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Article ; Online: Early postoperative MRI findings following anterior cervical discectomy and fusion: What to expect when the unexpected happens.

Mazur-Hart, David J / Nguyen, Kristey T / Pettersson, David R / Ross, Donald A

World neurosurgery: X

2023 Volume 19, Page(s) 100188

Abstract: Background: Magnetic resonance imaging (MRI) is not routinely ordered following spinal fusion. Some literature suggests MRIs are unhelpful due to postoperative changes that obscure interpretation. We aim to describe findings of acute postoperative MRI ... ...

Abstract	Background: Magnetic resonance imaging (MRI) is not routinely ordered following spinal fusion. Some literature suggests MRIs are unhelpful due to postoperative changes that obscure interpretation. We aim to describe findings of acute postoperative MRI following anterior cervical discectomy and fusion (ACDF). Methods: The authors retrospectively analyzed adult MRIs completed within 30 days of ACDF (from 2005-2022). T1 and T2 signal intensity in the interbody space dorsal to the graft, mass effect on the dura/spinal cord, intrinsic spinal cord T2 signal, and interpretability were reviewed. Results: In 38 patients there were 58 ACDF levels (1, 2, and 3 levels; 23, 10, and 5, respectively). MRIs were completed on mean postoperative day 8.37 (range; 0-30 days). T1-weighted imaging was described as isointense, hyperintense, heterogenous, and hypointense in 48 (82.8%), 5 (8.6%), 3 (5.2%), and 2 levels (3.4%), respectively. T2-weighted imaging was described as hyperintense, heterogenous, isointense, and hypointense in 41 (70.7%), 12 (20.7%), 3 (5.2%), and 2 levels (3.4%), respectively. There was no mass effect in 27 levels (46.6%), 14 (24.1%) had thecal sac compression, and 17 (29.3%) had cord compression. Conclusions: The majority of MRIs exhibited readily compression and intrinsic spinal cord signal even with various types of fusion constructs. Early MRI after lumbar surgery can be difficult to interpret. However, our results support the use of early MRI to investigate neurological complaints following ACDF. Our findings do not support the idea that epidural blood products and mass effect on the cord are seen in most postoperative MRIs after ACDF.
Language	English
Publishing date	2023-03-21
Publishing country	United States
Document type	Journal Article
ISSN	2590-1397
ISSN (online)	2590-1397
DOI	10.1016/j.wnsx.2023.100188
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Article ; Online: Editorial: Advancements in deep brain stimulation for chronic pain control.

Staudt, Michael D / Yaghi, Nasser K / Mazur-Hart, David J / Shirvalkar, Prasad

Frontiers in pain research (Lausanne, Switzerland)

2023 Volume 4, Page(s) 1293919

Language	English
Publishing date	2023-10-23
Publishing country	Switzerland
Document type	Editorial
ISSN	2673-561X
ISSN (online)	2673-561X
DOI	10.3389/fpain.2023.1293919
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Article ; Online: Bone morphogenetic protein and cancer in spinal fusion: a propensity score-matched analysis.

Mazur-Hart, David J / Yamamoto, Erin A / Yoo, Jung / Orina, Josiah N

Journal of neurosurgery. Spine

2023 Volume 39, Issue 6, Page(s) 722–728

Abstract: Objective: Bone morphogenetic protein (BMP) has been increasingly used in spinal surgery to promote arthrodesis. Because BMP stimulates cellular proliferation, its association with tumorigenesis is a concern. Previous research has generated conflicting ... ...

