPatient ageSite infectionUnivariate analysisCefazolinComorbidity indexMultivariate analysisAntibiotic subgroupsTraumatic diagnosesSurgical site infection following isolated lumbar discectomy increases odds of revision lumbar surgery within first 6 months, but not beyond
Kim L, Halperin S, Grauer J. Surgical site infection following isolated lumbar discectomy increases odds of revision lumbar surgery within first 6 months, but not beyond. The Spine Journal 2024, 24: 1459-1466. PMID: 38570035, DOI: 10.1016/j.spinee.2024.03.017.Peer-Reviewed Original ResearchSurgical site infectionRevision lumbar surgeryLumbar discectomyLumbar surgeryElixhauser Comorbidity IndexSite infectionFactors associated with surgical site infectionPreoperative diagnosis of infectionIncidence of secondary surgeryLumbar discectomy patientsDiagnosis of infectionMultivariate logistic regressionPreoperative diagnosisDiscectomy patientsPostoperative complicationsIndex surgeryPatient ageSecondary surgerySpinal surgeryIndependent predictorsAdult patientsLumbar fusionPerforming surgeryDiscectomyI&DPhysical Therapy Utilization After Single-level Posterior Lumbar Fusion
Gouzoulis M, Moran J, Jeong S, Galivanche A, Kammien A, Jabbouri S, Grauer J. Physical Therapy Utilization After Single-level Posterior Lumbar Fusion. Spine 2024, 49: e272-e278. PMID: 38349019, DOI: 10.1097/brs.0000000000004958.Peer-Reviewed Original ResearchSingle-level posterior lumbar fusionPosterior lumbar fusionPhysical therapyOdds ratioLumbar fusionPhysical therapy utilizationFemale sexLevel posterior lumbar fusionsReturn to activityDecreased odds ratioOutpatient therapyPredictors of therapyTiming of therapyMinority of patientsOutpatient PTNonmedical factorsAdministrative databasesMedicaid insuranceTherapy utilizationPractice patternsCommercial insuranceInsurance plansPatient characteristicsSurgeryTherapy
2023
Weight 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 outcomes
2022
Single-level posterior lumbar fusions in patients with Ehlers Danlos Syndrome not found to be associated with increased postoperative adverse events or five-year reoperations
Gouzoulis MJ, Kammien AJ, Zhu JR, Gillinov SM, Moore HG, Grauer JN. Single-level posterior lumbar fusions in patients with Ehlers Danlos Syndrome not found to be associated with increased postoperative adverse events or five-year reoperations. North American Spine Society Journal (NASSJ) 2022, 11: 100136. PMID: 35783003, PMCID: PMC9241136, DOI: 10.1016/j.xnsj.2022.100136.Peer-Reviewed Original ResearchSingle-level posterior lumbar fusionPosterior lumbar fusionEhlers-Danlos syndromeMinor adverse eventsElixhauser Comorbidity IndexAdverse eventsEDS patientsAdult patientsLumbar fusionDanlos syndromeKaplan-Meier survival curvesRare connective tissue disorderPostoperative adverse eventsRate of reoperationRisk of complicationsNon-ED patientsLog-rank testConnective tissue disordersMultivariate logistical regressionSignificant differencesChi-square testPLF casesComorbidity indexReoperation rateRetrospective studyAdverse 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 range
2021
Postoperative bracing practices after elective lumbar spine surgery: A questionnaire study of U.S. spine surgeons
Pathak N, Scott MC, Galivanche AR, Burroughs PJ, Moore HG, Hilibrand AS, Malpani R, Justen M, Varthi AG, Grauer JN. Postoperative bracing practices after elective lumbar spine surgery: A questionnaire study of U.S. spine surgeons. North American Spine Society Journal (NASSJ) 2021, 5: 100055. PMID: 35141620, PMCID: PMC8820027, DOI: 10.1016/j.xnsj.2021.100055.Peer-Reviewed Original ResearchElective lumbar surgeryLumbar surgerySpine surgerySpine surgeonsElective lumbar spine surgeryMajority of respondentsElective spine surgeryUse of orthosesLumbar spine surgeryLateral interbody fusionNon-fusion surgeryDuration of useChi-square testType of braceEvidence-based practiceInterbody fusionLumbar fusionSurgeon respondentsSurgeryMost surgeonsSacral orthosisSurgeonsOrthosesOne-way analysisDemographic information
2020
Perioperative adverse events after different fusion approaches for single-level lumbar spondylosis
Gala RJ, Ottesen TD, Kahan JB, Varthi AG, Grauer JN. Perioperative adverse events after different fusion approaches for single-level lumbar spondylosis. North American Spine Society Journal (NASSJ) 2020, 1: 100005. PMID: 35141578, PMCID: PMC8820031, DOI: 10.1016/j.xnsj.2020.100005.Peer-Reviewed Original ResearchTransforaminal lumbar interbody fusionPerioperative adverse eventsPosterior spinal fusionLumbar spondylosisAdverse eventsLumbar fusionChi-squared testInterbody fusionNational Quality Improvement Program databaseQuality Improvement Program databaseSingle-level lumbar fusionPropensity scoreLong-term outcome studiesImprovement Program databaseGood surgical techniqueLong-term outcomesLow back painSingle-level fusionDifferent surgical approachesPosterior lumbar fusionLumbar interbody fusionPearson's chi-squared testDifferent fusion proceduresAP fusionPerioperative complications
2018
Adverse Events Following Posterior Lumbar Fusion: A Comparison of Spine Surgeons Perceptions and Reported Data for Rates and Risk Factors.
