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4. Exploring the incidence and risk factors of reoperation for symptomatic adjacent segment disease following cervical decompression and fusion.

Author

Shahzad, Hania, Alvarez, Paul, Pallumeera, Mustaqueem, Bhatti, Nazihah, Yu, Elizabeth, Phillips, Frank, Khan, Safdar, and Singh, Varun

Subjects
Adjacent segment disease, Cervical disc disorder, Cervical fusion, Cervical spondylosis, Postoperative complication, Revision surgery
Abstract

BACKGROUND: Patients with long-term follow-up after cervical decompression and fusion have often been noted to have development of adjacent segment degeneration with a smaller subset of these patients progressing to adjacent segment disease (ASD), which results in the development of new symptomatic radiculopathy or myelopathy referable to a site either directly above or below a prior fused segment. The cause of ASD is multifactorial often involving natural age-related progression of spondylosis, accelerated progression following cervical decompression and fusion, operative technique, and patient-related factors. The effect of age at the time of index cervical decompression and fusion on the need for reoperation for ASD is not fully understood. This study aims to establish underlying risk factors for the development of symptomatic cervical ASD following cervical decompression and fusion requiring reoperation in patients of various age groups. METHODS: A retrospective database review of patients aged 20 or greater with insurance claims of primary cervical decompression and fusion over the course of 11 years and 10 months (January 01, 2010-October 31, 2022) was conducted using an insurance claims database. The primary outcome was to evaluate the incidence of cervical ASD requiring reoperation amongst patients stratified by age at the time of their primary procedure. Secondary outcomes included an evaluation of various risk factors for ASD following cervical decompression and fusion including surgeon-controlled factors such as the number of levels fused and approach taken, patient cervical pathology including cervical disc disorder and cervical spondylosis, and underlying patient medical comorbidities including osteoporosis and vitamin D deficiency, and substance use. RESULTS: A total of 60,292 patient records were analyzed, where the overall reoperation incidence for symptomatic ASD was 6.57%, peaking at 8.12% among those aged 30 to 39 and decreasing with age. Regression analysis revealed ages lower than 50 years as more predictive for the development of symptomatic ASD requiring reoperation. Multivariate regression analysis identified predictive factors for reoperation, including age, Elixhauser Comorbidity Index (ECI), multiple-level surgery, cervical spondylosis, cervical disc disorder, osteoporosis, and vitamin D deficiency. Notably, these factors had a variable impact across various age groups, as revealed by subgroup analysis. CONCLUSIONS: The incidence of reoperation secondary to symptomatic ASD is 6.57%, highest in those aged 30 to 39. The surgical approach had no significant impact on the need for reoperation, but multiple-level fusions posed a consistent risk in the development of symptomatic ASD requiring reoperation. Patient factors like degenerative disc disease, spondylosis, osteoporosis, and vitamin D deficiency were associated, urging further age-specific risk assessment and nonoperative intervention exploration.

Published
2024

5. Predictive factors of symptomatic lumbar pseudoarthrosis following multilevel primary lumbar fusion.

Author

Shahzad, Hania, Ahmad, Moizzah, Singh, Varun, Bhatti, Nazihah, Yu, Elizabeth, Phillips, Frank, and Khan, Safdar

Subjects
Comorbidities, Lumbar pseudoarthrosis, Predictive factors, Spinal fusion, Substance use disorders, Surgical approaches
Abstract

