A5016324135- Spine and Intervertebral Disc Pathology
- Cervical and Thoracic Myelopathy
- Nerve Injury and Rehabilitation
- Spinal Cord Injury Research
- Musculoskeletal pain and rehabilitation
- Spinal Fractures and Fixation Techniques
- Advanced Neuroimaging Techniques and Applications
- Scoliosis diagnosis and treatment
- Pelvic and Acetabular Injuries
- Peripheral Nerve Disorders
- Medical Imaging and Analysis
- MRI in cancer diagnosis
- Anesthesia and Pain Management
- Spinal Dysraphism and Malformations
- Cardiac, Anesthesia and Surgical Outcomes
- Trauma Management and Diagnosis
- Myofascial pain diagnosis and treatment
- Cardiovascular Issues in Pregnancy
- Neuroscience and Neural Engineering
- Delphi Technique in Research
- Muscle activation and electromyography studies
- Cerebrospinal fluid and hydrocephalus
- Bone and Joint Diseases
- Stroke Rehabilitation and Recovery
- Nerve injury and regeneration
Neurological Surgery
2021-2025
Washington University in St. Louis
2021-2025
University of Iowa
2024
University of Utah
2023
Copyright Licensing Agency
2023
Mayo Clinic
2020
Peripheral nerve trauma impacts both social and occupational quality of life. Patients are typically young subsequently suffer from lifelong disability. Unlike the central nervous system, peripheral system has capacity to regenerate along previous or new connections. Yet, complete functional recovery been an elusive clinical objective despite development advanced microsurgical techniques repair nerves. In recent decades significant amount work expanded focus towards establishing facets...
Importance Cervical spinal cord injury (SCI) causes devastating loss of upper extremity function and independence. Nerve transfers are a promising approach to reanimate limbs; however, there remains paucity high-quality evidence supporting clinical benefit for patients with tetraplegia. Objective To evaluate the utility nerve reanimation limb in Design, Setting, Participants In this prospective case series, adults cervical SCI paralysis whose recovery plateaued were enrolled between...
Prospective cohort study. This study aims to define Substantial Clinical Benefit (SCB) thresholds for PROMIS physical function (PF) and pain interference (PI) in lumbar or thoracolumbar spine surgery population. Patient-reported outcome measures (PROMs) are widely used assess treatment efficacy. SCB is a relatively new concept that represents substantial improvement perceived by the patient. prospective included adults aged 21-85 years, undergoing lumbar/ degenerative disease, reporting at...
Neurosurgeons and hospitals devote tremendous resources to improving recovery from lumbar spine surgery. Current efforts predict surgical rely on one-time patient report health record information. However, longitudinal mobile (mHealth) assessments integrating symptom dynamics ecological momentary assessment (EMA) wearable biometric data may capture important influences recovery. Our objective was evaluate whether a preoperative mHealth EMA with Fitbit monitoring improved predictions of surgery
Despite an increased understanding of the impact socioeconomic status on neurosurgical outcomes, neighborhood-level social determinants lumbar spine surgery patient-reported outcomes remains unknown.To evaluate geographic deprivation physical and mental health patients.A single-center retrospective cohort study analyzing patients undergoing for degenerative disease from 2015 to 2018 was performed. Surgeries were categorized as decompression only or with fusion. The area index used define...
OBJECTIVE High cervical spinal cord injury (SCI) results in complete loss of upper-limb function, resulting debilitating tetraplegia and permanent disability. Spontaneous motor recovery occurs to varying degrees some patients, particularly the 1st year postinjury. However, impact this on long-term functional outcomes remains unknown. The objective study was characterize degree order inform priorities for research interventions that restore function patients with high SCI. METHODS A...
BACKGROUND AND OBJECTIVES: Advanced diffusion-weighted MRI (DWI) modeling, such as diffusion tensor imaging (DTI) and basis spectrum (DBSI), may help guide rehabilitation strategies after surgical decompression for cervical spondylotic myelopathy (CSM). Currently, however, postoperative DWI is difficult to interpret, owing signal distortions from spinal instrumentation. Therefore, we examined the relationship between DTI/DBSI—extracted rostral C3 level—and clinical outcome measures at 2-year...
