2022
Postoperative spine surgical site infections: high rate of failure of one-stage irrigation and debridement
Dhodapkar M, Galivanche A, Halperin S, Elaydi A, Rubio D, Grauer J. Postoperative spine surgical site infections: high rate of failure of one-stage irrigation and debridement. The Spine Journal 2022, 23: 484-491. PMID: 36549456, DOI: 10.1016/j.spinee.2022.12.005.Peer-Reviewed Original ResearchConceptsSurgical site infectionElective spine surgerySpine surgeryInitial managementRate of SSIInfection characteristicsSpine surgical site infectionPostoperative surgical site infectionRetrospective case-control studyPresence of bacteremiaRisk stratification toolCase-control studySingle academic institutionTimes greater oddsDevastating complicationSite infectionMultivariable analysisStratification toolSurgical managementSurgical variablesIndex procedureSurgical interventionRisk factorsInclusion criteriaLarge cohortAnalysis of the Frequency, Characteristics, and Reasons for Termination of Spine-related Clinical Trials
Caruana DL, Kim D, Galivanche AR, David WB, Justen MA, Moushey AM, Sheth AH, Paranjpe MD, Grauer JN. Analysis of the Frequency, Characteristics, and Reasons for Termination of Spine-related Clinical Trials. Clinical Spine Surgery A Spine Publication 2022, 35: e596-e600. PMID: 35351841, DOI: 10.1097/bsd.0000000000001323.Peer-Reviewed Original ResearchConceptsClinical trialsTrial terminationTrial characteristicsMultivariate analysisCross-sectional analysisInvestigation of drugsInsufficient accrualResults databaseInterventional studyDetermine predictorsClinical studiesBACKGROUND DATACommon reasonAssess reasonsRecruitment statusTrialsPredictors of terminationSearch termsSpineCompletion ratesRegistryPredictorsStudyTermination
2020
Industry Payments to Orthopedic Spine Surgeons Reported by the Open Payments Database
Pathak N, Mercier MR, Galivanche AR, Mets EJ, Bovonratwet P, Bagi PS, Varthi AG, Grauer JN. Industry Payments to Orthopedic Spine Surgeons Reported by the Open Payments Database. Clinical Spine Surgery A Spine Publication 2020, 33: e572-e578. PMID: 32324671, DOI: 10.1097/bsd.0000000000000993.Peer-Reviewed Original Research
2019
Admission NarxCare Narcotics Scores are not Associated With Adverse Surgical Outcomes or Self-reported Patient Satisfaction Following Elective Spine Surgery.
Galivanche AR, Mercier MR, Adrados M, Pathak N, McLynn RP, Anandasivam NS, Varthi AG, Rubin LE, Grauer JN. Admission NarxCare Narcotics Scores are not Associated With Adverse Surgical Outcomes or Self-reported Patient Satisfaction Following Elective Spine Surgery. Spine 2019, 44: 1515-1522. PMID: 31356498, DOI: 10.1097/brs.0000000000003120.Peer-Reviewed Original ResearchConceptsMultivariate logistic regressionPatient satisfactionAdverse eventsNarcotic scoreSurvey response rateSpine surgeryResponse rateLogistic regressionSelf-reported patient satisfactionElective spine surgeryPreoperative opioid usePostoperative patient satisfactionTime of admissionAdverse surgical outcomesSpine surgery casesHospital Consumer AssessmentHCAHPS survey resultsDifferent narcoticsNarcotic usagePerioperative outcomesNarcotic utilizationOpioid usePatient characteristicsPostoperative outcomesNarcotic groupCardiac Complications Related to Spine Surgery: Timing, Risk Factors, and Clinical Effect.