BACKGROUND: Lumbar spinal fusion surgery is a well-established treatment for various spinal disorders. However, one of its complications, pseudoarthrosis, poses a significant concern. This study aims to explore the incidence, time and predictive factors contributing to pseudoarthrosis in patients who have undergone lumbar fusion surgery over a 10-year period. METHODS: Data for this research was sourced from the PearlDiver database where insurance claims of patients who underwent multilevel lumbar spinal fusion between 01/01/2010 and 10/31/2022 were examined for claims of pseudoarthrosis within the 10 years of their index procedure. A variety of demographic, comorbid, and surgical factors were assessed, including age, gender, Elixhauser Comorbidity Index (ECI), surgical approach, substance use disorders and history of spinal disorders. Statistical analyses, including chi-squared tests, multivariate analysis, and cox survival analysis were employed to determine significant associations. RESULTS: Among the 76,337 patients included in this retrospective study, 2.70% were diagnosed with symptomatic lumbar pseudoarthrosis at an average of 7.38 years in a 10-year follow-up. Multivariate and Cox hazard analyses revealed that significant predictors of symptomatic pseudoarthrosis development following multilevel primary lumbar fusion include vitamin D deficiency, osteoarthritis, opioid and NSAID use, tobacco use, and a prior history of congenital spine disorders. CONCLUSIONS: In summary, this study revealed a 2.70% incidence of symptomatic lumbar pseudoarthrosis within 10 years of the index procedure. It highlighted several potential predictive factors, including comorbidities, surgical approaches, and substance use disorders, associated with the development of symptomatic pseudoarthrosis. Future research should focus on refining our understanding of these factors to improve patient outcomes and optimize healthcare resource allocation.

Published
2024

7. Discovery of circulating blood biomarkers in patients with and without Modic changes of the lumbar spine: a preliminary analysis

Author

Aboushaala, Khaled, Chee, Ana V., Toro, Sheila J., Vucicevic, Rajko, Yuh, Catherine, Dourdourekas, Jake, Patel, Ishani K., Espinoza-Orias, Alejandro, Oh, Chundo, Al-Harthi, Lena, Karppinen, Jaro, Goldberg, Edward J., Phillips, Frank M., Colman, Matthew, Williams, Frances M. K., Borgia, Jeffrey A., Green, Stefan, Forsyth, Christopher, An, Howard S., and Samartzis, Dino

Published
2024
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11. Randomized Trial of Augmented Pelvic Fixation in Patients Undergoing Thoracolumbar Fusion for Adult Spine Deformity: Initial Results from a Multicenter Randomized Trial

Author

Mundis, Gregory, Herzog, Joshua, Buchholz, Avery, Eastlack, Robert, Elder, Benjamin, Lieberman, Isador, Kim, Han Jo, Matheus, Virgilio, Snowden, Ryan, Franke, Jorg, Klapproth, Lars, Leveque, Jean-Christophe, Sembrano, Jonathan, Arakal, Raj, Chapman, Matt, Khan, Safdar, Lee, Robert, Belanger, Theodore, Wong, Cyrus, Ajayi, Olaide, Kazemi, Noojan, Park, Paul, Singla, Anuj, Buckland, Aaron, Hah, Raymond, Khalil, Jad, Kleck, Christopher, Mokawem, Michael, Nemani, Venu, Turner, Jay, Colman, Matt, Hirschl, Robert, Kent, Roland, Kuhns, Craig, Prestamburgo, Domenico, Sethi, Rajiv, Smith, Gregory, Uribe, Juan, Cress, Marshall C., Dewald, Christopher, Fogelson, Jeremy, Martin, Chris, Meiler, Katherine, Mullin, Jeffrey, Oppenlander, Mark, Ou-Yang, David, Phillips, Frank, Polly, David, Mundis, Greg, Leveque, Jean-Christopher, Elder, Benjamin D., Martin, Christopher, and Shaffrey, Christopher

Published
2024
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16. Prospective, randomized, multicenter study of intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: 12-month results

Author

Smuck, Matthew, Khalil, Jad, Barrette, Kevin, Hirsch, Joshua Adam, Kreiner, Scott, Koreckij, Theodore, Garfin, Steven, Mekhail, Nagy, Beall, Douglas, Bainbridge, Scott, Kalapos, Paul, Phillips, Frank, Keel, John, Wang, Jeffrey, Munyon, Charles, Markman, John, Vrooman, Bruce, Anand, Neel, Lieberman, Daniel, Shannon, Larry, Calodney, Aaron, Yonemura, Ken, Goodman, Bradly, Moore, Gregory, Schaufele, Michael, and Rhyne, Dan Nguyen Al

Subjects
Pain Research, Clinical Trials and Supportive Activities, Chronic Pain, Neurosciences, Clinical Research, 6.3 Medical devices, 6.1 Pharmaceuticals, Evaluation of treatments and therapeutic interventions, Humans, Low Back Pain, Pain Measurement, Prospective Studies, Quality of Life, Treatment Outcome, INTRACEPT Trial Investigators, back pain, chronic pain, outcomes, Clinical Sciences, Anesthesiology
Abstract

