Medicine and Health Sciences Commons^™

Clinic Emotions, Rachel Sisley

EMET Projects

This is a sketch of a woman walking into a clinic with her three children, being greeted by a member of the nursing staff. There are two additional staff members in the background. Overlaid on the sketch are acrylic paints representing the emotions of each person. For the mother holding her newborn, the dark blue around her represents sadness, the white represents isolation, and the purple represents detachment. Her toddler behind her, as well as the nurse greeting her, are both outlined in orange and light blue, representing happiness and calmness, respectively. Her newborn and the toddler at her hip …

Investigation Of Dynamic Regulation Of Tfeb Nuclear Shuttling By Microfluidics And Quantitative Modelling, Iacopo Ruolo, Sara Napolitano, Lorena Postiglione, Gennaro Napolitano, Andrea Ballabio, Diego Di Bernardo

Duncan NRI Faculty and Staff Publications

Transcription Factor EB (TFEB) controls lysosomal biogenesis and autophagy in response to nutritional status and other stress factors. Although its regulation by nuclear translocation is known to involve a complex network of well-studied regulatory processes, the precise contribution of each of these mechanisms is unclear. Using microfluidics technology and real-time imaging coupled with mathematical modelling, we explored the dynamic regulation of TFEB under different conditions. We found that TFEB nuclear translocation upon nutrient deprivation happens in two phases: a fast one characterised by a transient boost in TFEB dephosphorylation dependent on transient calcium release mediated by mucolipin 1 (MCOLN1) followed …

From Pregnancy To Beyond: Renewed Emphasis On Comprehensive Hiv Prevention In South Africa., Chibuzor M. Babalola, Remco P.H. Peters, Christina A. Muzny, Dvora Joseph Davey, Christopher M. Taylor, Mandisa M. Mdingi, Freedom Mukomana, Lindsey De Vos, Andrew Medina-Marino, Jeffrey D. Klausner

School of Medicine Faculty Publications

No abstract provided.

Effect Of Testosterone Treatment During Puberty In Boys With Klinefelter Syndrome (The Tipy Study): Protocol For A Nationwide Randomised, Double-Blinded, Placebo-Controlled Study, Ida Dyhr Caspersen, Andrés Felipe Østergaard Fritzbøger, Jørgen Holm Petersen, Niels Birkebæk, Ann-Margrethe Rønholt Christensen, Anders Jørgen Schou, Kurt Kristensen, Judith L. Ross, Shanlee Davis, Gary Butler, Sophie Van Rijn, Anders Juul, Lise Aksglaede

Department of Pediatrics Faculty Papers

INTRODUCTION: Klinefelter syndrome (KS) is a genetic condition characterised by the presence of an extra X chromosome in males (47,XXY). KS is associated with various phenotypic characteristics in adult life, including infertility, hypogonadism and increased risk of type II diabetes, cardiovascular disease and osteoporosis. Additionally, individuals with KS often experience mental health challenges and functional impairments that significantly impact their quality of life. Currently, testosterone replacement therapy (TRT) in adolescence is considered the first-line treatment by some physicians for patients with KS and biochemical signs of hypogonadism. However, comprehensive evidence on its effectiveness in preventing typical phenotypic traits associated with …

Inflammation And Gut Barrier Function-Related Genes And Colorectal Cancer Risk In Western European Populations, Hannah B Mandle, Mazda Jenab, Marc J Gunter, Anne Tjønneland, Anja Olsen, Christina C Dahm, Jie Zhang, Pierre-Emmanuel Sugier, Joseph Rothwell, Gianluca Severi, Rudolf Kaaks, Verena A Katzke, Matthias B Schulze, Giovanna Masala, Sabina Sieri, Salvatore Panico, Carlotta Sacerdote, Catalina Bonet, Maria-Jose Sánchez, Pilar Amiano, José María Huerta, Marcela Guevara, Richard Palmqvist, Thyra Löwenmark, Aurora Perez-Cornago, Elisabete Weiderpass, Alicia K Heath, Amanda J Cross, Paolo Vineis, David J Hughes, Veronika Fedirko

