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Article ; Online: In Reply to the Letter to the Editor Regarding "Early Changes to Neurosurgery Resident Training During the COVID-19 Pandemic at a Large United States Academic Medical Center".

Burks, Joshua D / Luther, Evan M / Komotar, Ricardo J

2021 Volume 146, Page(s) 423

MeSH term(s)	Academic Medical Centers ; COVID-19 ; Humans ; Neurosurgery ; Pandemics ; SARS-CoV-2 ; United States
Language	English
Publishing date	2021-03-15
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2020.11.095
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Article ; Online: Outcomes in patients with large vessel occlusion strokes undergoing mechanical thrombectomy with concurrent COVID-19: a nationwide retrospective analysis.

Ramsay, Ian A / Fountain, Hayes / Elarjani, Turki / Govindarajan, Vaidya / Silva, Michael / Abdelsalam, Ahmed / Burks, Joshua D / Starke, Robert M / Luther, Evan

Journal of neurointerventional surgery

2024 Volume 16, Issue 4, Page(s) 342–346

Abstract: Background: Preliminary studies show that patients with large vessel occlusion (LVO) acute ischemic strokes have worse outcomes with concurrent COVID-19 infection. We investigated the outcomes for patients with LVO strokes undergoing mechanical ... ...

Abstract	Background: Preliminary studies show that patients with large vessel occlusion (LVO) acute ischemic strokes have worse outcomes with concurrent COVID-19 infection. We investigated the outcomes for patients with LVO strokes undergoing mechanical thrombectomy (MT) with concurrent COVID-19 infection. Methods: The National Inpatient Database (NIS) was used for our analysis. Patients in the year 2020 with an ICD-10 diagnosis code for acute ischemic stroke and procedural code for MT were included with and without COVID-19. Odds ratios (OR) were calculated using a logistic regression model with age, sex, stroke location, Elixhauser comorbidity score, and other patient variables deemed clinically relevant as covariates. Results: Patients in the COVID-19 group were younger (64.3±14.4 vs 69.4±14.5 years, P<0.001), had a higher rate of inpatient mortality (22.4% vs 10.1%, P<0.001), and a longer length of stay (10 vs 6 days, P<0.001). Patients with COVID-19 had higher odds of death (OR 2.78, 95% CI 2.11 to 3.65) and lower odds of a routine discharge (OR 0.65, 95% CI 0.48 to 0.89). There was no difference in the odds of subsequent stroke and cerebral hemorrhage, but patients with COVID-19 had statistically significantly higher odds of respiratory failure, pulmonary embolism, deep vein thrombosis, myocardial infarction, acute kidney injury, and sepsis. Conclusions: Patients with LVOs undergoing MT within the 2020 NIS database had worse outcomes when co-diagnosed with COVID-19, likely due to non-neurological manifestations of COVID-19.
MeSH term(s)	Humans ; Retrospective Studies ; COVID-19 ; Ischemic Stroke/surgery ; Ischemic Stroke/etiology ; Thrombectomy/adverse effects ; Treatment Outcome ; Stroke/etiology ; Arterial Occlusive Diseases/etiology ; Brain Ischemia/therapy ; Brain Ischemia/etiology
Language	English
Publishing date	2024-03-14
Publishing country	England
Document type	Journal Article
ZDB-ID	2514982-9
ISSN	1759-8486 ; 1759-8478
ISSN (online)	1759-8486
ISSN	1759-8478
DOI	10.1136/jnis-2023-020263
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Article ; Online: Dose Adjustment Associated Complications of Bone Morphogenetic Protein: A Longitudinal Assessment.

De Stefano, Frank A / Elarjani, Turki / Burks, Joshua D / Burks, Stephen S / Levi, Allan D

World neurosurgery

2021 Volume 156, Page(s) e64–e71

Abstract: Objective: Bone morphogenetic protein (BMP) is a growth factor that aids in osteoinduction and promotes bone fusion. There is a lack of literature regarding recombinant human BMP-2 (rhBMP-2) dosage in different spine surgeries. This study aims to ... ...

