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Article: Editorial: Optimization of spine surgery outcomes in the pre-, peri-, and postoperative settings.

Rasouli, Jonathan J / Steinberger, Jeremy

2023 Volume 10, Page(s) 1235095

Language	English
Publishing date	2023-08-21
Publishing country	Switzerland
Document type	Editorial
ZDB-ID	2773823-1
ISSN	2296-875X
ISSN	2296-875X
DOI	10.3389/fsurg.2023.1235095
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Commentary: Susceptibility Sensitive Magnetic Resonance Imaging Displays Pallidofugal and Striatonigral Fiber Tracts.

Kopell, Brian Harris / Rasouli, Jonathan J

Operative neurosurgery (Hagerstown, Md.)

2019 Volume 12, Issue 4, Page(s) 339

Language	English
Publishing date	2019-12-20
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/NEU.0000000000001250
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Zs.A 1424 -ON-: Show issues

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Article ; Online: Reply-to-Letter: Disparities in Outcomes by Insurance Payer Groups for Patients Undergoing Anterior Cervical Discectomy and Fusion.

Neifert, Sean N / Rasouli, Jonathan J / Caridi, John M

Spine

2020 Volume 45, Issue 15, Page(s) E974

MeSH term(s)	Cervical Vertebrae/surgery ; Diskectomy ; Humans ; Insurance
Language	English
Publishing date	2020-05-18
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	752024-4
ISSN	1528-1159 ; 0362-2436
ISSN (online)	1528-1159
ISSN	0362-2436
DOI	10.1097/BRS.0000000000003564
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Zs.A 1305: Show issues

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Article ; Online: In Reply to "Optimal Strategy to Control Surgical Site Infection Following Deep Brain Stimulation Surgery: Adequate Management of Risk Factors, Topical Application of Vancomycin Powder in the Surgical Wound, and Preoperative Antibiotic Prophylaxis".

Kopell, Brian H / Rasouli, Jonathan J

World neurosurgery

2017 Volume 101, Page(s) 791

MeSH term(s)	Anti-Bacterial Agents ; Antibiotic Prophylaxis ; Deep Brain Stimulation ; Humans ; Risk Factors ; Surgical Wound ; Surgical Wound Infection ; Vancomycin
Chemical Substances	Anti-Bacterial Agents ; Vancomycin (6Q205EH1VU)
Language	English
Publishing date	2017
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.2017.02.069
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Zs.A 1159: Show issues

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Article ; Online: The Adjunctive Use of Vancomycin Powder Appears Safe and May Reduce the Incidence of Surgical-Site Infections After Deep Brain Stimulation Surgery.

Rasouli, Jonathan J / Kopell, Brian Harris

World neurosurgery

2016 Volume 95, Page(s) 9–13

Abstract: Background: Postoperative surgical-site infections (SSIs) are a common complication after deep brain stimulation (DBS) surgery, occurring at a quoted rate of approximately 1%-9%. Intraoperative vancomycin powder has demonstrated efficacy in reducing ... ...

