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Article: Comparing Cortical Bone Trajectory and Traditional Pedicle Screws in Transforaminal Lumbar Interbody Fusion: A Retrospective Cohort Study of One-Year Outcomes.

Gutierrez, Juanmarco / Erwood, Andrew M / Malcolm, James G / Grogan, Dayton P / Greven, Alexander C / Gary, Matthew F / Rodts, Gerald E / Stricsek, Geoffrey P / Refai, Daniel

Cureus

2023 Volume 15, Issue 8, Page(s) e43237

Abstract: Introduction: This is a retrospective study of consecutive patients undergoing transforaminal lumbar interbody fusion (TLIF) at a single institution. The objective of this study was to compare the long-term results associated with cortical bone ... ...

Abstract	Introduction: This is a retrospective study of consecutive patients undergoing transforaminal lumbar interbody fusion (TLIF) at a single institution. The objective of this study was to compare the long-term results associated with cortical bone trajectory (CBT) and traditional pedicle screw (TPS) via posterolateral approach in TLIF. Methods: Consecutive patients treated from November 2014 to March 2019 were included in the CBT TLIF group, while consecutive patients treated from October 2010 to August 2017 were included in the TPS TLIF group. Inclusion criteria comprised single-level or two-level TLIF for degenerative spondylolisthesis with stenosis and at least one year of clinical and radiographic follow-up. Variables of interest included pertinent preoperative, perioperative, and postoperative data. Non-parametric evaluation was performed using the Wilcoxon test. Fisher's exact test was used to assess group differences for nominal data. Results: Overall, 140 patients met the inclusion criteria; 69 patients had CBT instrumentation (mean follow-up 526 days) and 71 patients underwent instrumentation placement via TPS (mean follow-up 825 days). Examination of perioperative and postoperative outcomes demonstrate comparable results between the groups with perioperative complications, length of stay, discharge destination, surgical revision rate, and fusion rates all being similar between groups (p = 0.1; p = 0.53; p = 0.091; p = 0.61; p = 0.665, respectively). Conclusions: CBT in the setting of TLIF offer equivalent outcomes to TPS with TLIF at both short- and long-term intervals of care.
Language	English
Publishing date	2023-08-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.43237
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Letter: Neurosurgical Management of Spinal Pathology Via Telemedicine During the COVID-19 Pandemic: Early Experience and Unique Challenges.

Greven, Alexander C M / Rich, Christopher W / Malcolm, James G / Bray, David P / Rodts, Gerald E / Refai, Daniel / Gary, Matthew F

Neurosurgery

2020 Volume 87, Issue 2, Page(s) E192–E196

Keywords	covid19
Language	English
Publishing date	2020-04-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	135446-2
ISSN	1524-4040 ; 0148-396X
ISSN (online)	1524-4040
ISSN	0148-396X
DOI	10.1093/neuros/nyaa165
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Article ; Online: Telemedicine in Spine Surgery: Outcomes for 138 Patients With Virtual Preoperative Assessment Compared to Historical Controls.

Greven, Alexander C M / McGinley, Beau M / Nakirikanti, Anudeep S / Couceyro, Jordan D / Malcolm, James G / Rodts, Gerald E / Refai, Daniel / Gary, Matthew F

World neurosurgery

2022 Volume 161, Page(s) e495–e499

Abstract: Introduction: COVID-19 has accelerated the use of telemedicine in all aspects of health care delivery, including initial surgical evaluation. No existing literature investigates the safety and efficacy of telemedicine to preoperatively evaluate spine ... ...

Abstract	Introduction: COVID-19 has accelerated the use of telemedicine in all aspects of health care delivery, including initial surgical evaluation. No existing literature investigates the safety and efficacy of telemedicine to preoperatively evaluate spine surgery candidates. Our objectives were: (1) Compare the change in visual analogue scale (VAS) scores between the telemedicine preoperative visit and in-person preoperative visit groups. (2) Compare the average surgical time, estimated blood loss (EBL), length of hospital stay (LOS), rates of intraoperative complications, rates of readmission, and rates of reoperation between the telemedicine preoperative visit and in-person preoperative visit groups. Methods: The previously stated metrics were collected for 276 patients, 138 who were exclusively evaluated preoperatively with telemedicine and 138 historical controls who were evaluated preoperatively in person. We used χ Results: There were no significant differences in the mean change in VAS scores (-2.7 ± 3.1 telemedicine vs. -2.2 ± 3.7 in-person, P = 0.317), mean percentage change in VAS scores (-40.5% ± 54.3% vs. -39.5% ± 66.6%, P = 0.811), mean surgical time (2.4 ± 1.4 hours vs. 2.3 ± 1.3 ours, P = 0.527), mean EBL (150.4 ± 173.3 mL vs. 156.7 ± 255.0 mL, P = 0.811), mean LOS (3.3 ± 2.4 days vs. 3.3 ± 2.5 days, P = 0.954), intraoperative complication rates (0.7% vs. 1.4%, P = 0.558), reoperation rates (7.9% vs. 4.3%, P = 0.208), or readmission rates (10.1% vs. 5.1%, P = 0.091) between the telemedicine preoperative visit and in-person preoperative visit groups. Conclusions: Preoperative evaluation via telemedicine leads to the same short-term surgical outcomes as in-person evaluation with no increased risk of surgical complications.
MeSH term(s)	Benchmarking ; COVID-19/epidemiology ; Humans ; Intraoperative Complications ; Length of Stay ; Telemedicine
Language	English
Publishing date	2022-02-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2022.02.041
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Article: Correction to: Low-chloride- versus high-chloride-containing hypertonic solution for the treatment of subarachnoid hemorrhage-related complications: The ACETatE (A low ChloriE hyperTonic solution for brain Edema) randomized trial.