Abstract	Objective: Bone morphogenetic protein (BMP) has been increasingly used in spinal surgery to promote arthrodesis. Because BMP stimulates cellular proliferation, its association with tumorigenesis is a concern. Previous research has generated conflicting conclusions on the risk of cancer in patients receiving BMP. The authors aimed to compare the incidence of solid organ and hematopoietic malignancies in patients undergoing spinal arthrodesis with or without BMP. Methods: The PearlDiver Mariner Patient Claims Database was queried for patients undergoing thoracolumbar fusion between 2015 and 2021. Patients with preexisting malignancy were excluded. Data were analyzed for incidence of solid organ malignancy and hematopoietic malignancy diagnosed after spinal surgery. Propensity score matching using age, sex, tobacco usage, and year of surgery was performed between patients who did and those who did not receive BMP. Results: Among patients without prior solid organ malignancy, BMP was used in 22,139 patients and not used in 306,249. In the propensity score-matched group, 3.1% of the BMP group developed solid organ malignancy following surgery compared with 3.5% in the non-BMP group. The relative risk (RR) of developing solid organ malignancy after BMP exposure was 0.89 (95% CI 0.81-0.98, p = 0.02). Among patients without prior hematopoietic malignancy, BMP was used in 23,505 patients and not used in 328,796 patients. In the propensity score-matched group, 0.4% of the BMP group developed hematopoietic malignancy compared with 0.6% of the non-BMP group. The RR of developing hematopoietic malignancy after BMP exposure was 0.71 (95% CI 0.55-0.93, p = 0.015). Conclusions: BMP use in thoracolumbar fusion was not associated with an increased risk of new malignancy, which further supports emerging data on the lack of an association between BMP use and increased malignancy.
MeSH term(s)	Humans ; Spinal Fusion/adverse effects ; Propensity Score ; Bone Morphogenetic Proteins/adverse effects ; Neoplasms/epidemiology ; Neoplasms/surgery ; Hematologic Neoplasms/chemically induced ; Bone Morphogenetic Protein 2/adverse effects
Chemical Substances	Bone Morphogenetic Proteins ; Bone Morphogenetic Protein 2
Language	English
Publishing date	2023-09-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2158643-3
ISSN	1547-5646 ; 1547-5654
ISSN (online)	1547-5646
ISSN	1547-5654
DOI	10.3171/2023.4.SPINE22584
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Article: Developing Data‐Rich Video of Surface Water–Groundwater Interactions for Public Engagement

Christenson, Catherine / Hart, David J. / Cardiff, Michael / Richmond, Susan / Fratta, Dante

Ground water. 2022 May, v. 60, no. 3

2022

Abstract: Communication of hydrologic data to the public can be improved by connecting data to the places they represent. In our example of data communication, we coupled hydrologic data with simultaneously collected video as both a scientific and public ... ...

Abstract	Communication of hydrologic data to the public can be improved by connecting data to the places they represent. In our example of data communication, we coupled hydrologic data with simultaneously collected video as both a scientific and public engagement tool. This note presents a method for collecting spatially and temporally dense datasets of water‐quality and geophysical data on small streams and lakes, and for displaying the data in a user‐friendly format using commercially available software. With this method, multiple instruments are mounted on a canoe and a controlled survey float is carried out to collect data. The data stream is georeferenced and logged using an Arduino microcontroller to provide detailed information about spatial variability. We employed these continuous data‐collection methods at small streams and lakes across Wisconsin, USA. Comparison of stream‐float sensor data to lab reported data, data collected by alternative sensors, and previously collected data in our study areas indicates that the low‐cost temperature, electrical conductivity, pH, and dissolved oxygen sensors performed well. GoPro cameras recorded video throughout the duration of data collection. Our established water‐quality and geophysical data collection methods are inexpensive, fast, and reliable, which qualify them as excellent tools for fine‐scale spatial understanding of stream and lake habitats' health. Data‐rich video connects point measurements of water properties to the appearance of the native environment. This method helps improve our understanding of groundwater and surface water interactions in complex hydrogeologic systems, enhance communication amongst stakeholders, and provide context when monitoring and managing sensitive habitats.
Keywords	citizen participation ; computer software ; data collection ; dissolved oxygen ; electrical conductivity ; geophysics ; georeferencing ; groundwater ; hydrologic data ; lakes ; pH ; stakeholders ; streams ; surface water ; surveys ; temperature ; water quality ; Wisconsin
Language	English
Dates of publication	2022-05
Size	p. 426-433.
Publishing place	Blackwell Publishing Ltd
Document type	Article
Note	JOURNAL ARTICLE
ZDB-ID	246212-6
ISSN	1745-6584 ; 0017-467X
ISSN (online)	1745-6584
ISSN	0017-467X
DOI	10.1111/gwat.13165
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Article ; Online: To screen or not to screen: vertebral artery injuries in blunt cervical spine trauma.

Hart, David J

World neurosurgery

2013 Volume 80, Issue 3-4, Page(s) 309–310

MeSH term(s)	Female ; Humans ; Male ; Spinal Injuries/surgery ; Vertebral Artery/injuries ; Vertebral Artery/surgery ; Wounds, Nonpenetrating/surgery
Language	English
Publishing date	2013-09
Publishing country	United States
Document type	Comment ; Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2012.10.032
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Article ; Online: Stealth Autoguide for robotic-assisted laser ablation for lesional epilepsy: illustrative case.

