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Article ; Online: Commentary: Preoperative HbA1c > 8% Is Associated With Poor Outcomes in Lumbar Spine Surgery: A Michigan Spine Surgery Improvement Collaborative Study.

Park, Christine / Gottfried, Oren N

2021 Volume 89, Issue 6, Page(s) E308–E309

MeSH term(s)	Glycated Hemoglobin A ; Humans ; Michigan ; Neurosurgical Procedures ; Spinal Fusion
Chemical Substances	Glycated Hemoglobin A
Language	English
Publishing date	2021-05-06
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	135446-2
ISSN	1524-4040 ; 0148-396X
ISSN (online)	1524-4040
ISSN	0148-396X
DOI	10.1093/neuros/nyab327
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Article ; Online: In Reply: Institutional Review of Mortality in 5434 Consecutive Neurosurgery Patients: Are We Improving?

Elsamadicy, Aladine A / Gottfried, Oren N

Neurosurgery

2019 Volume 85, Issue 1, Page(s) E164

MeSH term(s)	Neurosurgery ; Neurosurgical Procedures
Language	English
Publishing date	2019-06-13
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	10.1093/neuros/nyz110
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Article: True Differences in Poor Outcome Risks Between Revision and Primary Lumbar Spine Surgeries.

Cook, Chad E / Garcia, Alessandra N / Park, Christine / Gottfried, Oren

HSS journal : the musculoskeletal journal of Hospital for Special Surgery

2021 Volume 17, Issue 2, Page(s) 192–199

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2021-03-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	2250601-9
ISSN	1556-3324 ; 1556-3316
ISSN (online)	1556-3324
ISSN	1556-3316
DOI	10.1177/1556331621995136
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Article ; Online: Psychological, mobility, and satisfaction variables mediate the relationship between baseline back pain intensity and long-term outcomes in individuals who underwent lumbar spine surgery.

Garcia, Alessandra N / Cook, Chad E / Gottfried, Oren

Musculoskeletal science & practice

2021 Volume 55, Page(s) 102424

Abstract: ... to predict disability and quality of life.: Results: 26,130 individuals (n = 13,740 males, mean age 60.2 ...

Abstract	Background: In patients who receive spine surgery, pain is relational to disability and quality of life, but exactly how this influence is mediated is not fully understood. Mediation analyses allow an understanding of a known relationship by exploring the underlying mechanism or processes by which one variable influences another. Objectives: To determine the mediating influence of psychological, mobility, and satisfaction variables on the relationship between preoperative back pain intensity and 12-month disability and quality of life in individuals who underwent lumbar spine surgery. Design: This mediation analysis study used data from the Quality Outcomes Database (QOD) Lumbar Spine Surgical Registry. Methods: There were included individuals who received lumbar spine surgery for degenerative spine conditions. The exposure variable was preoperative back pain intensity. Mediator variables were depression/anxiety, mobility, and satisfaction. Outcomes included disability and quality of life. Separate multiple mediator models were conducted using the Hayes PROCESS, Model 4 with bias-corrected bootstrapping (5000 samples) to predict disability and quality of life. Results: 26,130 individuals (n = 13,740 males, mean age 60.2 [SD = 13.8) were included. We observed a significant indirect effect through the mediators (anxiety/depression, mobility and satisfaction), for both disability (b = 0.31, 95%CI = 0.26, 0.35) and quality of life (b = -0.44, 95%CI = -0.48, -0.41). Conclusion: Our study suggests that the relationship between preoperative back pain intensity (exposure) and long-term disability and quality of life (outcomes) is partially mediated by anxiety/depression, mobility, and patient satisfaction in individuals who received lumbar spine surgery.
MeSH term(s)	Back Pain ; Humans ; Lumbar Vertebrae/surgery ; Male ; Middle Aged ; Personal Satisfaction ; Prospective Studies ; Quality of Life
Language	English
Publishing date	2021-07-04
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2888772-4
ISSN	2468-7812
ISSN (online)	2468-7812
DOI	10.1016/j.msksp.2021.102424
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Article ; Online: Measuring Outcomes in Spinal Deformity Surgery.