Sadan, Ofer / Singbartl, Kai / Kraft, Jacqueline / Plancher, Joao McONeil / Greven, Alexander C M / Kandiah, Prem / Pimentel, Cederic / Hall, C L / Papangelou, Alexander / Asbury, William H / Hanfelt, John J / Samuels, Owen

Journal of intensive care

2020 Volume 8, Page(s) 66

Abstract: This corrects the article DOI: 10.1186/s40560-020-00449-0.]. ...

Abstract	[This corrects the article DOI: 10.1186/s40560-020-00449-0.].
Language	English
Publishing date	2020-09-01
Publishing country	England
Document type	Published Erratum
ZDB-ID	2739853-5
ISSN	2052-0492
ISSN	2052-0492
DOI	10.1186/s40560-020-00485-w
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Article: Low-chloride- versus high-chloride-containing hypertonic solution for the treatment of subarachnoid hemorrhage-related complications: The ACETatE (A low ChloriE hyperTonic solution for brain Edema) randomized trial.

Journal of intensive care

2020 Volume 8, Page(s) 32

Abstract: Background: Recent reports have demonstrated that among patients with subarachnoid hemorrhage (SAH) treated with hypertonic NaCl, resultant hyperchloremia has been associated with the development of acute kidney injury (AKI). We report a trial comparing ...

Abstract	Background: Recent reports have demonstrated that among patients with subarachnoid hemorrhage (SAH) treated with hypertonic NaCl, resultant hyperchloremia has been associated with the development of acute kidney injury (AKI). We report a trial comparing the effect of two hypertonic solutions with different chloride contents on the resultant serum chloride concentrations in SAH patients, with a primary outcome aimed at limiting chloride elevation. Methods: A low ChloridE hyperTonic solution for brain Edema (ACETatE) trial is a single-center, double-blinded, double-dummy, randomized pilot trial comparing bolus infusions of 23.4% NaCl and 16.4% NaCl/Na-acetate for the treatment of cerebral edema in patients with SAH. Randomization occurred when patients developed hyperchloremia (serum Cl Results: We enrolled 59 patients, of which 32 developed hyperchloremia and required hyperosmolar treatment. 15 patients were randomized to the 23.4% NaCl group, and 17 patients were randomized to the 16.4% NaCl/Na-acetate group. Although serum chloride levels increased similarly in both groups, the NaCl/Acetate group showed a significantly lower Cl Conclusions: Our pilot trial showed the feasibility and safety of replacing 23.4% NaCl infusions with 16.4% NaCl/Na-acetate infusions to treat cerebral edema in patients with SAH. The degree of hyperchloremia was similar in the two groups. 16.4% NaCl/Na-acetate infusions led to lower Cl Trial registration: clinicaltrials.gov # NCT03204955, registered on 6/28/2017.
Language	English
Publishing date	2020-05-04
Publishing country	England
Document type	Journal Article
ZDB-ID	2739853-5
ISSN	2052-0492
ISSN	2052-0492
DOI	10.1186/s40560-020-00449-0
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Article ; Online: Complication rate of overlapping versus nonoverlapping functional and stereotactic surgery: a retrospective cohort study.

Greven, Alexander C M / Douglas, J Miller / Nakirikanti, Anudeep S / Malcolm, James G / Campbell, Melissa / Easley, Kirk A / Laxpati, Nealen G / Lamanna, Jason J / Bray, David P / Howard, Brian M / Willie, Jon T / Boulis, Nicholas M / Gross, Robert E

Journal of neurosurgery

2022 Volume 138, Issue 4, Page(s) 1043–1049

Abstract: Objective: Overlapping surgery, in which one attending surgeon manages two overlapping operating rooms (ORs) and is present for all the critical portions of each procedure, is an important policy that improves healthcare access for patients and case ... ...