Abstract	Background: Postoperative surgical-site infections (SSIs) are a common complication after deep brain stimulation (DBS) surgery, occurring at a quoted rate of approximately 1%-9%. Intraoperative vancomycin powder has demonstrated efficacy in reducing SSIs after cranial and spinal surgery; however, its use during DBS surgery has yet to be established. In this study, we describe the senior author's experience with the use of intraoperative vancomycin powder to prevent SSIs after DBS surgery. Methods: We retrospectively examined the incidence of SSI in 297 patients who underwent DBS surgery at the Mount Sinai Health System from September 2012 to December 2015. All patients underwent a uniform perioperative antiseptic protocol, including thorough skin cleansing, intravenous anticephalosporin antibiotics, copious irrigation, and the application of topical vancomycin powder (1 g) before skin closure. Patient information was obtained through a review of electronic medical records. Primary outcome was the incidence of SSI, which was defined per the standards of the Centers for Disease Control and Prevention and confirmed with wound cultures. Results: Four patients developed clinical signs and symptoms of SSI (1.3%); all were men with Parkinson disease. The primary organism responsible was Staphylococcus aureus (75%). Two patients presented with neurostimulator infections, and 2 presented with parietal connector-site infections between 2 months and 1 year after initial surgery. No patients in our series developed topical or systemic reactions attributable to the use of vancomycin powder. Conclusions: In our experience, vancomycin powder has demonstrated safety and efficacy as an adjunct medication for infection prophylaxis after DBS surgery. Further prospective studies with larger patient cohorts are warranted.
MeSH term(s)	Administration, Topical ; Aged ; Anti-Bacterial Agents/therapeutic use ; Antibiotic Prophylaxis/methods ; Burkholderia Infections/drug therapy ; Burkholderia Infections/epidemiology ; Burkholderia cepacia ; Cefuroxime/therapeutic use ; Deep Brain Stimulation ; Device Removal ; Doxycycline/therapeutic use ; Dystonia/therapy ; Humans ; Incidence ; Intraoperative Care ; Male ; Middle Aged ; Neurosurgical Procedures ; Parkinson Disease/therapy ; Powders ; Prosthesis Implantation ; Prosthesis-Related Infections/epidemiology ; Prosthesis-Related Infections/prevention & control ; Retrospective Studies ; Staphylococcal Infections/drug therapy ; Staphylococcal Infections/epidemiology ; Staphylococcus aureus ; Surgical Wound Infection/epidemiology ; Surgical Wound Infection/prevention & control ; Vancomycin/therapeutic use
Chemical Substances	Anti-Bacterial Agents ; Powders ; Vancomycin (6Q205EH1VU) ; Doxycycline (N12000U13O) ; Cefuroxime (O1R9FJ93ED)
Language	English
Publishing date	2016-11
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.2016.07.063
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Article ; Online: C1-C2 Arthrodesis With C1 Lateral Mass and C2 Parsicle Screws Combined With Interlaminar Arthrodesis and Wiring.

Rasouli, Jonathan J / Momin, Arbaz / Fiani, Brian / Shao, Jianning / Moore, Timothy A

Clinical spine surgery

2021 Volume 35, Issue 2, Page(s) 76–79

Abstract: C1-C2 arthrodesis is a common procedure performed for the correction of atlantoaxial instability due to a host of pathologies, including degenerative, neoplastic, congenital, and trauma. While there is clinical equipoise, C1-C2 fusion is associated with ... ...

Abstract	C1-C2 arthrodesis is a common procedure performed for the correction of atlantoaxial instability due to a host of pathologies, including degenerative, neoplastic, congenital, and trauma. While there is clinical equipoise, C1-C2 fusion is associated with a lower morbidity than occipital-cervical fusion. However, due to the unique morphometric characteristics of the C1 lateral mass, and the challenges that its fixation presents, some surgeons may elect to extend the construct to the occiput rather than attempt a C1-C2 fusion. Here, we describe our freehand technique of safely and expeditiously performing a C1-C2 fusion with C1 lateral mass and C2 "parsicle" screws. In patients with high preprocedural probability to develop pseudarthrosis, we combine our instrumented fusion with interlaminar bone graft wiring, as similarly described by Gallie. We believe the C2 "parsicle" screw avoids the technical challenges of placing a traditional C2 pedicle screw and accommodates a much larger screw length than those placed in the C2 pars. Practical surgical tips, pearls, and potential complications are discussed in detail.
MeSH term(s)	Atlanto-Axial Joint/diagnostic imaging ; Atlanto-Axial Joint/surgery ; Cervical Vertebrae/diagnostic imaging ; Cervical Vertebrae/surgery ; Humans ; Joint Instability/surgery ; Pedicle Screws ; Spinal Diseases ; Spinal Fusion/methods
Language	English
Publishing date	2021-05-20
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.0000000000001210
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Zs.A 2427: Show issues

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Article ; Online: Opioid Alternatives in Spine Surgery: A Narrative Review.

Rajan, Shobana / Devarajan, Jagan / Krishnaney, Ajit / George, Arun / Rasouli, Jonathan J / Avitsian, Rafi

Journal of neurosurgical anesthesiology

2020 Volume 34, Issue 1, Page(s) 3–13

Abstract: Adequate analgesia is known to improve outcomes after spine surgery. Despite recent attention highlighting the negative effects of narcotics and their addiction potential, opioids have been the mainstay of management for providing analgesia following ... ...