Bergin, Stephen M / Abd-El-Barr, Muhammad M / Gottfried, Oren N / Goodwin, C Rory / Shaffrey, Christopher I / Than, Khoi D

Neurosurgery clinics of North America

2023 Volume 34, Issue 4, Page(s) 689–696

Abstract: Outcome assessment in adult spinal deformity has evolved from radiographic analysis of curve correction to patient-centered perception of health-related quality-of-life. Oswestry Disability Index and the Scoliosis Research Society-22 Patient ... ...

Abstract	Outcome assessment in adult spinal deformity has evolved from radiographic analysis of curve correction to patient-centered perception of health-related quality-of-life. Oswestry Disability Index and the Scoliosis Research Society-22 Patient Questionnaire are the predominantly used patient-reported outcome (PRO) measurements for deformity surgery. Correction of sagittal alignment correlates with improved PRO. Functional outcomes and accelerometer measurements represent newer methods of measuring outcomes but have not yet been widely adopted or validated. Further adoption of a minimum set of core outcome domains will help facilitate international comparisons and benchmarking, and ultimately enhance value-based healthcare.
MeSH term(s)	Adult ; Humans ; Neurosurgical Procedures ; Outcome Assessment, Health Care ; Quality of Life ; Scoliosis/diagnostic imaging ; Scoliosis/surgery
Language	English
Publishing date	2023-07-23
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1196855-2
ISSN	1558-1349 ; 1042-3680
ISSN (online)	1558-1349
ISSN	1042-3680
DOI	10.1016/j.nec.2023.06.013
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Article ; Online: Discharge destination influences risks of readmission and complications after lumbar spine surgery in severely disabled patients.

Park, Christine / Cook, Chad E / Garcia, Alessandra N / Gottfried, Oren N

Clinical neurology and neurosurgery

2021 Volume 207, Page(s) 106801

Abstract: Objective: For individuals with severe disability requiring spine surgery, appropriate discharge destination is a challenging and complex decision. Past studies have found associations between discharge destination and postoperative outcomes but were ... ...

Abstract	Objective: For individuals with severe disability requiring spine surgery, appropriate discharge destination is a challenging and complex decision. Past studies have found associations between discharge destination and postoperative outcomes but were limited by biases in sampling characteristics. The purpose of this study was to explore whether there is an association between discharge destination and odds of worse postoperative outcomes in high-risk individuals with severe/crippling/bedbound disability who received lumbar spine surgery. Methods: This was an observational study using the Quality Outcomes Database Spine Registry. Subjects were limited to age ≥18 years, primary lumbar spine surgery, and severe disability at baseline (Oswestry Disability Index [ODI] ≥50%). Discharge destination was dichotomized to home or healthcare institution. Results: Of the 13,050 patients, 11,859 patients (90.9%) were discharged home and 1191 (9.1%) patients were discharged to a healthcare institution. Individuals who were discharged to a healthcare institution were older (68.6 vs 56.9 p < 0.001) and had worse baseline characteristics (higher American Society of Anesthesiology [ASA] score, presence of back pain, and prevalence of comorbidities, all p < 0.001) compared to those who were discharged home. In covariate-controlled multivariate analysis, the home discharge cohort had lower rates of hospital readmission (OR = 0.68, 95% CI 0.55, 0.84) and revision surgery (OR = 0.56, 95% CI 0.37, 0.85) within three months and return to operating room (OR = 0.46, 95% CI 0.34-0.63) and complications (all OR < 0.50 except hematoma, p < 0.01) within 30 days than the institution discharge cohort. Conclusion: Severity of disability measured by ODI may influence but does not dictate discharge destination and the associated postoperative outcomes.
MeSH term(s)	Adult ; Aged ; Disability Evaluation ; Disabled Persons ; Female ; Humans ; Lumbar Vertebrae ; Male ; Middle Aged ; Neurosurgical Procedures/adverse effects ; Neurosurgical Procedures/methods ; Patient Discharge ; Patient Readmission/statistics & numerical data ; Postoperative Complications/epidemiology ; Retrospective Studies ; Spinal Diseases/surgery
Language	English
Publishing date	2021-07-07
Publishing country	Netherlands
Document type	Journal Article ; Observational Study
ZDB-ID	193107-6
ISSN	1872-6968 ; 0303-8467
ISSN (online)	1872-6968
ISSN	0303-8467
DOI	10.1016/j.clineuro.2021.106801
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Article ; Online: The Collective Influence of Social Determinants of Health on Individuals Who Underwent Lumbar Spine Revision Surgeries: A Retrospective Cohort Study.