Abstract	Objective: Overlapping surgery, in which one attending surgeon manages two overlapping operating rooms (ORs) and is present for all the critical portions of each procedure, is an important policy that improves healthcare access for patients and case volumes for surgeons and surgical trainees. Despite several studies demonstrating the safety and efficacy of overlapping neurosurgical operations, the practice of overlapping surgery remains controversial. To date, there are no studies that have investigated long-term complication rates of overlapping functional and stereotactic neurosurgical procedures. The primary objective of this study was to investigate the 1-year complication rates and OR times for nonoverlapping versus overlapping functional procedures. The secondary objective was to gain insight into what types of complications are the most prevalent and test for differences between groups. Methods: Seven hundred eighty-three functional neurosurgical cases were divided into two cohorts, nonoverlapping (n = 342) and overlapping (n = 441). The American Society of Anesthesiologists (ASA) scale score was used to compare the preoperative risk for both cohorts. A complication was defined as any surgically related reason that required readmission, reoperation, or an unplanned emergency department or clinic visit that required intervention. Complications were subdivided into infectious and noninfectious. Chi-square tests, independent-samples t-tests, and uni- and multivariable logistic regressions were used to determine significance. Results: There were no significant differences in mean ASA scale score (2.7 ± 0.6 for both groups, p = 0.997) or overall complication rates (8.8% nonoverlapping vs 9.8% overlapping, p = 0.641) between the two cohorts. Infections accounted for the highest percentage of complications in both cohorts (46.6% vs 41.8%, p = 0.686). There were no statistically significant differences between mean in-room OR time (187.5 ± 141.7 minutes vs 197.1 ± 153.0 minutes, p = 0.373) or mean open-to-close time (112.2 ± 107.9 minutes vs 121.0 ± 123.1 minutes, p = 0.300) between nonoverlapping and overlapping cases. Conclusions: There was no increased risk of 1-year complications or increased OR time for overlapping functional and stereotactic neurosurgical procedures compared with nonoverlapping procedures.
MeSH term(s)	Humans ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Retrospective Studies ; Neurosurgical Procedures/adverse effects ; Neurosurgical Procedures/methods ; Reoperation/adverse effects ; Orthopedic Procedures/adverse effects
Language	English
Publishing date	2022-09-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	3089-2
ISSN	1933-0693 ; 0022-3085
ISSN (online)	1933-0693
ISSN	0022-3085
DOI	10.3171/2022.8.JNS212363
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Article: Letter: Neurosurgical Management of Spinal Pathology Via Telemedicine During the COVID-19 Pandemic: Early Experience and Unique Challenges

Greven, Alexander C M / Rich, Christopher W / Malcolm, James G / Bray, David P / Rodts, Gerald E / Refai, Daniel / Gary, Matthew F

Neurosurgery

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #133322
Database	COVID19

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Article ; Online: Letter

Greven, Alexander C M / Rich, Christopher W / Malcolm, James G / Bray, David P / Rodts, Gerald E / Refai, Daniel / Gary, Matthew F

Neurosurgery

Neurosurgical Management of Spinal Pathology Via Telemedicine During the COVID-19 Pandemic: Early Experience and Unique Challenges

2020 Volume 87, Issue 2, Page(s) E192–E196

Keywords	Surgery ; Clinical Neurology ; covid19
Language	English
Publisher	Oxford University Press (OUP)
Publishing country	uk
Document type	Article ; Online
ZDB-ID	135446-2
ISSN	1524-4040 ; 0148-396X
ISSN (online)	1524-4040
ISSN	0148-396X
DOI	10.1093/neuros/nyaa165
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Telemedicine in the Evaluation and Management of Neurosurgical Spine Patients: Questionnaire Assessment of 346 Consecutive Patients.

Greven, Alexander C M / McGinley, Beau M / Guisse, Ndeye F / McGee, Lynessa J / Pirkle, Sarah / Malcolm, James G / Rodts, Gerald E / Refai, Daniel / Gary, Matthew F

Spine

2020 Volume 46, Issue 7, Page(s) 472–477

Abstract: Study design: Retrospective questionnaire study of all patients seen via telemedicine during the COVID-19 pandemic at a large academic institution.: Objective: This aim of this study was to compare patient satisfaction of telemedicine clinic to in- ... ...