Abstract	Adequate analgesia is known to improve outcomes after spine surgery. Despite recent attention highlighting the negative effects of narcotics and their addiction potential, opioids have been the mainstay of management for providing analgesia following spine surgeries. However, side effects including hyperalgesia, tolerance, and subsequent dependence restrict the generous usage of opioids. Multimodal analgesia regimens acting through different mechanisms offer significant opioid sparing and minimize the side effects of individual drugs. Hence, they are being increasingly incorporated into enhanced recovery protocols. Multimodal analgesia includes drugs such as N-methyl-D-aspartate antagonists, nonsteroidal anti-inflammatory drugs and membrane-stabilizing agents, neuraxial opioids, local anesthetic infiltration, and fascial compartment blocks. Analgesia started before the painful stimulus, termed preemptive analgesia, facilitates subsequent pain management. Both nonsteroidal anti-inflammatory drugs and neuraxial analgesia have been conclusively shown to reduce opioid requirements after spine surgery, and there is a resurgence of interest in the use of low-dose ketamine or methadone. Neuraxial narcotics offer enhanced analgesia for a longer duration with lower dosage and side effect profiles compared with systemic opioid administration. Fascial compartment blocks are increasingly used as they provide effective analgesia with fewer adverse effects. In this narrative review, we will discuss multimodality analgesic regimens incorporating opioid-sparing adjuvants to manage pain after spine surgery.
MeSH term(s)	Analgesia ; Analgesics ; Analgesics, Opioid/therapeutic use ; Humans ; Pain Management ; Pain, Postoperative/drug therapy
Chemical Substances	Analgesics ; Analgesics, Opioid
Language	English
Publishing date	2020-06-19
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1018119-2
ISSN	1537-1921 ; 0898-4921
ISSN (online)	1537-1921
ISSN	0898-4921
DOI	10.1097/ANA.0000000000000708
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Zs.A 2656: Show issues

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Article: Cervical Spine Alignment in the Sagittal Axis: A Review of the Best Validated Measures in Clinical Practice.

Martini, Michael L / Neifert, Sean N / Chapman, Emily K / Mroz, Thomas E / Rasouli, Jonathan J

Global spine journal

2020 Volume 11, Issue 8, Page(s) 1307–1312

Abstract: Study design: Review of the best-validated measures of cervical spine alignment in the sagittal axis.: Objective: Describe the C2-C7 Cobb Angle, C2-C7 sagittal vertical axis, chin-brow to vertical angle, T1 slope minus C2-C7 lordosis, C2 slope, and ... ...

Abstract	Study design: Review of the best-validated measures of cervical spine alignment in the sagittal axis. Objective: Describe the C2-C7 Cobb Angle, C2-C7 sagittal vertical axis, chin-brow to vertical angle, T1 slope minus C2-C7 lordosis, C2 slope, and different types of cervical kyphosis. Methods: Search PubMed for recent technical literature on radiograph-based measurements of the cervical spine. Results: Despite the continuing use of measures developed many years ago such as the C2-C7 Cobb angle, there are new radiographic parameters being published and utilized in recent years, including the C2 slope. Further research is needed to compare older and newer measures for cross-validation. Utilizing these measures to determine the degree of correction intraoperatively and postoperatively will enable surgeons to optimize patient-level outcomes. Conclusion: Cervical spinal deformity can be a debilitating condition characterized by cervical spinal misalignment that affects the elderly more commonly than young populations. Many of these validated measures of cervical spinal alignment are useful in clinical settings due to their ease of implementation and correlations with various postoperative and health-related quality of life outcomes.
Language	English
Publishing date	2020-11-18
Publishing country	England
Document type	Journal Article
ZDB-ID	2648287-3
ISSN	2192-5690 ; 2192-5682
ISSN (online)	2192-5690
ISSN	2192-5682
DOI	10.1177/2192568220972076
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Article ; Online: Technical Note: Preemptive Surgical Revision of Impending Deep Brain Stimulation Hardware Erosion.

Barrett, Thomas F / Rasouli, Jonathan J / Taub, Peter / Kopell, Brian H

World neurosurgery

2018 Volume 111, Page(s) 41–46

Abstract: Background: While deep brain stimulation (DBS) is a relatively safe procedure, skin erosion is a commonly reported hardware complication that can threaten the DBS system. Patients with Parkinson disease are especially at risk for this complication due ... ...