Faculty, Staff and Student Publications

Gut barrier dysfunction and related inflammation are known to be associated with the development and progression of colorectal cancer (CRC). We investigated associations of 292 single-nucleotide polymorphisms (SNPs) from 27 genes related to endotoxins/lipopolysaccharide (LPS) sensing and tolerance, mucin synthesis, inflammation, and Crohn's disease with colon and rectal cancer risks. Incident CRC cases (N = 1374; colon = 871, rectum = 503) were matched 1:1 to controls nested within the European Prospective Investigation into Cancer and Nutrition cohort. Previously measured serum concentrations of gut barrier function and inflammation biomarkers (flagellin/LPS-specific immunoglobulins and C-reactive protein [CRP]) were available for a sub-set …

Adding Metastasis-Directed Therapy To Standard-Of-Care Systemic Therapy For Oligometastatic Breast Cancer (Extend): A Multicenter, Randomized Phase 2 Trial, Jay P Reddy, Alexander D Sherry, Bryan Fellman, Suyu Liu, Tharakeswara Bathala, Cara Haymaker, Lorenzo Cohen, Benjamin D Smith, David Ramirez, Simona F Shaitelman, Stephen G Chun, Marina Medina-Rosales, Mediget Teshome, Abenaa Brewster, Carlos H Barcenas, Alexandre Reuben, Amol J Ghia, Ethan B Ludmir, Daniel Weed, Shalin J Shah, Melissa P Mitchell, Wendy A Woodward, Daniel R Gomez, Chad Tang

Faculty, Staff and Student Publications

PURPOSE: Prior evidence suggests a progression-free survival (PFS) benefit from adding metastasis-directed therapy (MDT) to standard-of-care (SOC) systemic therapy for patients with some oligometastatic solid tumors. Randomized trials testing this hypothesis in breast cancer have yet to be published. We sought to determine whether adding MDT to SOC systemic therapy improves PFS in oligometastatic breast cancer.

METHODS AND MATERIALS: External Beam Radiation to Eliminate Nominal Metastatic Disease is a multicenter phase 2 randomized basket trial testing the addition of MDT to SOC systemic therapy in patients with ≤5 metastases (NCT03599765). Patients were randomly assigned 1:1 to MDT (definitive local treatment …

Respiratory Muscle Strength Training For Persistent Dyspnea In Individuals With Post-Covid-19, Sandra P. Morgan

USF Tampa Graduate Theses and Dissertations

Severe acute respiratory syndrome 2 coronavirus has resulted in more than 775 million known cases and greater than seven million deaths globally. Up to 25% of patients experience ongoing symptoms three months after the acute illness, and up to 30% of these individuals report persistent dyspnea. The overall aims of this dissertation are to 1) examine the risk factors and predictors for developing persistent dyspnea, 2) measure the effects of respiratory muscle strength training on dyspnea, pulmonary symptoms, quality of life, pulmonary function, and functional capacity, and 3) compare the outcomes of two different respiratory muscle strength training interventions.

In …

Science Under Siege: Protecting Scientific Progress In Turbulent Times, James Briscoe, Craig E Franklin, Daniel A Gorelick, E Elizabeth Patton, Michael Way

Faculty, Staff and Students Publications

No abstract provided.

Superior Preclinical Efficacy Of Co-Treatment With Brg1/Brm And Flt3 Inhibitor Against Aml Cells With Flt3 Mutations, Warren Fiskus, Christopher P Mill, Jessica Piel, Mike Collins, Murphy Hentemann, Branko Cuglievan, Christine E Birdwell, Kaberi Das, Hanxi Hou, John A Davis, Antrix Jain, Anna Malovannaya, Tapan M Kadia, Naval Daver, Koji Sasaki, Koichi Takahashi, Danielle Hammond, Patrick K Reville, Lauren B Flores, Sanam Loghavi, Xiaoping Su, Courtney D Dinardo, Kapil N Bhalla

Faculty, Staff and Student Publications

Although treatment with standard frontline therapies, including a FLT3 inhibitor (FLT3i) reduces AML burden and achieves clinical remissions, most patients with AML with FLT3 mutation relapse due to therapy-resistant stem/progenitor cells. The core ATPases, BRG1 (SMARCA4) and BRM (SMARCA2) of the canonical (c) BAF (BRG1/BRM-associated factor) complex is a dependency in AML cells, including those harboring FLT3 mutations. We have previously reported that treatment with FHD-286, a BRG1/BRM ATPases inhibitor, induces differentiation and loss of viability of AML stem/progenitor cells. Findings of present studies demonstrate that treatment with FHD-286 induces lethality in AML cells, regardless of sensitivity or resistance to …