Abstract	Objective: Bone morphogenetic protein (BMP) is a growth factor that aids in osteoinduction and promotes bone fusion. There is a lack of literature regarding recombinant human BMP-2 (rhBMP-2) dosage in different spine surgeries. This study aims to investigate the trends in rhBMP-2 dosage and the associated complications in spinal arthrodesis. Methods: A retrospective study was conducted investigating spinal arthrodesis using rhBMP-2. Variables including age, procedure type, rhBMP-2 size, complications, and postoperative imaging were collected. Cases were grouped into the following surgical procedures: anterior lumbar interbody fusion/extreme lateral interbody fusion (ALIF/XLIF), posterior lumbar interbody fusion/transforaminal lumbar interbody fusion (PLIF/TLIF), posterolateral fusion (PLF), anterior cervical discectomy and fusion (ACDF), and posterior cervical fusion (PCF). Results: A total of 1209 patients who received rhBMP-2 from 2006 to 2020 were studied. Of these, 230 were categorized as ALIF/XLIF, 336 as PLIF/TLIF, 243 as PLF, 203 as ACDF, and 197 as PCF. PCF (P < 0.001), PLIF/TLIF (P < 0.001), and PLF (P < 0.001) demonstrated a significant decrease in the rhBMP-2 dose used per level, with major transitions seen in 2018, 2011, and 2013, respectively. In our sample, 129 complications following spinal arthrodesis were noted. A significant relation between rhBMP-2 size and complication rates (χ Conclusions: BMP is an effective compound in fusing adjacent spine segments. However, it carries some regional complications. We demonstrate a decreasing trend in the dose/vertebral level. A decrease rhBMP-2 dose per level correlated with a decrease in complication rates.
MeSH term(s)	Bone Morphogenetic Protein 2/administration & dosage ; Bone Morphogenetic Protein 2/adverse effects ; Cohort Studies ; Diskectomy/adverse effects ; Diskectomy/trends ; Dose-Response Relationship, Drug ; Humans ; Longitudinal Studies ; Postoperative Complications/chemically induced ; Postoperative Complications/etiology ; Postoperative Complications/prevention & control ; Recombinant Proteins/administration & dosage ; Recombinant Proteins/adverse effects ; Retrospective Studies ; Spinal Diseases/drug therapy ; Spinal Diseases/surgery ; Spinal Fusion/adverse effects ; Spinal Fusion/trends ; Transforming Growth Factor beta/administration & dosage ; Transforming Growth Factor beta/adverse effects
Chemical Substances	Bone Morphogenetic Protein 2 ; Recombinant Proteins ; Transforming Growth Factor beta ; recombinant human bone morphogenetic protein-2
Language	English
Publishing date	2021-09-13
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.2021.08.142
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Article ; Online: Concurrent bacterial endocarditis is associated with worse inpatient outcomes for large vessel occlusions.

Ramsay, Ian A / Elarjani, Turki / Govindarajan, Vaidya / Silva, Michael A / Abdelsalam, Ahmed / Burks, Joshua D / Starke, Robert M / Luther, Evan

Journal of neurointerventional surgery

2023

Abstract: Background: Neurological complications of bacterial endocarditis (BE) are common, including acute ischemic stroke (AIS). Although mechanical thrombectomy (MT) is effective for large vessel occlusion (LVO) stroke, data are limited on MT for LVOs in ... ...

Abstract	Background: Neurological complications of bacterial endocarditis (BE) are common, including acute ischemic stroke (AIS). Although mechanical thrombectomy (MT) is effective for large vessel occlusion (LVO) stroke, data are limited on MT for LVOs in patients with endocarditis. We assess outcomes in patients treated with thrombectomy for LVOs with concurrent BE. Methods: The National Inpatient Sample (NIS) was used. The NIS was queried from October 2015-2019 for patients receiving MT for LVO of the middle cerebral artery. Odds ratios (OR) were calculated using a multivariate logistic regression model. Results: A total of 635 AIS with BE patients and 57 420 AIS only patients were identified undergoing MT. AIS with BE patients had a death rate of 26.8% versus 10.2% in the stroke alone cohort, and were also less likely to have a routine discharge (10.2% vs 20.9%, both P<0.0001). AIS with BE patients had higher odds of death (OR 3.94) and lower odds of routine discharge (OR 0.23). AIS with BE patients also had higher rates of post-treatment cerebral hemorrhage, 39.4% vs 23.7%, with an OR of 2.20 (P<0.0001 for both analyses). These patients also had higher odds of other complications, including hydrocephalus, respiratory failure, acute kidney injury, and sepsis. Conclusion: While MT can be used to treat endocarditis patients with LVOs, these patients have worse outcomes. Additional investigations should be undertaken to better understand their clinical course, and further develop treatments for endocarditis patients with stroke.
Language	English
Publishing date	2023-08-16
Publishing country	England
Document type	Journal Article
ZDB-ID	2514982-9
ISSN	1759-8486 ; 1759-8478
ISSN (online)	1759-8486
ISSN	1759-8478
DOI	10.1136/jnis-2023-020381
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Article ; Online: Perioperative Outcomes in Transcarotid Artery Revascularization Versus Carotid Endarterectomy or Stenting Nationwide.

