2024
Robotic Versus Navigation Assisted Posterior Lumbar Fusion: A National Database Study.
Gouzoulis M, Seddio A, Winter A, Jabbouri S, Zhu J, Rubio D, Varthi A, Grauer J. Robotic Versus Navigation Assisted Posterior Lumbar Fusion: A National Database Study. Spine 2024 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 index
2023
Lumbar Laminotomy: Variables Affecting 90-day Overall Reimbursement
Halperin S, Dhodapkar M, Gouzoulis M, Laurans M, Varthi A, Grauer J. Lumbar Laminotomy: Variables Affecting 90-day Overall Reimbursement. Journal Of The American Academy Of Orthopaedic Surgeons 2023, 32: 265-270. PMID: 38064482, DOI: 10.5435/jaaos-d-23-00365.Peer-Reviewed Original ResearchPostoperative adverse eventsAdverse eventsInsurance typePostoperative emergency department visitsPostoperative emergency departmentEmergency department visitsElixhauser Comorbidity IndexMultivariable linear regression modelsMultivariable linear regressionHealthcare deliveryIndications of traumaPostoperative readmissionsComorbidity indexInfectious diagnosisConservative treatmentPerioperative dataDepartment visitsEmergency departmentOutpatient surgeryLarge cohortSpinal proceduresExclusion criteriaDiskectomyOverall reimbursementCommon procedure
2022
Demographic and economic trends in vertebral fracture surgeries throughout the United States
Beschloss AM, Taghlabi KM, Rodriguez DA, Lee N, Gupta S, Bondar K, Lombardi JM, Varthi A, Faraji A, Saifi C. Demographic and economic trends in vertebral fracture surgeries throughout the United States. North American Spine Society Journal (NASSJ) 2022, 12: 100175. PMID: 36281323, PMCID: PMC9587355, DOI: 10.1016/j.xnsj.2022.100175.Peer-Reviewed Original ResearchFracture surgeryNational Inpatient SampleVertebral fracturesHospital costsRelevant public health concernHealth care utilizationHigh-impact traumaRate of fracturesPublic health concernValue-based careInpatient mortalityPatient ageSurgical treatmentCare utilizationHospital chargesMean ageInpatient SampleInsurance typeMortality rateSurgeryDemographic dataSuch fracturesMore surgeonsUnderlying causeHealth concernComparison of postoperative outcomes in patients with and without osteoporosis undergoing single-level anterior cervical discectomy and fusion
Kammien AJ, Galivanche AR, Joo PY, Elaydi A, Whang P, Saifi C, Grauer JN, Varthi A. Comparison of postoperative outcomes in patients with and without osteoporosis undergoing single-level anterior cervical discectomy and fusion. North American Spine Society Journal (NASSJ) 2022, 12: 100174. PMID: 36299450, PMCID: PMC9589019, DOI: 10.1016/j.xnsj.2022.100174.Peer-Reviewed Original ResearchSingle-level anterior cervical discectomyAnterior cervical discectomyAdverse eventsCervical discectomySingle-level ACDF proceduresSurgical planningComorbidity-matched patientsPerioperative adverse eventsSingle-level ACDFLog-rank analysisLong-term outcomesNational administrative databaseSetting of osteoporosisACDF proceduresConcomitant proceduresPatient characteristicsPostoperative outcomesGraft subsidenceOsteoporosis groupBony unionPatient counselingPatient counsellingAdministrative databasesReoperationExclusion criteriaIn-hospital complications after cervical fusion in cases with versus without cerebral palsy
Galivanche AR, Gillinov SM, Mercier MR, Schneble CA, Varthi AG, Grauer JN, Frumberg DB. In-hospital complications after cervical fusion in cases with versus without cerebral palsy. North American Spine Society Journal (NASSJ) 2022, 12: 100167. PMID: 36132746, PMCID: PMC9483629, DOI: 10.1016/j.xnsj.2022.100167.Peer-Reviewed Original ResearchMinor adverse eventsCerebral palsyHospital complicationsAdverse eventsCervical fusionNational Inpatient Sample databaseMultiple logistic regression modelHospital adverse eventsCervical spine pathologyCervical fusion surgeryRetrospective cohort designMultiple logistic regressionLogistic regression modelsHospital mortalityMore comorbiditiesHospital morbidityHospital stayPerioperative outcomesPreoperative variablesPropensity matchingSurgical interventionFusion surgeryCohort designSpine pathologyCervical pathologyA comparison of in-hospital outcomes after elective anterior cervical discectomy and fusion in cases with and without Parkinson's Disease