Buck, Erin / Rethorn, Zachary D / Garcia, Alessandra N / Cook, Chad E / Gottfried, Oren

World neurosurgery

2022 Volume 165, Page(s) e619–e627

Abstract: Objective: To analyze the collective effect of social determinants of health (SDH) on lumbar spine revision surgery outcomes using a retrospective cohort study design.: Methods: Data from the Quality Outcomes Database were used, including 7889 adults ...

Abstract	Objective: To analyze the collective effect of social determinants of health (SDH) on lumbar spine revision surgery outcomes using a retrospective cohort study design. Methods: Data from the Quality Outcomes Database were used, including 7889 adults who received lumbar spine revision surgery and completed 3 and 12 months' follow-up. The SDH of interest included race/ethnicity, educational attainment, employment status, insurance payer, and sex. A stepwise regression model using each number of SDH conditions present (0 of 5, 1 of 5, 2 of 5, ≥3 of 5) was used to assess the collective influence of SDH. The odds of demonstrating a minimum clinically important difference was evaluated in back and leg, disability, quality of life, and patient satisfaction at 3-months and 12-months follow-up. Results: An additive effect for SDH was found across all outcome variables at 3 and 12 months. Individuals with ≥3 SDH were at the lowest odds of meeting the minimum clinically important difference of each outcome. At 12 months, individuals with ≥3 SDH had a 67%, 65%, 71%, 65%, and 46% decrease in the odds of a clinically meaningful outcome in back and leg pain, disability, quality of life, and patient satisfaction. Conclusions: Health care teams should evaluate SDH in individuals who may be considered for lumbar spine revision surgery. Viewing social factors in aggregate may be useful as a screening tool for lumbar spine revision surgeries to identify at risk patients who may require pre-emptive care strategies and postoperative resources to mitigate these risks.
MeSH term(s)	Adult ; Humans ; Lumbar Vertebrae/surgery ; Quality of Life ; Reoperation ; Retrospective Studies ; Social Determinants of Health ; Social Factors ; Treatment Outcome
Language	English
Publishing date	2022-06-27
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.2022.06.107
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Article ; Online: Posterior Cervical Decompression and Fusion With Exoscope: 2-Dimensional Operative Video.

Srinivasan, Ethan S / Crutcher, Clifford L / Shaffrey, Christopher I / Gottfried, Oren N / Than, Khoi D

Operative neurosurgery (Hagerstown, Md.)

2022 Volume 22, Issue 2, Page(s) e83

Abstract: Posterior cervical decompression and fusion is an effective strategy for correction of cervical spondylotic myelopathy. Here, we highlight the operative treatment of a 63-yr-old man entailing a 4-level posterior cervical laminectomy and fusion, with the ... ...

Abstract	Posterior cervical decompression and fusion is an effective strategy for correction of cervical spondylotic myelopathy. Here, we highlight the operative treatment of a 63-yr-old man entailing a 4-level posterior cervical laminectomy and fusion, with the use of an exoscope throughout. The patient initially presented with symptoms of gait dysfunction and loss of fine motor control in the upper extremities, without neck pain or radiculopathy. His imaging demonstrated a congenitally narrowed spinal canal with cervical stenosis at C3-C4, C5-C6, and C6-C7. The patient consented to the procedure and publication of his image, along with other participants and any identifiable individuals. The operation proceeded with the patient in a prone position with midline dissection to the posterior elements of C3-C6. Pilot holes were drilled in the lateral masses and C3-C4, C4-C5, C5-C6, and C6-C7 laminectomies performed using a high-speed drill, with removal of the laminae en bloc. Lateral mass screws were inserted and precontoured rods secured, with morselized autograft and allograft bone chips placed for arthrodesis. Postoperatively, the patient reported noted improvement in his symptoms.
MeSH term(s)	Cervical Vertebrae/diagnostic imaging ; Cervical Vertebrae/surgery ; Decompression ; Humans ; Laminectomy/methods ; Male ; Radiculopathy/surgery ; Spinal Cord Diseases/surgery
Language	English
Publishing date	2022-01-11
Publishing country	United States
Document type	Journal Article ; Video-Audio Media
ZDB-ID	2767575-0
ISSN	2332-4260 ; 2332-4252
ISSN (online)	2332-4260
ISSN	2332-4252
DOI	10.1227/ONS.0000000000000058
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Article: Pushing the Limits of Minimally Invasive Spine Surgery-From Preoperative to Intraoperative to Postoperative Management.

