Search

Your search keyword '"Golubovsky, Joshua L."' showing total 20 results
Start Over Author "Golubovsky, Joshua L."
20 results on '"Golubovsky, Joshua L."'

11. Osteobiologics

Author

Golubovsky, Joshua L, primary, Ejikeme, Tiffany, additional, Winkelman, Robert, additional, and Steinmetz, Michael P, additional

Published
2021
Full Text
View/download PDF

17. The Role of Additional Spine Surgery in the Management of Failed Back Surgery Syndrome, Complex Regional Pain Syndrome, and Intractable Pain in the Setting of Previous or Concurrent Spinal Cord Stimulation: Indications and Outcomes

Author

Maldonado-Naranjo, Andres L., primary, Golubovsky, Joshua L., additional, Frizon, Leonardo A., additional, Hogue, Olivia, additional, Lobel, Darlene A., additional, Machado, Andre G., additional, Steinmetz, Michael P., additional, and Nagel, Sean J., additional

Published
2019
Full Text
View/download PDF

20. Predictors of second-sided deep brain stimulation for Parkinson's disease.

Author

Golubovsky JL, Li H, Momin A, Shao J, Lee MY, Frizon LA, Hogue O, Walter B, Machado AG, and Nagel SJ

Abstract

Objective: Parkinson's disease (PD) is a progressive neurological movement disorder that is commonly treated with deep brain stimulation (DBS) surgery in advanced stages. The purpose of this study was to investigate factors that affect time to placement of a second-sided DBS lead for PD when a unilateral lead is initially placed for asymmetrical presentation. The decision whether to initially perform unilateral or bilateral DBS is largely based on physician and/or patient preference., Methods: This study was a retrospective cohort analysis of patients with PD undergoing initial unilateral DBS for asymmetrical disease between January 1999 and December 2017 at the authors' institution. Patients treated with DBS for essential tremor or other conditions were excluded. Variables collected included demographics at surgery, time since diagnosis, Unified Parkinson's Disease Rating Scale motor scores (UPDRS-III), patient-reported quality-of-life outcomes, side of operation, DBS target, intraoperative complications, and date of follow-up. Paired t-tests were used to assess mean changes in UPDRS-III. Cox proportional hazards analysis and the Kaplan-Meier method were used to determine factors associated with time to second lead insertion over 5 years., Results: The final cohort included 105 patients who underwent initial unilateral DBS for asymmetrical PD; 59% of patients had a second-sided lead placed within 5 years with a median time of 34 months. Factors found to be significantly associated with early second-sided DBS included patient age 65 years or younger, globus pallidus internus (GPi) target, and greater off-medication reduction in UPDRS-III score following initial surgery. Older age was also found to be associated with a smaller preoperative UPDRS-III levodopa responsiveness score and with a smaller preoperative to postoperative medication-off UPDRS-III change., Conclusions: Younger patients, those undergoing GPi-targeted unilateral DBS, and patients who responded better to the initial DBS were more likely to undergo early second-sided lead placement. Therefore, these patients, and patients who are more responsive to medication preoperatively (as a proxy for DBS responsiveness), may benefit from consideration of initial bilateral DBS.

Published
2020
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results