Background: Depression is common in spine surgery candidates and may influence postoperative outcomes. Ecological momentary assessments (EMAs) can overcome limitations of existing depression screening methods (e.g., recall bias, inaccuracy historical diagnoses) by longitudinally monitoring symptoms daily life. In this study, we compared EMA-based assessment with retrospective self-report (a 9-item Patient Health Questionnaire [PHQ-9]) chart-based diagnosis lumbar candidates. We further...
A major shortcoming in optimizing care for patients with cervical spondylotic myelopathy (CSM) is the lack of robust quantitative imaging tools offered by conventional MRI. Advanced MRI modalities, such as diffusion (dMRI), including tensor (DTI) and basis spectrum (DBSI), may help address this limitation providing granular evaluations spinal cord microstructure.
Background and objective While several experimental studies have demonstrated the neuroprotective role of volatile anesthetics after spinal cord injury (SCI), impact on improving neurologic outcomes in cord-injured patients is not known. Hence, this study aimed to examine functional chronic cervical SCI undergoing peripheral nerve transfer procedures. Methods We conducted a retrospective analysis involving adult with upper extremity paralysis procedures between September 1, 2015, January 31,...
Study Design: Prospective cohort study. Objective: To provide a primer of the glymphatic system, discuss its potential relevance in evaluating spinal diseases like cervical spondylotic myelopathy (CSM), and describe possible imaging markers system derived from advanced diffusion-weighted (dMRI), namely diffusion tensor (DTI) basis spectrum (DBSI). Summary Background Data: The is recently described physiological process that plays an integral role macroscopic waste clearance CNS through...
INTRODUCTION: Cervical spinal cord injury (SCI) results in devastating paralysis. Spinal column (i.e., traumatic SCI) may result worse outcomes as compared to non-traumatic SCI. However, there remains a lack robust data determining the role of etiology prognosticating after cervical METHODS: From prospective cohort SCI model systems, we included adult patients >15 years with SCI, neurological-level C1-C8, ASIA impairment-scale (AIS) A-D, presented within 30-days Traumatic was defined...
INTRODUCTION: While patient-reported outcome measures (PROM) are widely used to assess outcomes, they subjective tools with associated limitations. By assessing objective measures, mobile health technology such as wearable devices, can address these shortcomings. Although the association between activity and spine disease severity has been established, precise thresholds of their meaningful change in after surgery have not. METHODS: This prospective single-center study recruited patients...
INTRODUCTION: Spinal cord injury (SCI) patients face mental health challenges, with an estimated 22% receiving a depression diagnosis after SCI. Depressed SCI tend to have increased complications such as pressure ulcers and may experience greater mortality. However, less is known about the effect of preexisting on outcomes. METHODS: The multicenter, prospectively maintained Model Systems database was used. Adult traumatic enrolled within 30-days from 2010-2016 were included. Functional...
BACKGROUND: Diffusion basis spectrum imaging (DBSI) is a noninvasive quantitative modality that may improve understanding of cervical spondylotic myelopathy (CSM) pathology through detailed evaluations spinal cord microstructural compartments. OBJECTIVE: To determine the utility DBSI as biomarker CSM disease severity. METHODS: A single-center prospective cohort study enrolled 50 patients with and 20 controls from 2018 to 2020. All underwent clinical evaluation diffusion-weighted MRI,...
Importance Traumatic cervical spinal cord injury (SCI) can result in debilitating paralysis. Following SCI, accurate early prediction of upper limb recovery serve an important role guiding the appropriateness and timing reconstructive therapies. Objective To develop a clinical rule to prognosticate functional after SCI. Design, Setting, Participants This prognostic study was retrospective review longitudinal cohort including patients enrolled National SCI model systems (SCIMS) database US....
Rapid growth in smartphone use has expanded opportunities to mobile health (mHealth) technology collect real-time patient-reported and objective biometric data. These data may have important implication for personalized treatments of degenerative spine disease. However, no large-scale study examined the feasibility acceptability these methods surgery patients.To evaluate a multimodal preoperative mHealth assessment patients with disease.Adults undergoing elective were provided Fitbit...