Ramsay, Ian A / Burks, Joshua D / Lu, Victor M / Silva, Michael / Abdelsalam, Ahmed / Starke, Robert M / Luther, Evan

Operative neurosurgery (Hagerstown, Md.)

2023 Volume 25, Issue 5, Page(s) 453–460

Abstract: Background and objectives: Transcarotid artery revascularization (TCAR) is a newer treatment for carotid stenosis where the carotid artery is accessed directly in the neck for stenting. It is less invasive than carotid endarterectomy (CEA) and has less ... ...

Abstract	Background and objectives: Transcarotid artery revascularization (TCAR) is a newer treatment for carotid stenosis where the carotid artery is accessed directly in the neck for stenting. It is less invasive than carotid endarterectomy (CEA) and has less embolic potential than carotid artery stenting (CAS), but population-level utilization of TCAR and outcomes are currently unknown. Our study compares outcomes of TCAR with those of CEA and CAS. Methods: The National Inpatient Database was used for years 2015 to 2019. A multivariate logistic regression model was used to compare CEA, CAS, and TCAR outcomes with age, sex, race, hospital teaching status, symptomatic carotid disease status, side of procedure, intraoperative monitoring, and the weighted Elixhauser comorbidity score as covariates. Results: TCAR comprised 0.69% of these procedures in 2016, rising to 1.35% in 2019. The inpatient rates of death, stroke, and myocardial infarction for TCAR were 0.63% (95% confidence interval: 0.36%, 1.06%), 0.42% (0.21%, 0.80%), and 1.46% (1.04%, 2.05%), respectively. Compared with CEA, TCAR had statistically insignificant difference odds of death, odds ratio (95% CI) for stroke was 0.47 (0.25, 0.87), and for myocardial infarction, it was 0.66 (0.37, 0.94). Compared with CAS, for TCAR, the odds ratio for death was 0.41 (0.24, 0.71), and for stroke, it was 0.48 (0.26, 0.91). Conclusion: TCAR is underutilized relative to other revascularization techniques yet has favorable outcomes compared with CEA and CAS. TCAR may be preferred to CAS in patients not surgical candidates for CEA and has a less invasive possibility for those eligible for CEA.
MeSH term(s)	Humans ; Endarterectomy, Carotid ; Carotid Stenosis/surgery ; Risk Factors ; Risk Assessment ; Stents ; Treatment Outcome ; Stroke/epidemiology ; Stroke/surgery ; Arteries ; Myocardial Infarction
Language	English
Publishing date	2023-09-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2767575-0
ISSN	2332-4260 ; 2332-4252
ISSN (online)	2332-4260
ISSN	2332-4252
DOI	10.1227/ons.0000000000000865
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Article ; Online: In Reply to the Letter to the Editor Regarding "Safety Analysis of Bilateral Laser Interstitial Thermal Therapy for Treatment of Butterfly Glioma".

Jamshidi, Aria M / Burks, Joshua D / Eichberg, Daniel G / Komotar, Ricardo J / Ivan, Michael

World neurosurgery

2021 Volume 147, Page(s) 238

MeSH term(s)	Animals ; Brain Neoplasms/therapy ; Butterflies ; Glioma/surgery ; Humans ; Hyperthermia, Induced ; Lasers
Language	English
Publishing date	2021-03-05
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2020.12.011
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Article ; Online: Commentary: Microsurgical Clipping of a Recurrent Posterior Communicating Artery Aneurysm With Intradural Anterior Clinoidectomy: 2-Dimensional Operative Video.

Abdelsalam, Ahmed / Silva, Michael A / Lu, Victor M / Burks, Joshua D / Starke, Robert M / Luther, Evan M

Operative neurosurgery (Hagerstown, Md.)

2022 Volume 24, Issue 2, Page(s) e142–e143

MeSH term(s)	Humans ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/surgery ; Carotid Artery, Internal/surgery ; Neurosurgical Procedures/methods
Language	English
Publishing date	2022-12-09
Publishing country	United States
Document type	Video-Audio Media ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Comment
ZDB-ID	2767575-0
ISSN	2332-4260 ; 2332-4252
ISSN (online)	2332-4260
ISSN	2332-4252
DOI	10.1227/ons.0000000000000549
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Article ; Online: Commentary: Middle Meningeal Artery Embolization for Chronic Subdural Hematoma Using N-Butyl Cyanoacrylate With D5W Push Technique.