Bovonratwet P, Bohl DD, Malpani R, Haynes MS, Rubio DR, Ondeck NT, Shultz BN, Mahal AR, Grauer JN. Cardiac Complications Related to Spine Surgery: Timing, Risk Factors, and Clinical Effect. Journal Of The American Academy Of Orthopaedic Surgeons 2019, 27: 256-263. PMID: 30897607, DOI: 10.5435/jaaos-d-17-00650.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overDatabases, FactualFemaleHeart ArrestHumansIncidenceIntraoperative ComplicationsLength of StayMaleMiddle AgedMonitoring, PhysiologicMultivariate AnalysisMyocardial InfarctionOrthopedic ProceduresPatient ReadmissionPerioperative PeriodPostoperative ComplicationsRisk FactorsSpineTime FactorsYoung AdultConceptsCardiac complicationsSpine surgeryRisk factorsPostoperative periodNational Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement ProgramNational Surgical Quality Improvement ProgramQuality Improvement Program databaseSurgical Quality Improvement ProgramPerioperative cardiac complicationsHigh-risk patientsImprovement Program databaseInsulin-dependent diabetesLarge cohort studyQuality Improvement ProgramPreoperative anemiaPostoperative lengthCohort studyPerioperative periodPrimary outcomeClinical effectsCardiac arrestMyocardial infarctionProgram databaseAmerican College
2018
Dialysis is an independent risk factor for perioperative adverse events, readmission, reoperation, and mortality for patients undergoing elective spine surgery
Ottesen TD, McLynn RP, Zogg CK, Shultz BN, Ondeck NT, Bovonratwet P, Bellamkonda KS, Rubin LE, Grauer JN. Dialysis is an independent risk factor for perioperative adverse events, readmission, reoperation, and mortality for patients undergoing elective spine surgery. The Spine Journal 2018, 18: 2033-2042. PMID: 30077772, DOI: 10.1016/j.spinee.2018.04.007.Peer-Reviewed Original ResearchConceptsElective spine surgeryNon-dialysis patientsDialysis-dependent patientsPerioperative adverse eventsAdverse eventsDialysis patientsSpine surgeryUnplanned readmissionCohort studyPatient demographicsRisk factorsNational Surgical Quality Improvement Program databaseRisk-adjusted multivariate regressionsQuality Improvement Program databaseOperating roomDialysis-independent patientsInstitutional cohort studyMinor adverse eventsRetrospective cohort studyElective spinal surgeryImprovement Program databaseIndependent risk factorMajor adverse eventsPercentage of complicationsAdministrative database studyIncidence, Risk Factors, and Impact of Clostridium difficile Colitis After Spine Surgery
Bovonratwet P, Bohl DD, Russo GS, Ondeck NT, Singh K, Grauer JN. Incidence, Risk Factors, and Impact of Clostridium difficile Colitis After Spine Surgery. Spine 2018, 43: 861-868. PMID: 28953711, DOI: 10.1097/brs.0000000000002430.Peer-Reviewed Original ResearchConceptsClostridium difficile colitisDifficile colitisIndependent risk factorSpine surgical proceduresRisk factorsSpine surgerySurgical proceduresPosterior lumbar fusion proceduresPost-hospitalization followSpine surgery patientsHigh-risk patientsLarge cohort studyLumbar fusion proceduresPre-existing infectionLarge national databasePostoperative lengthCohort studyNSQIP databasePostoperative periodSurgery patientsPrimary outcomeRetrospective studyDifficile infectionClinical impactInfection diagnosisInaccuracies 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 studies
2017
Results of Database Studies in Spine Surgery Can Be Influenced by Missing Data
Basques BA, McLynn RP, Fice MP, Samuel AM, Lukasiewicz AM, Bohl DD, Ahn J, Singh K, Grauer JN. Results of Database Studies in Spine Surgery Can Be Influenced by Missing Data. Clinical Orthopaedics And Related Research® 2017, 475: 2893-2904. PMID: 27896677, PMCID: PMC5670041, DOI: 10.1007/s11999-016-5175-7.Peer-Reviewed Original ResearchMeSH KeywordsComorbidityData AccuracyData CollectionData MiningDatabases, FactualDecision Support TechniquesHumansLength of StayLogistic ModelsMultivariate AnalysisOdds RatioOperative TimeOrthopedic ProceduresPostoperative ComplicationsPredictive Value of TestsProcess Assessment, Health CareRetrospective StudiesRisk AssessmentRisk FactorsSpinal DiseasesSpineTime FactorsTreatment OutcomeUnited StatesConceptsACS-NSQIP databaseAdverse eventsPreoperative laboratory valuesRisk factorsSpine surgeryOperating room timeLaboratory valuesSpine studiesACS-NSQIPDatabase studyRoom timeReference rangeQuality Improvement Program databasePerioperative laboratory valuesVariable reference rangesAnterior cervical discectomyImprovement Program databaseMost risk factorsLength of stayLarge database studiesDifferent risk factorsEffect sizeCervical discectomyMedical comorbiditiesGreater effect sizeThe Rothman Index as a predictor of postdischarge adverse events after elective spine surgery