The Role Of The Pthrp/Ihh Feedback Loop In The Unusual Growth Plate Location In Mammalian Metatarsals And Pisiforms., Philip Reno, Sherrie Wallace, Sarah N Doelp, Maria Biancaniello, Kelsey M. Kjosness

PCOM Scholarly Works

BACKGROUND: Longitudinal skeletal growth takes place in the cartilaginous growth plates. While growth plates are found at either end of conventional long bones, they occur at a variety of locations in the mammalian skeleton. For example, the metacarpals and metatarsals (MT) in the hands and feet form only a single growth plate at one end, and the pisiform in the wrist is the only carpal bone to contain a growth plate. We take advantage of this natural anatomical variation to test which components of the PTHrP/Ihh feedback loop, a fundamental regulator of chondrocyte differentiation, are specific to growth plate function. …

Reprogramming Aerobic Metabolism Mitigates Streptococcus Pyogenes Tissue Damage In A Mouse Necrotizing Skin Infection Model, Wei Xu, Tara R Bradstreet, Zongsen Zou, Suzanne Hickerson, Yuan Zhou, Hongwu He, Brian T Edelson, Michael G Caparon

2020-Current year OA Pubs

Disease tolerance is a host response to infection that limits collateral damage to host tissues while having a neutral effect on pathogen fitness. Previously, we found that the pathogenic lactic acid bacterium Streptococcus pyogenes manipulates disease tolerance using its aerobic mixed-acid fermentation pathway via the enzyme pyruvate dehydrogenase, but the microbe-derived molecules that mediate communication with the host's disease tolerance pathways remain elusive. Here we show in a murine model that aerobic mixed-acid fermentation inhibits the accumulation of inflammatory cells including neutrophils and macrophages, reduces the immunosuppressive cytokine interleukin-10, and delays bacterial clearance and wound healing. In infected macrophages, the …

Matrix Metalloproteinases Accelerate Pericellular Matrix Breakdown And Disrupt Mechanotransduction In Osteoarthritis, Jule Nieuwstraten, Rosa Riester, Ulf Krister Hofmann, Farshid Guilak, Marina Danalache

2020-Current year OA Pubs

The pericellular matrix (PCM) is a specialized, narrow matrix surrounding each chondrocyte in articular cartilage, together constituting the chondron - the fundamental metabolic and functional unit of cartilage. The PCM plays a vital role in mediating biomechanical and biochemical signals essential for chondrocyte function. In osteoarthritis (OA), a chronic joint disorder characterized by progressive cartilage degradation, the PCM is one of the earliest sites of catabolic degradation, primarily driven by matrix metalloproteinases (MMPs). This study aims to investigate the functional relationship between PCM degradation and chondrocyte mechanosignaling, with an emphasis on MMP-driven changes in mechanotransduction in osteoarthritic cartilage. Human chondrons …

Apc/C-Mediated Ubiquitylation Of Extranucleosomal Histone Complexes Lacking Canonical Degrons, Aleksandra Skrajna, Kyle M Lapak, Anh Nguyen, Dennis Goldfarb, Et Al.

2020-Current year OA Pubs

Non-degradative histone ubiquitylation plays a myriad of well-defined roles in the regulation of gene expression and choreographing DNA damage repair pathways. In contrast, the contributions of degradative histone ubiquitylation on genomic processes has remained elusive. Recently, the APC/C has been shown to ubiquitylate histones to regulate gene expression in pluripotent cells, but the molecular mechanism is unclear. Here we show that despite directly binding to the nucleosome through subunit APC3, the APC/C is unable to ubiquitylate nucleosomal histones. In contrast, extranucleosomal H2A/H2B and H3/H4 complexes are broadly ubiquitylated by the APC/C in an unexpected manner. Using a combination of cryo-electron …

Fast & Fair Peer Review: A Bold Experiment In Scientific Publishing, Daniel A Gorelick, Alejandra Clark

Faculty, Staff and Students Publications

No abstract provided.