IntroductionVertebral endplates, innervated by the basivertebral nerve (BVN), are a source of chronic low back pain correlated with Modic changes. A randomized trial comparing BVN ablation to standard care (SC) recently reported results of an interim analysis. Here, we report the results of the full randomized trial, including the 3-month and 6-month between-arm comparisons, 12-month treatment arm results, and 6-month outcomes of BVN ablation in the former SC arm.MethodsProspective, open label, 1:1 randomized controlled trial of BVN ablation versus SC in 23 US sites with follow-up at 6 weeks, 3, 6, 9, and 12 months. SC patients were re-baselined and followed up for 6 months post BVN ablation. The primary endpoint was the between-arm comparison of mean Oswestry Disability Index (ODI) change from baseline. Secondary endpoints were Visual Analog Scale (VAS), Short Form (SF-36), EuroQual Group 5 Dimension 5-Level Quality of Life (EQ-5D-5L), responder rates, and rates of continued opioid use.Results140 were randomized. Results from BVN ablation (n=66) were superior to SC (n=74) at 3 months for the primary endpoint (mean ODI reduction, difference between arms of -20.3 (CI -25.9 to -14.7 points; p

Published
2021

17. Intelligence-Based Spine Care Model: A New Era of Research and Clinical Decision-Making

Author

Mallow, G Michael, Siyaji, Zakariah K, Galbusera, Fabio, Espinoza-Orías, Alejandro A, Giers, Morgan, Lundberg, Hannah, Ames, Christopher, Karppinen, Jaro, Louie, Philip K, Phillips, Frank M, Pourzal, Robin, Schwab, Joseph, Sciubba, Daniel M, Wang, Jeffrey C, Wilke, Hans-Joachim, Williams, Frances MK, Mohiuddin, Shoeb A, Makhni, Melvin C, Shepard, Nicholas A, An, Howard S, and Samartzis, Dino

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, artificial, intelligence, machine, learning, computation, data, science, precision, personalized, spine, pain, disc, degeneration, low back pain, tumor, deformity, Clinical sciences
Published
2021

29. Howard S. An: 2023 International Society for the Study of the Lumbar Spine Wiltse Lifetime Achievement Award

Author

Samartzis, Dino, Aboushaala, Khaled, Albert, Todd J., Cha, Thomas, Chee, Ana, Diwan, Ashish D., Espinoza-Orias, Alejandro, Hu, Serena S., Inoue, Nozomu, Jacobs, Joshua J., Lenke, Lawrence G., Louie, Philip K., Martin, John T., Nassr, Ahmad, Oh, Chundo, Phillips, Frank M., Riew, Kiehyun Daniel, Shen, Francis H., Tannoury, Chadi, Vaccaro, Alexander R., Wong, Arnold Y.L., and Yoon, Sangwook Tim

Published
2023
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31. Adult Scoliosis

Author

Karukonda, Teja, Presciutti, Steven M., Moss, Isaac L., Phillips, Frank M., Phillips, Frank M., editor, Lieberman, Isador H., editor, Polly Jr., David W., editor, and Wang, Michael Y., editor

Published
2019
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33. The impact of reader fatigue on the accuracy of capsule endoscopy interpretation

Author

Ching, Hey-Long, Koulaouzidis, Anastasios, Yung, Diana, Panter, Simon, Mcalindon, Mark, Johnson, Matthew, Kurup, Arun, Shonde, Anthony, San-Juan Acosta, Miliedis, Sansone, Stefano, Simmon, Ebby, Thurston, Victoria, Healy, Ailish, Chetcuti Zammit, Stefania, Schembri, John, Lau, Michelle S, Lam, Ching, Nizamuddin, Mohammed, Baxter, Andrew, Patel, Jay, Archer, Tom, Oppong, Phillip, Phillips, Frank, Dorn, Tara, Fateen, Waleed, White, Jonathan, Budihal, Shivkumar, Tan, Huey, Tiwari, Rajini, Beg, Sabina, Card, Tim, Sidhu, Reena, Wronska, Ewa, and Ragunath, Krish

Published
2021
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34. List of Contributors