Mazur-Hart, David J / Yaghi, Nasser K / Shahin, Maryam N / Raslan, Ahmed M

Journal of neurosurgery. Case lessons

2022 Volume 3, Issue 6

Abstract: Background: Laser interstitial thermal therapy has been used in tumor and epilepsy surgery to maximize clinical treatment impact while minimizing morbidity. This intervention places a premium on accuracy. With the advent of robotics, neurosurgery is ... ...

Abstract	Background: Laser interstitial thermal therapy has been used in tumor and epilepsy surgery to maximize clinical treatment impact while minimizing morbidity. This intervention places a premium on accuracy. With the advent of robotics, neurosurgery is entering a new age of improved accuracy. Here, the authors described the use of robotic-assisted laser placement for the treatment of epileptiform lesions. Observations: The authors presented a case of a 21-year-old woman with medically intractable epilepsy, localized to left mesial temporal sclerosis and left temporal encephalocele by way of stereotactic electroencephalography, who presented for consideration of surgical intervention. When presented with resection versus laser ablation, the patient opted for laser ablation. The patient received robotic-assisted stereotactic laser ablation (RASLA) using a Stealth Autoguide. The patient was seizure free (10 weeks) after surgical ablation. Lessons: RASLA is an effective way to treat epilepsy. Here, the authors reported the first RASLA procedure with a Stealth Autoguide to treat epilepsy. The procedure can be performed effectively and efficiently for multiple epileptic foci without the need for bulkier robotic options or head frames that may interfere with the use of magnetic resonance imaging for heat mapping.
Language	English
Publishing date	2022-02-07
Publishing country	United States
Document type	Journal Article
ISSN	2694-1902
ISSN (online)	2694-1902
DOI	10.3171/CASE21556
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Article ; Online: Surgical site infection in thoracic and lumbar fractures: incidence and risk factors in 11,401 patients from a nationwide administrative database.

Yamamoto, Erin A / Mazur-Hart, David J / Yoo, Jung / Orina, Josiah N

The spine journal : official journal of the North American Spine Society

2022 Volume 23, Issue 2, Page(s) 281–286

Abstract: Background context: The rate of surgical site infection (SSI) following elective spine surgery ranges from 0.5%‒10%. Published reports suggest a higher SSI rate in non-elective spine surgery such as spine trauma; however, there is a paucity of large ... ...

Abstract	Background context: The rate of surgical site infection (SSI) following elective spine surgery ranges from 0.5%‒10%. Published reports suggest a higher SSI rate in non-elective spine surgery such as spine trauma; however, there is a paucity of large database studies examining this issue. Purpose: The objective of this study was to investigate the incidence and risk factors of SSI in patients undergoing spine surgery for thoracic and lumbar fractures in a large population database. Study design/setting: This is a retrospective study utilizing the PearlDiver Patient Claims Database. Patient sample: Patients undergoing spine surgery for thoracic and lumbar fractures between 2015-2020 were identified in the PearlDiver Patient Claims Database using ICD-10 codes. Patients were excluded who had another surgery either 14 days before or 21 days after the index spine surgery, or pathologic fracture. Outcome measures: Rate of surgical site infection. Methods: Clinical data collected from the PearlDiver database based on ICD-10 codes included gender, age, diabetes, smoking status, obesity, Elixhauser Comorbidity Index (ECI), Charlson Comorbidity Index (CCI), and SSI. Univariate analysis was used to assess the association of potential risk factors and SSI. Multivariable analysis was used to identify independent risk factors of SSI. The authors have no conflicts of interest or funding sources to declare. Results: A total of 11,401 patients undergoing spine surgery for thoracic and lumbar fractures met inclusion criteria, and 1,065 patients were excluded. 860 patients developed SSI (7.5%). Risk factors significantly associated with SSI in univariate analysis included diabetes (OR 1.50; 95% CI, 1.30‒1.73; p<.001), obesity (OR 1.66; 95% CI, 1.44‒1.92; p<.001), increased age (p<.001), ECI (p<.001), and CCI (p<.001). On multivariable analysis, obesity and ECI were independently associated with SSI (p<.001 and p<.001, respectively). Conclusions: Non-elective surgery for thoracic and lumbar fractures is associated with a 7.5% risk of SSI. Obesity and ECI are independent predictors of SSI in this population. Limitations include the reliance on accurate insurance coding which may not fully capture all SSI, and in particular superficial SSI. These findings provide a broad overview of the risk of SSI in this population at a national level and may also help counsel patients regarding risk.
MeSH term(s)	Humans ; Surgical Wound Infection/epidemiology ; Surgical Wound Infection/etiology ; Retrospective Studies ; Incidence ; Risk Factors ; Spinal Fractures/epidemiology ; Spinal Fractures/surgery ; Spinal Fractures/complications ; Obesity/complications
Language	English
Publishing date	2022-10-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2037072-6
ISSN	1878-1632 ; 1529-9430
ISSN (online)	1878-1632
ISSN	1529-9430
DOI	10.1016/j.spinee.2022.10.007
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Article ; Online: Developing Data-Rich Video of Surface Water-Groundwater Interactions for Public Engagement.