Abstract	Study design: Retrospective questionnaire study of all patients seen via telemedicine during the COVID-19 pandemic at a large academic institution. Objective: This aim of this study was to compare patient satisfaction of telemedicine clinic to in-person visits; to evaluate the preference for telemedicine to in-person visits; to assess patients' willingness to proceed with major surgery and/or a minor procedure based on a telemedicine visit alone. Summary of background data: One study showed promising utility of mobile health applications for spine patients. No studies have investigated telemedicine in the evaluation and management of spine patients. Methods: An 11-part questionnaire was developed to assess the attitudes toward telemedicine for all patients seen within a 7-week period during the COVID-19 crisis. Patients were called by phone to participate in the survey. χ2 and the Wilcoxon Rank-Sum Test were performed to determine significance. Results: Ninety-five percent were "satisfied" or "very satisfied" with their telemedicine visit, with 62% stating it was "the same" or "better" than previous in-person appointments. Patients saved a median of 105 minutes by using telemedicine compared to in-person visits. Fifty-two percent of patients have to take off work for in-person visits, compared to 7% for telemedicine. Thirty-seven percent preferred telemedicine to in-person visits. Patients who preferred telemedicine had significantly longer patient-reported in-person visit times (score mean of 171) compared to patients who preferred in-person visits (score mean of 137, P = 0.0007). Thirty-seven percent of patients would proceed with surgery and 73% would proceed with a minor procedure based on a telemedicine visit alone. Conclusion: Telemedicine can increase access to specialty care for patients with prolonged travel time to in-person visits and decrease the socioeconomic burden for both patients and hospital systems. The high satisfaction with telemedicine and willingness to proceed with surgery suggest that remote visits may be useful for both routine management and initial surgical evaluation for spine surgery candidates.Level of Evidence: 3.
MeSH term(s)	Adolescent ; Adult ; Aged ; Ambulatory Care Facilities ; COVID-19 ; Female ; Humans ; Male ; Middle Aged ; Pandemics ; Patient Satisfaction ; Retrospective Studies ; Spinal Diseases/surgery ; Spine/surgery ; Surveys and Questionnaires ; Telemedicine ; Young Adult
Keywords	covid19
Language	English
Publishing date	2020-11-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	752024-4
ISSN	1528-1159 ; 0362-2436
ISSN (online)	1528-1159
ISSN	0362-2436
DOI	10.1097/BRS.0000000000003821
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Article: Telemedicine in the Evaluation and Management of Neurosurgical Spine Patients: Questionnaire Assessment of 346 Consecutive Patients

Greven, Alexander C M / McGinley, Beau M / Guisse, Ndeye F / McGee, Lynessa J / Pirkle, Sarah / Malcolm, James G / Rodts, Gerald E / Refai, Daniel / Gary, Matthew F

Abstract: STUDY DESIGN: Retrospective questionnaire study of all patients seen via telemedicine during the COVID-19 pandemic at a large academic institution. OBJECTIVE: This study was to compare patient satisfaction of telemedicine clinic to in-person visits; to ... ...

Abstract	STUDY DESIGN: Retrospective questionnaire study of all patients seen via telemedicine during the COVID-19 pandemic at a large academic institution. OBJECTIVE: This study was to compare patient satisfaction of telemedicine clinic to in-person visits; to evaluate the preference for telemedicine to in-person visits; to assess patients' willingness to proceed with major surgery and/or a minor procedure based on a telemedicine visit alone. SUMMARY OF BACKGROUND DATA: One study showed promising utility of mobile health applications for spine patients. No studies have investigated telemedicine in the evaluation and management of spine patients. METHODS: An 11-part questionnaire was developed to assess the attitudes towards telemedicine for all patients seen within a 7-week period during the COVID-19 crisis. Patients were called by phone to participate in the survey. Chi squared and the Wilcoxon Rank-Sum Test were performed to determine significance. RESULTS: Ninety-five percent were "satisfied" or "very satisfied" with their telemedicine visit, with 62% stating it was "the same" or "better" than previous in-person appointments. Patients saved a median of 105 minutes by using telemedicine compared to in-person visits. Fifty-two percent of patients have to take off work for in-person visits, compared to 7% for telemedicine. Thirty-seven percent preferred telemedicine to in-person visits. Patients who preferred telemedicine had significantly longer patient reported in-person visit times (score mean of 171) compared to patients who preferred in-person visits (score mean of 137), pâ=â0.0007. Thirty-seven percent of patients would proceed with surgery and 73% would proceed with a minor procedure based on a telemedicine visit alone. CONCLUSIONS: Telemedicine can increase access to specialty care for patients with prolonged travel time to in-person visits and decrease the socioeconomic burden for both patients and hospital systems. The high satisfaction with telemedicine and willingness to proceed with surgery suggest that remote visits may be useful for both routine management and initial surgical evaluation for spine surgery candidates. LEVEL OF EVIDENCE: 3.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #927287
Database	COVID19

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