Author

Ahmed, A. Karim, primary, Al-Saiegh, Fadi, additional, Albert, Todd J., additional, Aleem, Ilyas, additional, Alvarado, Anthony M., additional, Ames, Christopher P., additional, Anderson, Paul A., additional, Arnold, Paul M., additional, Benzel, Edward, additional, Bisson, Erica F., additional, Boaro, Alessandro, additional, Boody, Barrett S., additional, Brodke, Darrel S., additional, Brooks, Nathaniel P., additional, Buell, Thomas J., additional, Burke, Rebecca M., additional, Canseco, Jose A., additional, Cheng, Joseph S., additional, Chou, Dean, additional, Ehresman, Jeff, additional, Gandhi, Sapan D., additional, Goldstein, Zachary H., additional, Groff, Michael W., additional, Gupta, Raghav, additional, Harland, Tessa, additional, Harrop, James S., additional, Heary, Robert F., additional, Hoang, Stanley, additional, Holton, Kenneth J., additional, Hundal, Rajbir S., additional, Joseph, Jacob R., additional, Kalfas, Iain H., additional, Kanter, Adam S., additional, Katsuura, Yoshihiro, additional, Kim, Han Jo, additional, Kim, Jun S., additional, Kolluri, Kamal, additional, Leas, Daniel P., additional, Lehman, Ronald A., additional, Lenke, Lawrence G., additional, Liounakos, Jason I., additional, Mayer, Rory, additional, Mummaneni, Praveen V., additional, Nasser, Rani, additional, Nassr, Ahmad, additional, Owen, Robert J., additional, Padua, Fortunato G., additional, Park, Paul, additional, Park, Paul J., additional, Patel, Arati B., additional, Patel, Rakesh, additional, Pennicooke, Brenton, additional, Pennington, Zach, additional, Phillips, Frank M., additional, Pilitsis, Julie G., additional, Polly, David W., additional, Potts, Eric A., additional, Rao, Raj D., additional, Resnick, Daniel K., additional, Rivera, Joshua, additional, Saleh, Mohamed, additional, San Miguel, Jose E., additional, Sasso, Rick C., additional, Schmoller, Shelly K., additional, Sciubba, Daniel M., additional, Shaffrey, Christopher I., additional, Sheldon, Breanna L., additional, Sherrod, Brandon A., additional, Shorten, Peter, additional, Smith, Justin S., additional, Swong, Kevin, additional, Tan, Lee A., additional, Thomas, Daniel J., additional, Truong, Huy Q., additional, Vaccaro, Alexander R., additional, Wang, Michael Y., additional, Yee, Timothy J., additional, Yen, Chun-Po, additional, and Yener, Ulas, additional

Published
2022
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36. Assessment, endoscopy, and treatment in patients with acute severe ulcerative colitis during the COVID-19 pandemic (PROTECT-ASUC): a multicentre, observational, case-control study