Extensive Epigenomic Dysregulation Is A Hallmark Of Homologous Recombination Deficiency In Triple-Negative Breast Cancer, Youdinghuan Chen, Lucas A Salas, Jonathan D Marotti, Nicole P Jenkins, Chao Cheng, Todd W Miller, Arminja N Kettenbach, Brock C Christensen

Faculty, Staff and Students Publications

Triple-negative breast cancer (TNBC) is the most aggressive breast cancer subtype with substantial disease heterogeneity, limited treatment options, and dismal clinical outcomes. Some TNBCs display homologous recombination deficiency (HRD), a phenotype with elevated genomic burden and worse prognosis if left untreated but chemotherapeutic sensitivity. While the molecular landscape of TNBC is distinct from other breast cancer subtypes, the TNBC-specific link between HRD and epigenome-wide methylation has not been established. This study reports two independent cohorts of TNBC tumors (n = 32 and n = 58) with HRD and epigenomic landscapes measured by the Multiplex Ligation-dependent Probe Amplification assay and the …

Prevalence And Severity Of Depression After Stroke In South Texas: A Five-Year Retrospective Study, Edrick Garcia, Mayrin A. Perez, Kelsey Baker

Research Symposium

Stroke, a type of cerebrovascular disease, is becoming exceedingly common, causing approximately 1 in every 6 deaths in the United States. Healthcare disparities are prevalent within stroke, particularly in Hispanics. Here, we sought to understand disparities that exist in individuals with a stroke who identified as Hispanic. Particularly, we sought to understand the severity of depression after stroke in a predominantly Hispanic region: Rio Grande Valley (RGV), Texas. We hypothesized that the prevalence of depression would be reduced in RGV while depression severity, particularly in areas regarding self-worth, would be increased. To evaluate our hypothesis we conducted a five-year retrospective …

Effects Of Social Isolation On Locus Coeruleus Opioid Receptor Expression And Affective Behavior, John Tkaczynski, Jordan Riser, Maya Patel, Nicole Shellenbarger, Jin Park, Daniel Manvich, Daniel J Chandler

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Social isolation is a stressor that impairs homeostatic neuroendocrine functions and is associated with the development of several mood disorders characterized by persistent negative affect. Persistent feelings of loneliness have been growing public health concerns for several years and were greatly exacerbated by the onset of the COVID-19 pandemic. The problem has grown so severe the U.S. Surgeon General recently declared loneliness to be an epidemic health concern that is associated with poor mental and somatic health outcomes. Therefore, identifying mechanisms of neuroadaptation that contribute to the development of persistent negative affect is a critical step in the identifying better …

Facial Follicular Porokeratosis Simulating Discoid Lupus Erythematosus In An African American Woman, Pritika Singh, Layna Mager, Jeffrey Y. Liu, Jason B. Lee, Sylvia Hsu

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Quantifying Trends In Hospital Administrative Costs: Examining Urban-Rural Disparities, Barriers, And Opportunities For Cost Reduction In Healthcare, Lauree Handlon

MUSC Theses and Dissertations

Administrative and general (A&G) expenses in U.S. hospitals represent a growing financial burden, accounting for 15%–30% of healthcare expenditures. Despite this impact, A&G trends remain underexamined, particularly between rural and urban hospitals. This study used Medicare Cost Report data from over 4,400 short-term acute care hospitals from 2011 to 2022, combined with qualitative interviews with hospital executives, to assess rural-urban differences in A&G expenses. Using an explanatory sequential mixed-methods design, rural hospitals were found to consistently spend a higher proportion of total expenses on A&G salaries—18% more than urban hospitals, even after adjusting for hospital and financial characteristics. Although salary-related …

Exploring The Mechanistic Interplay Between Chronic Inflammation And Gastrointestinal Cancer In The Gut Microbiome: A Review, Hanan Mohamed Abd Elmoneim

Saudi Toxicology Journal

There are complex and heterogeneous immunological milieus of the gastrointestinal system, so there is a high mortality rate from malignancies affecting the gastrointestinal system. The pathophysiology of cancer has long been thought to be significantly influenced by inflammation. However, several of the mechanisms underlying its tumor-promoting activities have only lately been discovered. Both beneficial and harmful microorganisms play a crucial role in controlling the host immune system and, eventually, inflammation. Furthermore, bacteria may also influence how a tumor develops through different mechanisms, including long-term inflammation activation, changes to the tumor microenvironment, and genotoxic response induction. A significant percentage of cancers …

Glucagon-Like Peptide-1 Receptor Agonists: Exciting Avenues Beyond Weight Loss, Lalitha Sundararaman, Divakara Gouda, Anil Kumar, Sumithra Sundararaman, Basavana Goudra