Abdelsalam, Ahmed / Silva, Michael A / Luther, Evan M / Lu, Victor M / Thompson, John W / Burks, Joshua D / Saini, Vasu / Starke, Robert M

Neurosurgery

2022 Volume 91, Issue 2, Page(s) e63–e64

MeSH term(s)	Embolization, Therapeutic/methods ; Enbucrilate/therapeutic use ; Head ; Hematoma, Subdural, Chronic/therapy ; Humans ; Meningeal Arteries
Chemical Substances	Enbucrilate (F8CEP82QNP)
Language	English
Publishing date	2022-06-07
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	135446-2
ISSN	1524-4040 ; 0148-396X
ISSN (online)	1524-4040
ISSN	0148-396X
DOI	10.1227/neu.0000000000002051
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Article ; Online: In Reply: Transradial Flow-Diverting Stent Placement Through an Arteria Lusoria: 2-Dimensional Operative Video.

Hackett, Ashia M / Luther, Evan / Huang, Eric / Walker, Ariel P / Brim, Waverly Rose / Maddy, Krisna / Burks, Joshua D / Lu, Victor M / Silva, Michael A / Peterson, Eric C

Operative neurosurgery (Hagerstown, Md.)

2023 Volume 25, Issue 2, Page(s) e118

Language	English
Publishing date	2023-05-17
Publishing country	United States
Document type	Video-Audio Media ; Journal Article
ZDB-ID	2767575-0
ISSN	2332-4260 ; 2332-4252
ISSN (online)	2332-4260
ISSN	2332-4252
DOI	10.1227/ons.0000000000000772
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Article ; Online: Vertebral multiple myeloma with pathological fracture: the most common etiology for emergency spine surgery in patients with no cancer diagnosis on admission.

Burks, Joshua D / Elarjani, Turki / Jamshidi, Aria M / Govindarajan, Vaidya / Levi, Allan D

Neurosurgical focus

2021 Volume 50, Issue 5, Page(s) E2

Abstract: Objective: Vertebral compression fractures are common in multiple myeloma (MM). Modern treatment paradigms place emphasis on treatment with radiation, with surgery reserved for cases involving frank instability or severe neural compression. However, ... ...

Abstract	Objective: Vertebral compression fractures are common in multiple myeloma (MM). Modern treatment paradigms place emphasis on treatment with radiation, with surgery reserved for cases involving frank instability or severe neural compression. However, experience at the authors' institution has led them to suspect a more prominent role for surgical intervention in some settings. The authors undertook the present study to better understand the incidence of MM in undiagnosed patients who require urgent surgery for pathological vertebral fracture. Methods: The authors reviewed a prospectively collected database of all patients who underwent surgery with the senior author at their main hospital between June 1, 1998, and June 30, 2020. Patients admitted from the emergency room or after transfer from another hospital who then underwent surgery for pathological fracture during the same admission were included in the final analysis. Patients scheduled for elective surgery and those with previous cancer diagnoses were excluded. Results: Forty-three patients were identified as having undergone urgent surgical decompression and/or stabilization for pathological fracture. Histopathology confirmed diagnosis of MM in 22 (51%) patients, lung metastasis in 5 (12%) patients, and breast metastasis in 4 (9%) patients. Twelve (28%) patients were diagnosed with other types of metastatic carcinoma or undifferentiated disease. Sixteen of 29 (55%) men and 6 of 14 (42%) women were diagnosed with MM (p = 0.02). Seventeen of 34 (50%) patients who underwent surgery for neurological deficit, 5 of 6 (83%) patients who underwent surgery for spinal instability, and 0 (0%) patients who underwent surgery for pain with impending spinal cord injury were diagnosed with MM (p = 0.12). Conclusions: A majority of patients presenting to the authors' hospital with no history of malignancy who required urgent surgery for pathological compression fracture were found to have MM or plasmacytoma. This disease process may affect a significant portion of patients requiring decompressive or stabilizing surgery for compression fracture in academic medical centers.
MeSH term(s)	Emergency Service, Hospital ; Female ; Fractures, Compression ; Fractures, Spontaneous/diagnosis ; Fractures, Spontaneous/epidemiology ; Fractures, Spontaneous/etiology ; Humans ; Male ; Multiple Myeloma/complications ; Multiple Myeloma/diagnosis ; Multiple Myeloma/epidemiology ; Spinal Fractures/diagnosis ; Spinal Fractures/epidemiology ; Spinal Fractures/surgery ; Spinal Neoplasms/complications ; Spinal Neoplasms/epidemiology ; Spinal Neoplasms/surgery
Language	English
Publishing date	2021-04-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	2026589-X
ISSN	1092-0684 ; 1092-0684
ISSN (online)	1092-0684
ISSN	1092-0684
DOI	10.3171/2021.2.FOCUS201038
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