Christenson, Catherine / Hart, David J / Cardiff, Michael / Richmond, Susan / Fratta, Dante

Ground water

2022 Volume 60, Issue 3, Page(s) 426–433

Abstract	Communication of hydrologic data to the public can be improved by connecting data to the places they represent. In our example of data communication, we coupled hydrologic data with simultaneously collected video as both a scientific and public engagement tool. This note presents a method for collecting spatially and temporally dense datasets of water-quality and geophysical data on small streams and lakes, and for displaying the data in a user-friendly format using commercially available software. With this method, multiple instruments are mounted on a canoe and a controlled survey float is carried out to collect data. The data stream is georeferenced and logged using an Arduino microcontroller to provide detailed information about spatial variability. We employed these continuous data-collection methods at small streams and lakes across Wisconsin, USA. Comparison of stream-float sensor data to lab reported data, data collected by alternative sensors, and previously collected data in our study areas indicates that the low-cost temperature, electrical conductivity, pH, and dissolved oxygen sensors performed well. GoPro cameras recorded video throughout the duration of data collection. Our established water-quality and geophysical data collection methods are inexpensive, fast, and reliable, which qualify them as excellent tools for fine-scale spatial understanding of stream and lake habitats' health. Data-rich video connects point measurements of water properties to the appearance of the native environment. This method helps improve our understanding of groundwater and surface water interactions in complex hydrogeologic systems, enhance communication amongst stakeholders, and provide context when monitoring and managing sensitive habitats.
MeSH term(s)	Environmental Monitoring/methods ; Groundwater ; Lakes/chemistry ; Water ; Water Quality
Chemical Substances	Water (059QF0KO0R)
Language	English
Publishing date	2022-01-11
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	246212-6
ISSN	1745-6584 ; 0017-467X
ISSN (online)	1745-6584
ISSN	0017-467X
DOI	10.1111/gwat.13165
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Article ; Online: Stereotactic electroencephalography in epilepsy patients for mapping of neural circuits related to emotional and psychiatric behaviors: a systematic review.

Lopez Ramos, Christian G / Tan, Hao / Yamamoto, Erin A / Cleary, Daniel R / Mazur-Hart, David J / Shahin, Maryam N / Raslan, Ahmed M

Neurosurgical focus

2023 Volume 54, Issue 2, Page(s) E4

Abstract: Objective: Stereotactic electroencephalography (sEEG) is an increasingly utilized method for identifying electrophysiological processes underlying sensorimotor, cognitive, and emotional behaviors. In this review, the authors outline current research ... ...

Abstract	Objective: Stereotactic electroencephalography (sEEG) is an increasingly utilized method for identifying electrophysiological processes underlying sensorimotor, cognitive, and emotional behaviors. In this review, the authors outline current research using sEEG to investigate the neural activity underlying emotional and psychiatric behaviors. Understanding the current structure of intracranial research using sEEG will inform future studies of psychiatric disease and therapeutics for effective neuromodulation. Methods: The authors conducted a comprehensive systematic review of studies according to PRISMA guidelines to investigate behaviors related to psychiatric conditions in patients with epilepsy undergoing monitoring with sEEG. Articles indexed on PubMed between 2010 and 2022 were included if they studied emotions or affective behaviors or met the National Institute of Mental Health Research Domain Criteria positive and negative valence domains. Data extracted from articles included study sample size, paradigms and behavioral tasks employed, cortical and subcortical targets, EEG analysis methods, and identified electrophysiological activity underlying the studied behavior. The Newcastle-Ottawa Scale was used to assess bias risk. Results: Thirty-two primary articles met inclusion criteria. Study populations ranged from 3 to 39 patients. The most common structures investigated were the amygdala, insula, orbitofrontal cortex (OFC), hippocampus, and anterior cingulate cortex (ACC). Paradigms, stimuli, and behavioral tasks widely varied. Time-frequency analyses were the most common, followed by connectivity analyses. Multiple oscillations encoded a variety of behaviors related to emotional and psychiatric conditions. High gamma activity was observed in the amygdala and anterior insula in response to aversive audiovisual stimuli and in the OFC in response to reward processing. ACC beta band power increases and hippocampal-amygdala beta coherence variations were predictive of worsening mood states. Insular and amygdalar theta oscillations encoded social pain and fear learning, respectively. Most studies performed passing recordings, allowing for the decoding of affective states and depression symptoms, while other studies utilized direct stimulation, such as in the OFC to improve mood symptoms. Conclusions: Stereotactic EEG in epilepsy has identified multiple corticolimbic structures with specific oscillatory and synchronization activity underlying a diverse range of behaviors related to emotions and affective conditions. Given the heterogeneity of psychiatric conditions, sEEG provides an opportunity to study these neural correlates to develop personalized effective neuromodulatory treatments. Future studies should focus on optimizing paradigms and tasks to investigate a broad range of behavioral phenotypes that overlap across psychiatric conditions.
MeSH term(s)	Humans ; Emotions/physiology ; Electroencephalography/methods ; Epilepsy/surgery ; Prefrontal Cortex ; Fear
Language	English
Publishing date	2023-02-01
Publishing country	United States
Document type	Systematic Review ; Journal Article
ZDB-ID	2026589-X
ISSN	1092-0684 ; 1092-0684
ISSN (online)	1092-0684
ISSN	1092-0684
DOI	10.3171/2022.11.FOCUS22615
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Article ; Online: Evaluating Surgical Cervical Arthrodesis With a Novel MRI Grading Score.