Galivanche AR, Schneble CA, David WB, Mercier MR, Kammien AJ, Ottesen TD, Saifi C, Whang PG, Grauer JN, Varthi AG. A comparison of in-hospital outcomes after elective anterior cervical discectomy and fusion in cases with and without Parkinson's Disease. North American Spine Society Journal (NASSJ) 2022, 12: 100164. PMID: 36304443, PMCID: PMC9594612, DOI: 10.1016/j.xnsj.2022.100164.Peer-Reviewed Original ResearchMinor adverse eventsSerious adverse eventsAnterior cervical discectomyAdverse eventsParkinson's diseaseElective ACDFComorbidity burdenCervical discectomyMedical complicationsPD casesElective anterior cervical discectomyNational Inpatient Sample databaseGreater riskAssociation of PDCervical degenerative pathologyPostoperative medical complicationsLogistic regression modelsHospital complicationsHospital outcomesComplication rateSurgical complicationsUnmatched populationACDF casesSurgical interventionComorbidity variablesCorrelation of Patient Reported Satisfaction With Adverse Events Following Elective Posterior Lumbar Fusion Surgery: A Single Institution Analysis
Mercier MR, Galivanche AR, McLean R, Kammien AJ, Toombs CS, Rubio DR, Varthi AG, Grauer JN. Correlation of Patient Reported Satisfaction With Adverse Events Following Elective Posterior Lumbar Fusion Surgery: A Single Institution Analysis. North American Spine Society Journal (NASSJ) 2022, 12: 100160. PMID: 36118954, PMCID: PMC9478916, DOI: 10.1016/j.xnsj.2022.100160.Peer-Reviewed Original ResearchPosterior lumbar fusion surgeryLumbar fusion surgeryAdverse eventsHCAHPS surveyPLF surgeryFusion surgerySelf-reported patient satisfactionPostoperative adverse eventsRetrospective cohort analysisPost-discharge careSingle-institution analysisHospital Consumer AssessmentPatient satisfaction metricsCorrelation of patientsHCAHPS survey dataTop-box responsesPLF patientsSurvey response ratePatient satisfactionSingle institutionHospital experiencePatients' perceptionsHospital careCohort analysisPatientsUnderweight 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 infectionCharacteristics, Management, and Outcomes of Patients With Osteosarcoma: An Analysis of Outcomes From the National Cancer Database
Ottesen TD, Shultz BN, Munger AM, Sibindi C, Yurter A, Varthi AG, Grauer JN. Characteristics, Management, and Outcomes of Patients With Osteosarcoma: An Analysis of Outcomes From the National Cancer Database. JAAOS Global Research And Reviews 2022, 6: e22.00009. PMID: 35192571, PMCID: PMC8865506, DOI: 10.5435/jaaosglobal-d-22-00009.Peer-Reviewed Original ResearchConceptsLikelihood of deathDistant metastasisKaplan-Meier survival curvesNational Cancer DatabaseOutcomes of patientsPoor prognostic signMultivariate Cox analysisMeier survival curvesAnalysis of outcomesPatient characteristicsCox analysisPrognostic signSurgical excisionMale sexPatient survivalPatient numbersCancer DatabasePatient variablesTumor managementPrimary siteTumor typesSurvival curvesTreatment dataOsteosarcomaPatients
2021
COVID-positive ankle fracture patients are at increased odds of perioperative surgical complications following open reduction internal fixation surgery
Mercier MR, Galivanche AR, Brand JP, Pathak N, Medvecky MJ, Varthi AG, Rubin LE, Grauer JN. COVID-positive ankle fracture patients are at increased odds of perioperative surgical complications following open reduction internal fixation surgery. PLOS ONE 2021, 16: e0262115. PMID: 34972190, PMCID: PMC8719674, DOI: 10.1371/journal.pone.0262115.Peer-Reviewed Original ResearchConceptsCOVID-positive patientsAnkle fracture surgeryPerioperative adverse eventsAdverse eventsAnkle fracture patientsFracture surgeryFracture patientsOperative interventionAnkle fracturesPropensity matchingCOVID statusOpen reduction internal fixation surgeryPerioperative adverse outcomesPerioperative surgical complicationsMinor adverse eventsPostoperative adverse eventsSerious adverse eventsChronic kidney diseaseCOVID-19 Research DatabaseLong-term outcomesInternal fixation surgeryBasis of agePropensity-score matchingPostoperative complicationsNegative patients
2018
Different 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 database
2016
Is Outpatient Total Hip Arthroplasty Safe?