Drossopoulos, Peter N / Sharma, Arnav / Ononogbu-Uche, Favour C / Tabarestani, Troy Q / Bartlett, Alyssa M / Wang, Timothy Y / Huie, David / Gottfried, Oren / Blitz, Jeanna / Erickson, Melissa / Lad, Shivanand P / Bullock, W Michael / Shaffrey, Christopher I / Abd-El-Barr, Muhammad M

Journal of clinical medicine

2024 Volume 13, Issue 8

Abstract: The introduction of minimally invasive surgery ushered in a new era of spine surgery by minimizing the undue iatrogenic injury, recovery time, and blood loss, among other complications, of traditional open procedures. Over time, technological ... ...

Abstract	The introduction of minimally invasive surgery ushered in a new era of spine surgery by minimizing the undue iatrogenic injury, recovery time, and blood loss, among other complications, of traditional open procedures. Over time, technological advancements have further refined the care of the operative minimally invasive spine patient. Moreover, pre-, and postoperative care have also undergone significant change by way of artificial intelligence risk stratification, advanced imaging for surgical planning and patient selection, postoperative recovery pathways, and digital health solutions. Despite these advancements, challenges persist necessitating ongoing research and collaboration to further optimize patient care in minimally invasive spine surgery.
Language	English
Publishing date	2024-04-20
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm13082410
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Article ; Online: Quantifying the collective influence of social determinants of health using conditional and cluster modeling.

Rethorn, Zachary D / Garcia, Alessandra N / Cook, Chad E / Gottfried, Oren N

PloS one

2020 Volume 15, Issue 11, Page(s) e0241868

Abstract: Objectives: Our objective was to analyze the collective effect of social determinants of health (SDoH) on lumbar spine surgery outcomes utilizing two different statistical methods of combining variables.: Methods: This observational study analyzed ... ...

Abstract	Objectives: Our objective was to analyze the collective effect of social determinants of health (SDoH) on lumbar spine surgery outcomes utilizing two different statistical methods of combining variables. Methods: This observational study analyzed data from the Quality Outcomes Database, a nationwide United States spine registry. Race/ethnicity, educational attainment, employment status, insurance payer, and gender were predictors of interest. We built two models to assess the collective influence of SDoH on outcomes following lumbar spine surgery-a stepwise model using each number of SDoH conditions present (0 of 5, 1 of 5, 2 of 5, etc) and a clustered subgroup model. Logistic regression analyses adjusted for age, multimorbidity, surgical indication, type of lumbar spine surgery, and surgical approach were performed to identify the odds of failing to demonstrate clinically meaningful improvements in disability, back pain, leg pain, quality of life, and patient satisfaction at 3- and 12-months following lumbar spine surgery. Results: Stepwise modeling outperformed individual SDoH when 4 of 5 SDoH were present. Cluster modeling revealed 4 distinct subgroups. Disparities between the younger, minority, lower socioeconomic status and the younger, white, higher socioeconomic status subgroups were substantially wider compared to individual SDoH. Discussion: Collective and cluster modeling of SDoH better predicted failure to demonstrate clinically meaningful improvements than individual SDoH in this cohort. Viewing social factors in aggregate rather than individually may offer more precise estimates of the impact of SDoH on outcomes.
MeSH term(s)	Adult ; Aged ; Back Pain ; Cluster Analysis ; Cohort Studies ; Databases, Factual ; Educational Status ; Employment ; European Continental Ancestry Group ; Female ; Humans ; Lumbar Vertebrae/surgery ; Male ; Middle Aged ; Minority Groups ; Models, Statistical ; Quality of Life ; Retrospective Studies ; Social Determinants of Health/statistics & numerical data ; Social Determinants of Health/trends ; Socioeconomic Factors ; Treatment Outcome ; United States
Language	English
Publishing date	2020-11-05
Publishing country	United States
Document type	Journal Article ; Observational Study
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0241868
Database	MEDical Literature Analysis and Retrieval System OnLINE

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