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2. Association of Malnutrition with Surgical and Hospital Outcomes after Spine Surgery for Spinal Metastases: A National Surgical Quality Improvement Program Study of 1613 Patients

Author

Elsamadicy, Aladine A., primary, Havlik, John, additional, Reeves, Benjamin C., additional, Sherman, Josiah J. Z., additional, Craft, Samuel, additional, Serrato, Paul, additional, Sayeed, Sumaiya, additional, Koo, Andrew B., additional, Khalid, Syed I., additional, Lo, Sheng-Fu Larry, additional, Shin, John H., additional, Mendel, Ehud, additional, and Sciubba, Daniel M., additional

Published
2024
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3. Utilization of Machine Learning to Model Important Features of 30-day Readmissions following Surgery for Metastatic Spinal Column Tumors: The Influence of Frailty.

Author

Elsamadicy, Aladine A., Koo, Andrew B., Reeves, Benjamin C., Cross, James L., Hersh, Andrew, Hengartner, Astrid C., Karhade, Aditya V., Pennington, Zach, Akinduro, Oluwaseun O., Larry Lo, Sheng-Fu, Gokaslan, Ziya L., Shin, John H., Mendel, Ehud, and Sciubba, Daniel M.

Subjects
MACHINE learning, SPINE, DISEASE risk factors, PATIENT readmissions, SPINAL surgery
Abstract

Study Design: Retrospective cohort study Objective: The aim of this study was to determine the relative importance and predicative power of the Hospital Frailty Risk Score (HFRS) on unplanned 30-day readmission after surgical intervention for metastatic spinal column tumors. Methods: All adult patients undergoing surgery for metastatic spinal column tumor were identified in the Nationwide Readmission Database from the years 2016 to 2018. Patients were categorized into 3 cohorts based on the criteria of the HFRS: Low(<5), Intermediate(5-14.9), and High(≥ 15). Random Forest (RF) classification was used to construct predictive models for 30-day patient readmission. Model performance was examined using the area under the receiver operating curve (AUC), and the Mean Decrease Gini (MDG) metric was used to quantify and rank features by relative importance. Results: There were 4346 patients included. The proportion of patients who required any readmission were higher among the Intermediate and High frailty cohorts when compared to the Low frailty cohort (Low:33.9% vs. Intermediate:39.3% vs. High:39.2%, P <.001). An RF classifier was trained to predict 30-day readmission on all features (AUC =.60) and architecturally equivalent model trained using only ten features with highest MDG (AUC =.59). Both models found frailty to have the highest importance in predicting risk of readmission. On multivariate regression analysis, Intermediate frailty [ OR:1.32, CI(1.06,1.64), P =.012 ] was found to be an independent predictor of unplanned 30-day readmission. Conclusion: Our study utilizes machine learning approaches and predictive modeling to identify frailty as a significant risk-factor that contributes to unplanned 30-day readmission after spine surgery for metastatic spinal column metastases. [ABSTRACT FROM AUTHOR]

Published
2024
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4. Feasibility, safety, and efficacy of circumferential spine stereotactic body radiotherapy

Author

Dibs, Khaled, primary, Palmer, Joshua D., additional, Prasad, Rahul N., additional, Olausson, Alexander, additional, Bourekas, Eric C., additional, Boulter, Daniel, additional, Ayan, Ahmet S., additional, Cochran, Eric, additional, Marras, William S., additional, Mageswaran, Prasath, additional, Thomas, Evan, additional, Grecula, John, additional, Guiou, Michael, additional, Soghrati, Soheil, additional, Tili, Esmerina, additional, Raval, Raju R., additional, Mendel, Ehud, additional, Scharschmidt, Thomas, additional, Elder, James B., additional, Lonser, Russell, additional, Chakravarti, Arnab, additional, and Blakaj, Dukagjin M., additional

Published
2022
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5. Utilization of Machine Learning to Model Important Features of 30-day Readmissions following Surgery for Metastatic Spinal Column Tumors: The Influence of Frailty

Author

Elsamadicy, Aladine A., primary, Koo, Andrew B., additional, Reeves, Benjamin C., additional, Cross, James L., additional, Hersh, Andrew, additional, Hengartner, Astrid C., additional, Karhade, Aditya V., additional, Pennington, Zach, additional, Akinduro, Oluwaseun O., additional, Larry Lo, Sheng-Fu, additional, Gokaslan, Ziya L., additional, Shin, John H., additional, Mendel, Ehud, additional, and Sciubba, Daniel M., additional

Published
2022
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6. Spine Stereotactic Body Radiotherapy to Three or More Contiguous Vertebral Levels