Nelson SJ, Webb ML, Lukasiewicz AM, Varthi AG, Samuel AM, Grauer JN. Is Outpatient Total Hip Arthroplasty Safe? The Journal Of Arthroplasty 2016, 32: 1439-1442. PMID: 28065622, DOI: 10.1016/j.arth.2016.11.053.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedArthroplasty, Replacement, HipBlood TransfusionDatabases, FactualFemaleHumansInpatientsLength of StayLogistic ModelsMaleMiddle AgedMultivariate AnalysisOutpatientsPatient DischargePatient ReadmissionPatient SafetyPoisson DistributionPostoperative ComplicationsPropensity ScoreQuality ImprovementRegression AnalysisRetrospective StudiesYoung AdultConceptsOutpatient total hip arthroplastyTotal hip arthroplastyAdverse eventsPropensity scoreSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseGeneral health outcome measuresDays adverse eventsImprovement Program databaseMultivariate Poisson regressionHealth outcome measuresHospital dischargePostoperative dayBlood transfusionExtended LOSTHA patientsPotential confoundersInpatient proceduresProgram databaseRelative riskHip arthroplastyOutcome measuresSafety dataStudy groupPerioperative Outcomes After Cervical Laminoplasty Versus Posterior Decompression and Fusion
Varthi AG, Basques BA, Bohl DD, Golinvaux NS, Grauer JN. Perioperative Outcomes After Cervical Laminoplasty Versus Posterior Decompression and Fusion. Clinical Spine Surgery A Spine Publication 2016, 29: e226-e232. PMID: 25310393, DOI: 10.1097/bsd.0000000000000183.Peer-Reviewed Original ResearchConceptsMultilevel cervical pathologyBaseline patient characteristicsCervical laminoplastyShort-term outcomesPosterior decompressionLaminoplasty patientsFusion patientsCervical decompressionAdverse eventsPatient characteristicsCervical pathologySurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databasePropensity-adjusted multivariate analysisQuality Improvement Program databaseWorse short-term outcomesCharlson Comorbidity IndexPosterior cervical decompressionRetrospective cohort studyImprovement Program databaseLength of stayBivariate logistic regressionAnesthesiologists (ASA) scoreComorbidity indexPerioperative outcomesVariation in Resource Utilization for Patients With Hip and Pelvic Fractures Despite Equal Medicare Reimbursement
Samuel AM, Webb ML, Lukasiewicz AM, Basques BA, Bohl DD, Varthi AG, Lane JM, Grauer JN. Variation in Resource Utilization for Patients With Hip and Pelvic Fractures Despite Equal Medicare Reimbursement. Clinical Orthopaedics And Related Research® 2016, 474: 1486-1494. PMID: 26913512, PMCID: PMC4868172, DOI: 10.1007/s11999-016-4765-8.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overDiagnosis-Related GroupsFee-for-Service PlansFemaleFracture FixationHealth ResourcesHip FracturesHospital CostsHumansIntensive Care UnitsLength of StayMaleMedicarePatient Care BundlesPelvic BonesProcess Assessment, Health CareRegistriesRespiration, ArtificialRetrospective StudiesTime FactorsTrauma CentersTreatment OutcomeUnited StatesConceptsIntensive care unitDiagnosis-related groupsPelvic fracturesHip fractureInpatient lengthAcetabulum fracturesVentilator timeICU lengthHospital factorsVentilation timePelvis fracturesIntensive care unit stayNational Trauma Data BankTotal inpatient lengthTrue hospital costsMechanical ventilation timeInpatient resource utilizationHigh-energy traumaTrauma Data BankIncidence of fracturesNonoperative fracturesUnit stayTrauma patientsCare unitPelvic traumaSpinal Fracture in Patients With Ankylosing Spondylitis
Lukasiewicz AM, Bohl DD, Varthi AG, Basques BA, Webb ML, Samuel AM, Grauer JN. Spinal Fracture in Patients With Ankylosing Spondylitis. Spine 2016, 41: 191-196. PMID: 26579959, DOI: 10.1097/brs.0000000000001190.Peer-Reviewed Original ResearchConceptsNational Inpatient SampleSpinal fracturesAdverse eventsCervical fracturesSpinal columnHospital adverse eventsMortality of fracturesSmall case seriesSpinal cord injuryAnkylosed spinePatient demographicsRetrospective cohortThoracic fracturesCase seriesHigh morbidityInjury characteristicsInpatient stayMinor traumaCord injuryPatient populationCase reportInpatient SampleBACKGROUND DATAHigh riskPatientsCeramic-on-Ceramic Total Hip Arthroplasty in a Twelve-Year-Old Patient: Case Report with a 27-Year Follow-Up.