Department of Anesthesiology Faculty Papers

The last two decades have proffered many remarkable choices in managing type 1 and type 2 diabetes mellitus. Leading the list are glucagon-like peptide-1 receptor agonists (GLP1RAs), the first of which, exenatide, was approved by the FDA in 2005. Two other major classes of drugs have also entered the market: dipeptidyl peptidase-4 (DPP-4) inhibitors, commonly known as gliptins and approved in 2006, and sodium-glucose cotransporter-2 (SGLT-2) inhibitors, with the first approval occurring in 2013. These drugs have revolutionized the treatment of diabetes. Additionally, on the horizon, the once-weekly basal insulin analog insulin icodec and the once-weekly combination of insulin icodec …

Parent Feedback On The Reducing Emotional Distress For Childhood Hypoglycemia In Parents (Redchip) Intervention: A Qualitative Analysis., Nicole A. Kahhan, Maryjane S. Campbell, Mark A. Clements, Kimberly A. Driscoll, Amy I. Milkes, Holly K. O'Donnell, Susana R. Patton

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: Severe hypoglycemia is more common among young children with type 1 diabetes mellitus (T1DM) than older youth, and parents report significant hypoglycemia fear (HF). Parents experiencing HF describe constant and extreme worry about the occurrence of hypoglycemia and may engage in potentially risky behaviors to avoid hypoglycemia. Our team developed and tested a behavioral intervention, Reducing Emotional Distress for Childhood Hypoglycemia in Parents (REDCHiP), to decrease HF in parents of young children with T1DM. Here, we qualitatively analyzed parent feedback to refine and optimize future intervention iterations.

METHODS: The randomized pilot study included parents (n = 73) of …

Precision Phenotyping For Curating Research Cohorts Of Patients With Unexplained Post-Acute Sequelae Of Covid-19, Alaleh Azhir, Jonas Hügel, Jiazi Tian, Jingya Cheng, Ingrid V Bassett, Douglas S Bell, Elmer V Bernstam, Maha R Farhat, Darren W Henderson, Emily S Lau, Michele Morris, Yevgeniy R Semenov, Virginia A Triant, Shyam Visweswaran, Zachary H Strasser, Jeffrey G Klann, Shawn N Murphy, Hossein Estiri

Faculty, Staff and Student Publications

BACKGROUND: Scalable identification of patients with post-acute sequelae of COVID-19 (PASC) is challenging due to a lack of reproducible precision phenotyping algorithms, which has led to suboptimal accuracy, demographic biases, and underestimation of the PASC.

METHODS: In a retrospective case-control study, we developed a precision phenotyping algorithm for identifying cohorts of patients with PASC. We used longitudinal electronic health records data from over 295,000 patients from 14 hospitals and 20 community health centers in Massachusetts. The algorithm employs an attention mechanism to simultaneously exclude sequelae that prior conditions can explain and include infection-associated chronic conditions. We performed independent chart reviews …

Ob/Gyn Physician Perspectives On Maintenance Of Certification (Moc), Brent Bost

MUSC Theses and Dissertations

Abstract

Objective: To evaluate physician perspectives of the current maintenance of certification(MOC) activities utilized by the American Board of Obstetrics and Gynecology (ABOG).

Methods: We performed a convergent mixed methods study, using parallel quantitative and qualitative data collected via the internet plus paper surveys of a nationwide sample of Obstetrics and Gynecology (Ob/Gyn) physicians from November 12 to December 13, 2024. The questionnaire included 23 items about various aspects of maintenance of certification, physician burnout and demographics. Three open-ended questions regarding the pros and cons of MOC and recommendations for improvement were also included.

Results: Of the 5,083 requests sent, …

Exploring Health Equity With Culturally Specific Providers Of Permanent Supportive Housing, Judith Solomon

University Honors Theses

Chronic homelessness is an important public health issue. Permanent Supportive Housing (PSH) is a promising opportunity for transitioning people experiencing homelessness into housing, however there remain unaddressed racial inequities in service provision and outcomes. The aim of this study is to better understand the role of culturally specific (CS) providers of PSH in improving health equity. I analyzed interviews with CS PSH providers for themes related to health and healthcare. Providers spoke about the importance of connecting clients to healthcare. Providers stressed the importance of honesty and lived experience, highlighting the strong sense of responsibility to the community. Providers also …

Body Composition And Its Outcomes And Management In Multiple Sclerosis: Narrative Review, Ariel Kidwell-Chandler, Justin Jackson, Brenda Jeng, Stephanie L Silveira, Lara A Pilutti, Paul R Hibbing, Robert W Motl

Faculty, Staff and Student Publications

Background: There is emerging interest in obesity and its prevalence, outcomes, and management in people with multiple sclerosis (MS). Body mass index (BMI) is the traditional marker of obesity in MS, whereas body composition, inclusive of specific body tissue compartments (e.g., fat, bone, and muscle), is often overlooked despite its relevance.

