A5015905654- Spine and Intervertebral Disc Pathology
- Anesthesia and Pain Management
- Cardiac, Anesthesia and Surgical Outcomes
- Musculoskeletal pain and rehabilitation
- Scoliosis diagnosis and treatment
- Hip and Femur Fractures
- Pain Management and Opioid Use
- Spinal Fractures and Fixation Techniques
- Enhanced Recovery After Surgery
- Cervical and Thoracic Myelopathy
- Frailty in Older Adults
- Meningioma and schwannoma management
- Surgical site infection prevention
- Wound Healing and Treatments
- Opioid Use Disorder Treatment
- Clinical practice guidelines implementation
- Endometriosis Research and Treatment
- Cerebrospinal fluid and hydrocephalus
- Glioma Diagnosis and Treatment
- Uterine Myomas and Treatments
- Intraoperative Neuromonitoring and Anesthetic Effects
- Spinal Hematomas and Complications
- Neuroblastoma Research and Treatments
- Maternal and fetal healthcare
- Intensive Care Unit Cognitive Disorders
University of California San Diego Medical Center
2023
University of California, San Diego
2022
Rush University
2021
Rush University Medical Center
2016-2019
Duke Medical Center
2017
Duke University Hospital
2017
OBJECTIVE Postoperative delirium is common in elderly patients undergoing spine surgery and associated with a longer more costly hospital course, functional decline, postoperative institutionalization, higher likelihood of death within 6 months discharge. Preoperative cognitive impairment may be risk factor for the development delirium. The aim this study was to investigate relationship between baseline geriatric degenerative scoliosis. METHODS Elderly 65 years older planned elective spinal...
OBJECTIVE Wound infections following spinal surgery for deformity place a high toll on patients, providers, and the health care system. The prophylactic application of intraoperative vancomycin powder has been shown to lower infection risk after thoracolumbar decompression fusion correction. purpose this study was assess microbiological patterns postoperative surgical site (SSIs) use in adult patients undergoing surgery. METHODS All cases involving who underwent reconstruction at Duke...
OBJECTIVE Geriatric patients undergoing lumbar spine surgery have unique needs due to the physiological changes of aging. They are at risk for adverse outcomes such as delirium, infection, and iatrogenic complications, these in turn, contribute functional decline, nursing home admission, death. Whether preoperative perioperative comanagement by a geriatrician reduces incidence in-hospital complications length stay after elective remains unknown. METHODS A model elderly fusion was implemented...
Study Design. Ambispective cohort review. Objective. The aim of this study was to determine the effect allogeneic red blood cell (RBC) transfusion on postoperative patient complications profiles and 30-day readmission rates following elective spine surgery. Summary Background Data. Thirty-day hospital are being used as a proxy for quality care. Intra- or perioperative RBC transfusions associated with deleterious effects. Whether higher after surgery remains unknown. Methods. medical records...
Surgical drains are commonly used after spine surgery to minimize infection and hematoma formation. The aim of this study was determine the incidence post-operative complications spinal decompression fusion with without a subfascial drain.The medical records 139 adult (≥18 years old) deformity patients undergoing elective at major academic institution were reviewed. We identified 116 (83.5%) who had drain 23 (16.5%) did not have postoperative (No-Drain: n=23; Drain-Use: n=116). Patient...
Pre-existing cognitive impairment (CI) is emerging as a predictor of poor post-operative outcomes in elderly patients. Little known about impaired preoperative cognition and after elective spine surgery this patient population. The purpose study was to assess the prevalence neuro CI patients undergoing deformity its impact on postoperative outcomes.Elderly subjects spinal for correction adult degenerative scoliosis were enrolled study. Pre-operative baseline assessed using Saint Louis Mental...
Study Design. Retrospective cohort study. Objective. The purpose of this study is to characterize the utilization and costs MNTs prior spinal fusion surgery in patients with symptomatic lumbar stenosis or spondylolisthesis. Summary Background Data. long-term maximal nonoperative therapy (MNT) can be substantial, current era bundled payments, duration conservative trials should reassessed. Methods. A large insurance database was queried for spondylolisthesis undergoing index decompression...
Study Design. Retrospective analysis. Objective. To investigate sex differences in opioid use after lumbar decompression and fusion surgery for patients with symptomatic stenosis or spondylolisthesis. Summary of Background Data. Recent studies have demonstrated higher prevalence chronic pain states greater sensitivity among women compared men. Furthermore, responsivity to pharmacological non-pharmacological treatments been observed. Whether perioperative exists undergoing spondylolisthesis...
Retrospective cohort review.To determine whether higher levels of social support are associated with improved surgical outcomes after elective spine surgery.The medical records 430 patients (married, n = 313; divorced/separated/widowed, 71; single, 46) undergoing surgery at a major academic center were reviewed. Patients categorized by their marital status the time surgery. Patient demographics, comorbidities, and postoperative complication rates collected. All had prospectively collected...
Background: Alcohol use has been shown to affect surgical outcomes. However, it is unknown what effect alcohol on postoperative complications or readmission rates in spinal fusion surgery. The aim of this study determine the impact preoperative 30-day profile after adult elective for deformity correction (≥2 levels). Methods: medical records 1,010 patients undergoing levels) deformities at a major academic institution from 2005 2015 were reviewed. We identified 317 (31.4%) who had history...
Abstract BACKGROUND Although advances in implant materials, such as polyetheretherketone (PEEK), have been developed aimed to improve outcome after anterior cervical discectomy and fusion (ACDF), it is essential confirm whether these changes translate into clinically important sustained benefits. OBJECTIVE To compare the radiographic clinical outcomes of patients undergoing up 3-level ACDF with PEEK vs structural allograft implants. METHODS In this cohort study, symptomatic nonunion rates...
Background: Patient reported outcomes and length of hospital stay (LOS) are being used as a proxy for care. An extra day hospitalization costs thousands health care dollars. The choice intraoperative pain medications has been associated with decreased scores in other surgical subspecialties. However, the effects immediate post-operative patient-controlled analgesics (PCA)/intravenous (IV) medication on patient not well understood spine surgery. aim this study is to determine different...
Retrospective cohort review.To assess whether immediate postoperative neck pain scores accurately predict 12-month visual analog scale-neck (VAS-NP) outcomes following Anterior Cervical Discectomy and Fusion surgery (ACDF).This was a retrospective study of 82 patients undergoing elective ACDF at major academic medical center. Patient reported measures VAS-NP were recorded on the first day, then 6-weeks, 3, 6, 12-months after surgery. Multivariate correlation logistic regression methods...