Save AV, Varthi A, Talusan PG, Gala R, Nelson S, Keggi KJ. Ceramic-on-Ceramic Total Hip Arthroplasty in a Twelve-Year-Old Patient: Case Report with a 27-Year Follow-Up. Connecticut Medicine 2016, 80: 341-5. PMID: 27509640.Peer-Reviewed Original ResearchConceptsTotal hip arthroplastyCeramic total hip arthroplastyHip arthroplastyJuvenile patientsCase reportTwelve-year-old patientLong-term pain reliefJuvenile rheumatoid arthritisFemoral component looseningPain reliefRheumatoid arthritisExcellent outcomesRevision surgeryComponent looseningPatientsArthroplastyAge 12Hip prosthesisReportArthritisSurgeryYearsHip
2015
Overall Similar Infection Rates Reported in the Physician-reported Scoliosis Research Society Database and the Chart-abstracted American College of Surgeons National Surgical Quality Improvement Program Database
Webb ML, Lukasiewicz AM, Samuel AM, Bohl DD, Basques BA, Varthi AG, Grauer JN. Overall Similar Infection Rates Reported in the Physician-reported Scoliosis Research Society Database and the Chart-abstracted American College of Surgeons National Surgical Quality Improvement Program Database. Spine 2015, 40: 1431-1435. PMID: 26110664, DOI: 10.1097/brs.0000000000001033.Peer-Reviewed Original ResearchConceptsACS-NSQIP databaseSurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseQuality Improvement Program databaseImprovement Program databaseInfection rateSRS databasePostoperative infectionProgram databaseAmerican CollegeScoliosis Research Society MorbidityAcute postoperative infectionSurgeon-reported dataPostoperative infection rateRetrospective cohort studyNinth Revision codesSimilar infection ratesDegenerative spondylolithesisCohort studyScheuermann's kyphosisSurgical databaseRevision codesSurgical correctionBACKGROUND DATASurgical casesDo You Need Bone Graft Extenders for a 2- to 3-Level Posterior Lumbar Decompression and Fusion With Adequate Local Bone?
Varthi AG, Whang PG, Sasso RC, Smucker JD. Do You Need Bone Graft Extenders for a 2- to 3-Level Posterior Lumbar Decompression and Fusion With Adequate Local Bone? Clinical Spine Surgery A Spine Publication 2015, 28: 159-162. PMID: 25985462, DOI: 10.1097/bsd.0000000000000283.Peer-Reviewed Original Research
2014
Risk Factors for Short-term Adverse Events and Readmission After Arthroscopic Meniscectomy
Basques BA, Gardner EC, Varthi AG, Fu MC, Bohl DD, Golinvaux NS, Grauer JN. Risk Factors for Short-term Adverse Events and Readmission After Arthroscopic Meniscectomy. The American Journal Of Sports Medicine 2014, 43: 169-175. PMID: 25294869, DOI: 10.1177/0363546514551923.Peer-Reviewed Original ResearchConceptsSevere adverse eventsAdverse eventsRisk factorsMedical comorbiditiesOlder patientsArthroscopic meniscectomySurgeons National Surgical Quality Improvement Program databaseNational Surgical Quality Improvement Program databaseShort-term adverse eventsQuality Improvement Program databaseMultivariate logistic regression analysisOdds of readmissionPostoperative adverse eventsImprovement Program databaseHistory of smokingCase-control studyEvidence of osteoarthritisLevel of evidenceLogistic regression analysisComorbidity burdenPulmonary diseasePatient selectionPreoperative counselingCommon surgeryMean ageUse of an Operating Microscope During Spine Surgery Is Associated With Minor Increases in Operating Room Times and No Increased Risk of Infection
Basques BA, Golinvaux NS, Bohl DD, Yacob A, Toy JO, Varthi AG, Grauer JN. Use of an Operating Microscope During Spine Surgery Is Associated With Minor Increases in Operating Room Times and No Increased Risk of Infection. Spine 2014, 39: 1910-1916. PMID: 25188600, PMCID: PMC4192002, DOI: 10.1097/brs.0000000000000558.Peer-Reviewed Original ResearchConceptsOperating room timeRisk of infectionDay of surgerySurgical site infectionRoom timeSpine proceduresSite infectionOperative timeSpine surgeryNational Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement Program databaseMicroscope useMultivariate analysisDeep surgical site infectionSepsis/septic shockQuality Improvement Program databaseSuperficial surgical site infectionElective spinal proceduresElective spine proceduresOrgan space infectionAverage patient ageImprovement Program databaseAverage operative timeRetrospective database reviewMultivariate logistic regression