McLynn RP, Ondeck NT, Cui JJ, Swanson DR, Shultz BN, Bovonratwet P, Grauer JN. The Rothman Index as a predictor of postdischarge adverse events after elective spine surgery. The Spine Journal 2017, 18: 1149-1156. PMID: 29155251, DOI: 10.1016/j.spinee.2017.11.008.Peer-Reviewed Original ResearchConceptsElective spine surgeryPostdischarge adverse eventsMinor adverse eventsMajor adverse eventsAdverse eventsRothman IndexSpine surgeryMedical CenterOverall patient conditionRothman Index scoresHigh-risk patientsRate of readmissionRetrospective cohort studyLarge academic medical centerPostoperative day 30Body mass indexLength of stayAcademic medical centerPresent studyElectronic medical recordsLater scoresAnesthesiologists classHospital lengthPerioperative outcomesCohort studyRisk factors and pharmacologic prophylaxis for venous thromboembolism in elective spine surgery
McLynn RP, Diaz-Collado PJ, Ottesen TD, Ondeck NT, Cui JJ, Bovonratwet P, Shultz BN, Grauer JN. Risk factors and pharmacologic prophylaxis for venous thromboembolism in elective spine surgery. The Spine Journal 2017, 18: 970-978. PMID: 29056565, DOI: 10.1016/j.spinee.2017.10.013.Peer-Reviewed Original ResearchConceptsElective spine surgeryPrior venous thromboembolismPharmacologic prophylaxisVenous thromboembolismAssociation of patientSpine surgeryRisk factorsUnfractionated heparinVTE prophylaxisInstitutional cohortNational Surgical Quality Improvement Program databaseElective spine surgery patientsRate of VTEQuality Improvement Program databaseDependent functional statusPerioperative blood transfusionRetrospective cohort studySpine surgery patientsImprovement Program databaseIndependent risk factorRetrospective cohort analysisIncidence of hematomaLonger operative timeLumbar spine surgerySingle-institution cohort
2014
CORR Insights®: Incidence of Surgical Site Infection After Spine Surgery: What Is the Impact of the Definition of Infection?
Grauer JN, Samuel AM. CORR Insights®: Incidence of Surgical Site Infection After Spine Surgery: What Is the Impact of the Definition of Infection? Clinical Orthopaedics And Related Research® 2014, 473: 1620-1621. PMID: 25315280, PMCID: PMC4385354, DOI: 10.1007/s11999-014-4002-2.Peer-Reviewed Original ResearchUse 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“July Effect” in Elective Spine Surgery
Bohl DD, Fu MC, Gruskay JA, Basques BA, Golinvaux NS, Grauer JN. “July Effect” in Elective Spine Surgery. Spine 2014, 39: 603-611. PMID: 24384663, DOI: 10.1097/brs.0000000000000196.Peer-Reviewed Original ResearchConceptsSerious adverse eventsElective spine surgeryAdverse eventsJuly effectSpine surgeryResident involvementNational Surgical Quality Improvement Program databaseSurgeons National Surgical Quality Improvement Program databaseQuality Improvement Program databaseImprovement Program databaseMultivariate logistic regressionFirst academic quarterRetrospective cohortProgram databaseInclusion criteriaStudy populationBACKGROUND DATAAmerican CollegeLogistic regressionPatient safetySurgeryConflicting resultsRisky populationTraining periodInvolvement
2009
Reviewer’s comment concerning “the effect of intraoperative skeletal (skull-femoral) traction in apical vertebral rotation” by St Lewis et al. (MS-no: ESJO-D-08-00312R1)
Grauer JN. Reviewer’s comment concerning “the effect of intraoperative skeletal (skull-femoral) traction in apical vertebral rotation” by St Lewis et al. (MS-no: ESJO-D-08-00312R1). European Spine Journal 2009, 18: 357-357. PMID: 19172310, PMCID: PMC2899421, DOI: 10.1007/s00586-009-0882-3.Commentaries, Editorials and Letters
2008
Sterility of C-arm Fluoroscopy During Spinal Surgery
Biswas D, Bible JE, Whang PG, Simpson AK, Grauer JN. Sterility of C-arm Fluoroscopy During Spinal Surgery. Spine 2008, 33: 1913-1917. PMID: 18622356, DOI: 10.1097/brs.0b013e31817bb130.Peer-Reviewed Original ResearchConceptsPostoperative infectionSurgical casesC-armSwab samplesNegative controlSterile culture swabC-arm fluoroscopyPlacement of instrumentationProspective studyPostoperative contaminationSpinal surgerySpine surgeryIntraoperative contaminationIntraoperative fluoroscopySpinal alignmentBACKGROUND DATAFluoroscopic C-armSpinal operationsSpine surgeonsCulture swabsWhich Regions of the Operating Gown Should be Considered Most Sterile?