Author

Dibs, Khaled, primary, Blakaj, Dukagjin M., additional, Prasad, Rahul N., additional, Olausson, Alexander, additional, Bourekas, Eric C., additional, Boulter, Daniel, additional, Ayan, Ahmet S., additional, Cochran, Eric, additional, Marras, William S., additional, Mageswaran, Prasath, additional, Thomas, Evan, additional, Lee, Hyeri, additional, Grecula, John, additional, Raval, Raju R., additional, Mendel, Ehud, additional, Scharschmidt, Thomas, additional, Lonser, Russell, additional, Chakravarti, Arnab, additional, Elder, James B., additional, and Palmer, Joshua D., additional

Published
2022
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7. Field report: walking a tightrope of transparency

Author

Essandoh, Michael K., Salani, Ritu, Mendel, Ehud, Brod, Heather C., Koesters, Stephen C., and Satiani, Bhagwan

Subjects
Disclosure of information -- Surveys, Employers -- Surveys, Employee attitudes -- Surveys, Business, Health care industry
Abstract

Physician leaders are expected to possess or acquire the 'ideal' qualities of successful leaders. Such qualities include credibility, authenticity and transparency. Although these qualities are vital collectively to being a great physician leader, transparency poses a special challenge because it requires more strategic balance to find the optimal amount of information to share in both the academic and private practice environments. Although applicable to leaders at all levels, this is particularly relevant for senior leaders such as chief medical officers and others in the C-suite., IN A SURVEY OF 1,562 WORKERS, 1 IN 4 WORK ers said they did not trust their employer, and only half said their employer was open and upfront with them. [...]

Published
2017

18. Revisiting Postoperative Vision Loss following Non-Ocular Surgery: A Short Review of Etiology and Legal Considerations

Author

Mendel, Ehud, Stoicea, Nicoleta, Rao, Rahul, Niermeyer, Weston, Revilla, Stephen, Cluse, Marcus, Sandhu, Gurneet, Todaro, Gerald J., and Bergese, Sergio D.

Subjects
ischemic optic neuropathy, malpractice, Surgery, neurosurgery, non-ocular surgery with vision loss, postoperative vision loss
Abstract

Postoperative vision loss (POVL) following non-ocular surgery is a serious complication where the causes are not fully understood. Studies have identified several causes of POVL as well as risk factors and prevention strategies. POVL research is made difficult by the fact that cases are often subject to malpractice claims, resulting in a lack of public access to case reports. This literature review was conducted in order to identify legal issues as a major barrier to studying POVL and address how this affects current knowledge. Informed consent provides an opportunity to overcome legal challenges by reducing malpractice litigation through educating the patient on this outcome. Providing pertinent information regarding POVL during the informed consent process has potential to reduce malpractice claims and increase available clinical information.

Published
2017
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20. Systematic Review of the Outcomes of Surgical Treatment of Prostate Metastases to the Spine

Author

Clarke, Michelle J., primary, Molina, Camilo A., additional, Fourney, Daryl R., additional, Fisher, Charles G., additional, Gokaslan, Ziya L., additional, Schmidt, Meic H., additional, Rhines, Laurence D., additional, Fehlings, Michael G., additional, Laufer, Ilya, additional, Patel, Shreyaskumar R., additional, Rampersaud, Y. Raja, additional, Reynolds, Jeremy, additional, Chou, Dean, additional, Bettegowda, Chetan, additional, Mendel, Ehud, additional, Weber, Michael H., additional, and Sciubba, Daniel M., additional

Published
2017
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22. The Spinal Instability Neoplastic Score: Impact On Oncologic Decision-Making

Author

Orthopaedie Onderzoek, MS Orthopaedie Spine, Regenerative Medicine and Stem Cells, Versteeg, Anne L., Verlaan, Jorrit Jan, Sahgal, Arjun, Mendel, Ehud, Quraishi, Nasir A., Fourney, Daryl R., Fisher, Charles G., Orthopaedie Onderzoek, MS Orthopaedie Spine, Regenerative Medicine and Stem Cells, Versteeg, Anne L., Verlaan, Jorrit Jan, Sahgal, Arjun, Mendel, Ehud, Quraishi, Nasir A., Fourney, Daryl R., and Fisher, Charles G.

Published
2016

24. An Exploratory Electromyography-Based Coactivation Index for the Cervical Spine.

Author

Le, Peter, Aurand, Alexander, Best, Thomas M., Khan, Safdar N., Mendel, Ehud, and Marras, William S.