Author

Abdale, Shukri, Abbasi, Abdullah, Abusrewil, Anwar, Aghimien, Precious, Ahmed, Saeed, Ali, Akram, Ali, Amjad, Alkhoury, Jad, Allen, Patrick, Al-Rifaie, Ammar, Appleby, Richard, Arasaradnam, Ramesh, Arebi, Naila, Arms-Williams, Bradley, Ashraf, Muteeb, Au, Andrea, Avades, Tamar, Ayubi, Homira, Azhar, Saleha, Baillie, Samantha, Balarajah, Sharmili, Bancil, Aaron, Basit, Abdul, Bayati, Murad, Bell, Andrew, Berry, Alexander, Bhat, Shivaram, Bhattacharyya, Joya, Bishop, Sophia, Blackmore, Laura, Bond, Ashley, Borg-Bartolo, Simon, Botwright, Emma, Bouri, Sonia, Boyle, Stephen, Bradley, Neil, Brailsford, Fiona, Britton, Deborah, Brown, Caitlin, Butcher, Rhys, Butterworth, Jeffrey, Campbell, Rachel, Campbell, Roisin, Campbell, Iona, Carr, Ruth, Carter, Josiah, Cartlidge, Peter, Chandy, Rajiv, Chatten, Kelly, Chaudhary, Rakesh, Chee, Desmond, Cheesbrough, Jonathan, Churchhouse, Antonia, Chughtai, Sara, Clough, Jennie, Cole, Alexander, Cook, Johannah, Cooney, Rachel, Cotton, Sarah, Coulter, Archibald, Critchlow, Tamsin, Cuison, Frederic, Curran, Chris, Darie, Ana-Maria, Dart, Robin, Davwar, Pantong, Dawa, Kasamu Kabiru, Dhar, Anjan, Din, Shahida, Diong, Kok Leong, Disney, Benjamin, Dooks, Emma, Downey, Louise, D'Souza, Anita, Dyall, Lovesh, El Masri, Ali El Rida, Elias, Mary, Evans, Holli, Felwick, Richard, Finegan, Michael, Flanagan, Paul, Fofaria, Rishi, Fong, Steven Chung Ming, Fox, Richard, Fraser, Aileen, Frunza, Christian, Ghodeif, Alhassan, Ghosh, Nivedita, Gilroy, Leah, Good, Larissa, Gordon, John, Grasso, Nicola, Guéroult, Aurelién M, Gulliver, James, Guthrie, Sarah, Gwiggner, Markus, Hanna, Mina, Harlow, Christopher, Harrison, Wendy, Hart, Ailsa, Hawthorne, Barney, Henshaw, Julie, Herdman-Grant, Rosaleen, Hooper, Patricia, Howard, Willow, Hussain, Nasir, Hutton, Thomas, Htun, Aye Mya, Irving, Peter, Jagdish, Reema, Javed, Anum, Javed, Asima, Jayasooriya, Nishani, Johnson, Matthew, Johnston, Emma, Jones, Gareth-Rhys, Kanagasundaram, Cynthia, Karagkouni, Fotein, Kemp, Karen, Kemp, Cheryl, Khalil, Hesham, Khan, Najeebullah, Khasawneh, Mais, Khurshid, Bilal, King, Andrew, Kirkham, Beverley, Kirkham, Fiona, Kokwaro, Flora, Korani, Mohamed, Koumoutsos, Ioannis, Kumar, Aditi, Kuzhiyanjal, Anish John Kuriakose, Lakeland, Martyn, Laverick, Sophie, Lees, Charlie, Levell, Emma, Levison, Scott, Lim, Samuel, Lim, Yuen-Hui, Limdi, Jimmy, Lindsay, James Oliver, Lisle, Jessica, Lobo, Alan, Luber, Raphael, Lucaciu, Laura, Lyne, Holly, MacDonald, Jonathan, Mahalingam, Aarani, Mahgoub, Sara, Malakar, Ridhima, Marley, Fenella, Mason, Joy, Mazhar, Zia, McCaughan, Hannah, Naughton, Tracy, McCulloch, Adam, McIlwaine, Stuart, Meah, Nirmol, Mebarek, Leila, Mendall, Mike, Meiarasu, Radharetnas, Mir, Nasir, Mills, Tilly, Milton, Jentus, Moffat, Victoria, Moran, Gordon W, Morris, Liam, Morrison, Gary, Morrison, Graham, Mulligan, Robert, Murray, Charles, Murray, Jennifer, Musharaf, Mutwakil, Myers, Sally, Naeck-Boolauky, Pineshwari, Naranjo, Andres, Navaratnam, Janardhan, Naylor, Deanna, Nixon, Emma, Nixon, Kirsty, Nooredinvand, Hesam Ahmadi, Nosegbe, Uche, Olabintan, Olaolu, Ong Ming San, Elaine, Okpeh, Comfort, Owen, Hayley, Owen, Ruth, Palmer-Jones, Christopher, Peddada, Kalyan, Peerally, Mohammad, Perkins, Rebecca, Phillips, Frank, Pohl, Keith, Pollok, Richard, Powell, Nick, Qayyum, Farah, Qurashi, Maria, Quraishi, Mohammed Nabil, Ratcliffe, Elizabeth, Radford, Shellie, Rahmany, Sohail, Ramadan, Hanin, Ramadas, Arvind, Reddington, Anne, Riley, Tom, Rimmer, Peter, Ritchie, Susan, Roscoe, Jacqueline, Rosiou, Konstantina, Rowland, Siobhan, Sabine, Joseph, Saifuddin, Aamir, Samaan, Mark, Sarkar, Priya, Sarwar, Shahzad, Sasegbon, Ayodele, Saunders, Jayne, Sebepos-Rogers, Gregory, Seenan, John Paul, Selinger, Christian, Serna, Solange, Sethi, Sonika, Shale, Matthew, Shenderey, Richard, Shenoy, Achuth, Sherifat, Yousuf, Sheth, Roosey, Siakavellas, Spyros, Sikafi, Rafid, Singh, Amar, Singh, Salil, Singh, Updesh, Sivaji, Ganesh, Smith, Philip, Speight, R Alexander, Spence, Andy, Stansfield, Catherine, Steed, Helen, Suseeharan, Kishaani, Tabuso, Maria, Taucius, Donatas, Taylor, Joanne, Thakor, Amit, Tham, Tony, Townsend, Gill, Townsend, Tristan, Troth, Thomas, Tunney, Ruth, Turner, Kelly, Umar, Nosheen, Vakeeswarasarma, Vithushan, Verma, Ajay M, Wallace, Hazel, Wallis, Katharina, Walton, Hannah, Wang, Bo, Warner, Eleanor, Watson, Callum, Watson, Eleanor, Wen, Susie, Widlak, Monika, Williams, Maureen, Woods, Amy, Younge, Lisa, Zafar, Mansoor, Sebastian, Shaji, Walker, Gareth J, Kennedy, Nicholas A, Conley, Thomas E, Patel, Kamal V, Subramanian, Sreedhar, Kent, Alexandra J, Segal, Jonathan P, Brookes, Matthew J, Bhala, Neeraj, Gonzalez, Haidee A, Hicks, Lucy C, Mehta, Shameer J, and Lamb, Christopher A