Bible JE, Biswas D, Whang PG, Simpson AK, Grauer JN. Which Regions of the Operating Gown Should be Considered Most Sterile? Clinical Orthopaedics And Related Research® 2008, 467: 825-830. PMID: 18592330, PMCID: PMC2635444, DOI: 10.1007/s11999-008-0341-1.Peer-Reviewed Original Research
2007
Questionnaire Study of Neuromonitoring Availability and Usage for Spine Surgery
Magit DP, Hilibrand AS, Kirk J, Rechtine G, Albert TJ, Vaccaro AR, Simpson AK, Grauer JN. Questionnaire Study of Neuromonitoring Availability and Usage for Spine Surgery. Clinical Spine Surgery A Spine Publication 2007, 20: 282-289. PMID: 17538352, DOI: 10.1097/01.bsd.0000211286.98895.ea.Peer-Reviewed Original ResearchConceptsNeuromonitoring modalitiesSpine surgeonsThoracolumbar casesSpine surgerySurgeon preferenceIatrogenic neurologic injuryMotor-evoked potentialsPosterior cervical surgeryFellowship-trained surgeonsQuestionnaire studyOrthopedic spine surgeonsNeurosurgeon's preferenceCervical surgeryNeurologic statusNeurologic injuryCervical casesSurgeon satisfactionBACKGROUND DATASpinal proceduresSurgical proceduresSpecific indicationsSpine meetingsPreferred modalityDemographic dataNeuromonitoring
2006
Metastatic disease of the spine.
White AP, Kwon BK, Lindskog DM, Friedlaender GE, Grauer JN. Metastatic disease of the spine. Journal Of The American Academy Of Orthopaedic Surgeons 2006, 14: 587-98. PMID: 17030592, DOI: 10.5435/00124635-200610000-00001.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsTomography-guided biopsyIndividual patient factorsMetastatic spine diseaseLimitation of motionNew cancer diagnosesMagnetic resonance imagingAxial painCord compressionSurgical decompressionLocal tendernessMetastatic diseaseAnterior approachBone scanPatient factorsNeurologic compromiseNerve rootsPlain radiographsFrequent presentationPainful lesionsSpinal lesionsSpine diseaseRadionuclide studiesSpinal instabilitySpinal examinationSpine surgeonsHealos/Recombinant Human Growth and Differentiation Factor-5 Induces Posterolateral Lumbar Fusion in a New Zealand White Rabbit Model
Magit DP, Maak T, Trioano N, Raphael B, Hamouria Q, Polzhofer G, Drespe I, Albert TJ, Grauer JN. Healos/Recombinant Human Growth and Differentiation Factor-5 Induces Posterolateral Lumbar Fusion in a New Zealand White Rabbit Model. Spine 2006, 31: 2180-2188. PMID: 16946651, DOI: 10.1097/01.brs.0000232823.82106.0a.Peer-Reviewed Original ResearchConceptsRecombinant human growthDifferentiation factor 5Fusion ratePosterolateral lumbar spine fusionPosterolateral lumbar fusionIliac crest autograftLumbar spine fusionNew Zealand white rabbitsNew Zealand white rabbit modelZealand white rabbitsRabbit fusion modelWhite rabbit modelIntertransverse process fusionBone graft alternativesCrest autograftLumbar fusionBACKGROUND DATAHistologic differencesPreclinical studiesSpine fusionTreatment groupsFactor 5Histologic analysisBone graftFusion mass