Abstract	Background: While deep brain stimulation (DBS) is a relatively safe procedure, skin erosion is a commonly reported hardware complication that can threaten the DBS system. Patients with Parkinson disease are especially at risk for this complication due to their autonomic dysregulation and impaired nutrition. Early detection of impending skin erosion allows for intervention that may prevent hardware destruction. Here we report a novel technique to address this complication preemptively. We describe the use of an acellular dermal matrix to prevent skin erosion in 20 patients with Parkinson disease who were treated with DBS and showed signs of impending skin erosion. Methods: Twenty patients with signs of impending hardware erosion were identified. An acellular dermal matrix was surgically placed under the at-risk skin overlying the DBS lead. Results: None of the 20 patients treated with this technique went on to require further revision surgery or removal of hardware. Conclusions: Surgical placement of acellular dermal matrix in patients identified as having impending hardware erosions is a safe and cost-effective way to prevent hardware complications.
MeSH term(s)	Aged, 80 and over ; Corrosion ; Deep Brain Stimulation/adverse effects ; Electrodes, Implanted ; Equipment Failure ; Female ; Humans ; Neurosurgical Procedures/methods ; Parkinson Disease/surgery ; Postoperative Complications/prevention & control ; Postoperative Complications/therapy ; Reoperation/methods ; Scalp/surgery ; Skin/pathology ; Skin Diseases/etiology ; Skin Diseases/therapy ; Tissue Adhesives
Chemical Substances	Tissue Adhesives
Language	English
Publishing date	2018-03
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2017.12.045
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Article ; Online: Utility of Virtual Spine Neurosurgery Education for Medical Students.

Shlobin, Nathan A / Radwanski, Ryan E / Kortz, Michael W / Rasouli, Jonathan J / Gibbs, Wende N / Than, Khoi D / Baaj, Ali A / Shin, John H / Dahdaleh, Nader S

World neurosurgery

2022 Volume 163, Page(s) 179–186

Abstract: Objective: Distance learning has become increasingly important to expand access to neurosurgical spine education. However, emerging online spine education initiatives have largely focused on residents, fellows, and surgeons in practice. We aimed to ... ...

Abstract	Objective: Distance learning has become increasingly important to expand access to neurosurgical spine education. However, emerging online spine education initiatives have largely focused on residents, fellows, and surgeons in practice. We aimed to assess the utility of online neurosurgical spine education for medical students regarding career interests, knowledge, and technical skills. Methods: A survey assessing the demographics and effects of virtual spine education programming on the interests, knowledge, and technical skills was sent to attendees of several virtual spine lectures. The ratings were quantified using 7-point Likert scales. Results: A total of 36 responses were obtained, of which 15 (41.7%) were from first- or second-year medical students and 18 (50.0%) were from international students. Most respondents were interested in neurosurgery (n = 30; 80.3%), with smaller numbers interested in radiology (n = 3; 8.3%) and orthopedic surgery (n = 2; 5.6%). The rating of utility ranged from 5.69 ± 1.14 to 6.50 ± 0.81 for career, 5.83 ± 0.94 to 6.14 ± 0.80 for knowledge, and 5.22 ± 1.31 to 5.83 ± 1.06 for clinical skills. Of the 36 respondents, 26 (72.2%) preferred virtual neurosurgical spine education via intermixed lectures and interactive sessions. The most common themes regarding the utility of virtual spine education were radiology by 18 (50.0%), anatomy by 12 (33.3%), and case-based teaching by 8 (22.2%) respondents. Conclusions: Virtual distance learning for neurosurgical spine education is beneficial for students by enabling career exploration and learning content and clinical skills. Although the overall benefit was lowest for clinical skills, virtual programming could serve as an adjunct to traditional in-person exposure. Distance learning could also provide an avenue to reduce disparities in medical student neurosurgical spine education locally and globally.
MeSH term(s)	Clinical Competence ; Education, Medical ; Humans ; Neurosurgery/education ; Neurosurgical Procedures/education ; Students, Medical
Language	English
Publishing date	2022-06-21
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2021.07.135
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