Subjects
ELECTROMYOGRAPHY, CERVICAL vertebrae, TWISTING (Human body), LUMBAR vertebrae, NECK muscles, KINEMATICS, NECK pain, PHYSIOLOGY
Abstract

Objective Develop a coactivation index for the neck and test its effectiveness with complex dynamic head motions. Background Studies describing coactivation for the cervical spine are sparse in the literature. Of those in existence, they were either limited to a priori definitions of agonist/antagonist activity that limited the testing to sagittal and lateral planes or consisted of isometric exertions. Multiplanar movements would allow for a more realistic understanding of naturalistic movements in the cervical spine and propensity for neck pain. However, a gap in the literature exists in which a method to describe coactivation during complex dynamic motions does not exist for the cervical spine. Methods An electromyography-based coactivation index was developed for the cervical spine based on previously tested methodology used on the lumbar spine without a high-end model and tested using a series of different postures and speeds. Results Complex motions involving twisting (i.e., flexion and twisting) and higher speed had higher magnitudes of coactivation than uniplanar motions in the sagittal or lateral plane, which was expected. The coupled motion of flexion and twisting showed four to five times higher coactivation than uniplanar (sagittal or lateral) movements. Conclusion The coactivation index developed accommodates multiplanar, naturalistic movements. Testing of the index showed that motions requiring higher degrees of head control had higher effort due to coactivation, which was expected. Application Overall, this coactivation index may be utilized to understand the neuromuscular effort of various tasks in the cervical spine. [ABSTRACT FROM AUTHOR]

Published
2018
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25. A Systematic Review of Clinical Outcomes and Prognostic Factors for Patients Undergoing Surgery for Spinal Metastases Secondary to Breast Cancer

Author

Sciubba, Daniel M., primary, Goodwin, C. Rory, additional, Yurter, Alp, additional, Ju, Derek, additional, Gokaslan, Ziya L., additional, Fisher, Charles, additional, Rhines, Laurence D., additional, Fehlings, Michael G., additional, Fourney, Daryl R., additional, Mendel, Ehud, additional, Laufer, Ilya, additional, Bettegowda, Chetan, additional, Patel, Shreyaskumar R., additional, Rampersaud, Y. Raja, additional, Sahgal, Arjun, additional, Reynolds, Jeremy, additional, Chou, Dean, additional, Weber, Michael H., additional, and Clarke, Michelle J., additional

Published
2015
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27. Systematic Review of Surgical Treatment Outcomes of Prostate Metastases to the Spine

Author

Clarke, Michelle, primary, Molina, Camilo, additional, Fourney, Daryl, additional, Fisher, Charles, additional, Gokaslan, Ziya, additional, Schmidt, Meic, additional, Rhines, Laurence, additional, Fehlings, Michael, additional, Laufer, Ilya, additional, Patel, Shreyaskumar, additional, Rampersaud, Raja, additional, Reynolds, Jeremy, additional, Chou, Dean, additional, Bettegowda, Chetan, additional, Mendel, Ehud, additional, Weber, Michael, additional, and Sciubba, Daniel, additional

Published
2015
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35. A Systematic Review of Clinical Outcomes and Prognostic Factors for Patients Undergoing Surgery for Spinal Metastases Secondary to Breast Cancer

Author

Sciubba, Daniel M., Goodwin, C. Rory, Yurter, Alp, Ju, Derek, Gokaslan, Ziya L., Fisher, Charles, Rhines, Laurence D., Fehlings, Michael G., Fourney, Daryl R., Mendel, Ehud, Laufer, Ilya, Bettegowda, Chetan, Patel, Shreyaskumar R., Rampersaud, Y. Raja, Sahgal, Arjun, Reynolds, Jeremy, Chou, Dean, Weber, Michael H., and Clarke, Michelle J.

Abstract

Study Design Review of the literature.Objective Surgery and cement augmentation procedures are effective palliative treatment of symptomatic spinal metastases. Our objective is to systematically review the literature to describe the survival, prognostic factors, and clinical outcomes of surgery and cement augmentation procedures for breast cancer metastases to the spine.Methods We performed a literature review using PubMed to identify articles that reported outcomes and/or prognostic factors of the breast cancer patient population with spinal metastases treated with any surgical technique since 1990.Results The median postoperative survival for metastatic breast cancer was 21.7 months (8.2 to 36 months), the mean rate of any pain improvement was 92.9% (76 to 100%), the mean rate of neurologic improvement was 63.8% (53 to 100%), the mean rate of neurologic decline was 4.1% (0 to 8%), and the local tumor control rate was 92.6% (89 to 100%). Kyphoplasty studies reported a high rate of pain control in selected patients. Negative prognostic variables included hormonal (estrogen and progesterone) and human epidermal growth factor receptor 2 (HER2) receptor refractory tumor status, high degree of axillary lymph node involvement, and short disease-free interval (DFI). All other clinical or prognostic parameters were of low or insufficient strength.Conclusion With respect to clinical outcomes, surgery consistently yielded neurologic improvements in patients presenting with a deficit with a minimal risk of worsening; however, negative prognostic factors associated with shorter survival following surgery include estrogen receptor/progesterone receptor negativity, HER2 negativity, and a short DFI.

Published
2016
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