Mazur-Hart, David J / Godil, Jamila A / Larson, Erik W / Nugent, Joseph G / Gerges, Christina / Pettersson, David R / Ross, Donald A

Clinical spine surgery

2023 Volume 36, Issue 10, Page(s) E493–E498

Abstract: Study design: This was a single-institution retrospective study.: Objective: Evaluate a magnetic resonance imaging (MRI)-scoring system to differentiate arthrodesis from pseudoarthrosis following anterior cervical discectomy and fusion.: Summary of ...

Abstract	Study design: This was a single-institution retrospective study. Objective: Evaluate a magnetic resonance imaging (MRI)-scoring system to differentiate arthrodesis from pseudoarthrosis following anterior cervical discectomy and fusion. Summary of background data: Diagnostic workup following fusion surgery often includes MRI to evaluate neural structures and computed tomography (CT) and/or dynamic x-rays to evaluate instrumentation and arthrodesis. The use of MRI alone for these evaluations would protect patients from harmful CT and x-ray ionizing radiation. Methods: Neurosurgical attending evaluated CTs for arthrodesis or pseudoarthrosis. Blinded neuroradiology attending and neurosurgery senior resident evaluated independent T1 and T2 region of interest (ROI) signal intensity over instrumented disk space. Cerebral spinal fluid (CSF) at the cisterna magnum and distal adjacent uninstrumented vertebral body (VB) were also calculated. ROI interspace /ROI CSF and ROI interspace /ROI VB quotients were used to create T1- and T2-interspace interbody scores (IIS). Results: Study population (n=64 patients, 50% female) with a mean age of 51.72 years and 109 instrumented levels with 45 fused levels (41.3%) were included. T1-weighted MRI, median T1-IIS CSF for arthrodesis was 176.20 versus 130.92 for pseudoarthrosis ( P <0.0001), T1-IIS VB for arthrodesis was 68.52 and pseudoarthrosis was 52.71 ( P <0.0001). T2-weighted MRI, median T2-IIS CSF for arthrodesis was 27.72 and 14.21 for pseudoarthrosis ( P <0.0001), while T2-IIS VB for arthrodesis was 67.90 and 41.02 for pseudoarthrosis ( P <0.0001). The greatest univariable discriminative capability for arthrodesis via AUROC was T1-IIS VB (0.7743). Conclusion: We describe a novel MRI scoring system that may help determine arthrodesis versus pseudoarthrosis following anterior cervical discectomy and fusion. Postoperative symptomatic patients may only require MRI, which would protect patients from ionizing radiation. Level of evidence: Level IV.
MeSH term(s)	Humans ; Female ; Middle Aged ; Male ; Retrospective Studies ; Pseudarthrosis/surgery ; Spinal Fusion ; Magnetic Resonance Imaging/methods ; Radiography ; Cervical Vertebrae/diagnostic imaging ; Cervical Vertebrae/surgery ; Cervical Vertebrae/pathology ; Treatment Outcome
Language	English
Publishing date	2023-07-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	2849646-2
ISSN	2380-0194 ; 2380-0186
ISSN (online)	2380-0194
ISSN	2380-0186
DOI	10.1097/BSD.0000000000001487
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