Published
2021
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38. Spine surgeon perceptions of the challenges and benefits of telemedicine: an international study

Author

Riew, Grant J., Lovecchio, Francis, Samartzis, Dino, Bernstein, David N., Underwood, Ellen Y., Louie, Philip K., Germscheid, Niccole, An, Howard S., Cheung, Jason Pui Yin, Chutkan, Norman, Mallow, Gary Michael, Neva, Marko H., Phillips, Frank M., Sciubba, Daniel M., El-Sharkawi, Mohammad, Valacco, Marcelo, McCarthy, Michael H., Iyer, Sravisht, and Makhni, Melvin C.

Published
2021
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40. Prospective, multicenter clinical trial comparing M6-C compressible six degrees of freedom cervical disc with anterior cervical discectomy and fusion for the treatment of single-level degenerative cervical radiculopathy: 2-year results of an FDA investigational device exemption study

Author

Phillips, Frank M., Coric, Domagoj, Sasso, Rick, Lanman, Todd, Lavelle, William, Blumenthal, Scott, Lauryssen, Carl, Guyer, Richard, Albert, Todd, Zigler, Jack, Cammisa, Frank, and Milam, Robert Alden

Published
2021
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42. Answer to the letter to the editor by Zhi-Hui Dai concerning “Artificial intelligence in predicting early-onset adjacent segment degeneration following anterior cervical discectomy and fusion” by Rudisill SS et al. (Eur Spine J [2022]; doi: 10.1007/s00586-022-07238-3)

Author

Rudisill, Samuel S., Hornung, Alexander L., Barajas, J. Nicolás, Bridge, Jack J., Mallow, G. Michael, Lopez, Wylie, Sayari, Arash J., Louie, Philip K., Harada, Garrett K., Tao, Youping, Wilke, Hans-Joachim, Colman, Matthew W., Phillips, Frank M., An, Howard S., and Samartzis, Dino

Published
2022
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49. Risk of Subsequent Fusion After Isolated Decompression of Lumbar Facet Cysts

Author

Federico, Vincent P., primary, Forlenza, Enrico M., additional, Acuna, Alexander J., additional, Vucicevic, Rajko S., additional, Conaway, William K., additional, Nie, James W., additional, Butler, Alexander J., additional, Gabriel, Samy, additional, Lopez, Gregory D., additional, An, Howard S., additional, Colman, Matthew W., additional, and Phillips, Frank M., additional

Published
2024
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