Ondeck NT, Bohl DD, Bovonratwet P, McLynn RP, Cui JJ, Samuel AM, Webb ML, Grauer JN. Adverse Events Following Posterior Lumbar Fusion: A Comparison of Spine Surgeons Perceptions and Reported Data for Rates and Risk Factors. The International Journal Of Spine Surgery 2018, 12: 603-610. PMID: 30364864, PMCID: PMC6198632, DOI: 10.14444/5074.Peer-Reviewed Original ResearchPosterior lumbar fusionPatient risk factorsAdverse eventsRisk factorsPatient factorsLumbar fusionDegenerative conditionsElective posterior lumbar fusionSpine surgeons’ perceptionPostoperative adverse eventsAdverse event ratesUrinary tract infectionDeep vein thrombosisInsulin-dependent diabetesPostoperative complicationsCurrent smokingTract infectionsVein thrombosisDependent diabetesNSQIP dataExpectation settingInclusion criteriaAmerican CollegeSpine surgeonsEvent ratesIncidence and considerations of 90-day readmissions following posterior lumbar fusion
Cui JJ, Gala RJ, Ondeck NT, McLynn RP, Bovonratwet P, Shultz B, Grauer JN. Incidence and considerations of 90-day readmissions following posterior lumbar fusion. The Spine Journal 2018, 19: 631-636. PMID: 30219360, DOI: 10.1016/j.spinee.2018.09.004.Peer-Reviewed Original ResearchConceptsPosterior lumbar fusionDays of dischargeReadmission ratesBaseline readmission ratesHuman Investigation CommitteeAdmission ratesDay readmissionLumbar fusionUtilization Project Nationwide Readmissions DatabaseAverage daily admission rateBaseline admission rateBundled payment plansNationwide Readmissions DatabaseHospital admission dataAverage admission rateDaily admission ratesCalendar yearCurrent quality metricsPLF patientsPatient demographicsPostoperative dayRetrospective studyPatient counselingPatient outcomesSpine surgerySystematic 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 CollegePatientsInaccuracies in ICD Coding for Obesity Would Be Expected to Bias Administrative Database Spine Studies Toward Overestimating the Impact of Obesity on Perioperative Adverse Outcomes
McLynn RP, Geddes BJ, Cui JJ, Ondeck NT, Bovonratwet P, Shultz BN, Grauer JN. Inaccuracies in ICD Coding for Obesity Would Be Expected to Bias Administrative Database Spine Studies Toward Overestimating the Impact of Obesity on Perioperative Adverse Outcomes. Spine 2018, 43: 526-532. PMID: 28767639, DOI: 10.1097/brs.0000000000002356.Peer-Reviewed Original ResearchConceptsBody mass indexMajor adverse eventsAdverse eventsICD codesVenous thromboembolismElective posterior lumbar fusionGreater body mass indexPerioperative adverse outcomesPostoperative adverse eventsRetrospective cohort studyAssociation of obesityImpact of obesityLength of stayPosterior lumbar fusionLarge academic hospitalSpine surgery literaturePostoperative complicationsPostoperative factorsCohort studyMass indexAdverse outcomesLumbar fusionAcademic hospitalBACKGROUND DATASpine studiesComparison 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 outcomes