Objective: This narrative review (a) underscored the use and utility of dual-energy X-ray absorptiometry (DEXA) as an accurate and reliable measure of body composition; (b) thematically analyzed and synthesized the current evidence regarding body composition (using DEXA); and (c) determined gaps to be addressed in future research. Methods: …

Strategies To Improve Antibody-Mediated Protection Against Herpes Simplex Virus Infections, Matthew D. Slein

Dartmouth College Ph.D Dissertations

No efficacious vaccine exists for herpes simplex virus and the global burden of disease remains high. Antibodies can serve as potent therapeutics to protect high risk populations such as neonates. Although rare, neonatal HSV (nHSV) infections can result in significant mortality and lifelong neurological morbidity even with antiviral therapy. While HSV-specific maternally derived antibodies significantly reduce the risk of neonatal disease in humans, the mechanisms by which they mediate protection have yet to be described. Using a mouse model of neonatal HSV (nHSV) infections we aimed to determine the mechanisms of antibody-mediated protection using monoclonal antibodies (mAbs) targeting two of …

Tunneling Nanotube-Like Structures Regulate Distant Cellular Interactions During Heart Formation, Lianjie Miao, Yangyang Lu, Anika Nusrat, Guizhen Fan, Shaohua Zhang, Luqi Zhao, Chia-Ling Wu, Hongyan Guo, Trang Le Nu Huyen, Yi Zheng, Zhen-Chuan Fan, Weinian Shou, Robert J Schwartz, Yu Liu, Ashok Kumar, Haixin Sui, Irina I Serysheva, Alan R Burns, Leo Q Wan, Bin Zhou, Sylvia M Evans, Mingfu Wu

Faculty, Staff and Student Publications

In the developing mammalian heart, the endocardium and the myocardium are separated by so-called cardiac jelly. Communication between the endocardium and the myocardium is essential for cardiac morphogenesis. How membrane-localized receptors and ligands achieve interaction across the cardiac jelly is not understood. Working in developing mouse cardiac morphogenesis models, we used a variety of cellular, imaging, and genetic approaches to elucidate this question. We found that myocardium and endocardium interacted directly through microstructures termed tunneling nanotube-like structures (TNTLs). TNTLs extended from cardiomyocytes (CMs) to contact endocardial cells (ECs) directly. TNTLs transported cytoplasmic proteins, transduced signals between CMs and ECs, and …

In Case I Make It: An Autoethnographic Argument For Care, Space, And Utopia, Faelyn T. Cowan

USF Tampa Graduate Theses and Dissertations

Taking an autoethnographic and autotheoretical approach I examine within this project TomboloBooks’ Queer Comic Book Club. Drawing from José Esteban Mun֮oz’s ideas of queer utopia and Jen Jack Gieseking’s framework of constellations, and analyzing my own experiences, I present the Queer Comic Book Club (QCBC) as a moment of utopic queer worldmaking and argue for it’s potential as a site of alternative mental health care. Though I cannot provide here a generalizable model of book clubs as care, what I offer here is a series of possibilities, arguing for the potential of these spaces as community resources and sites of …

Should Proximal Fixation Be At C2 Or C3-C4? An Application Of The Operative Value Index For Elective Posterior Cervical Decompression And Fusion, Advith Sarikonda, D. Mitchell Self, Danyal Quraishi, Ashmal Sami, Emily L. Isch, Steven Glener, Joshua Heller, Srinivas Prasad, Ashwini Sharan, Jack Jallo, Alex R. Vaccaro, James Harrop, Ahilan Sivaganesan

Department of Neurosurgery Faculty Papers

BACKGROUND: There is clinical equipoise regarding the ideal upper instrumented vertebrae (UIV) for elective posterior cervical decompression and fusion (PCDF). Instrumentation may be performed at the axial C2 level, or at the subaxial C3/C4 vertebrae. To our knowledge, a true "value" (outcomes per dollar spent) comparison axial versus subaxial UIV for PCDF has never been performed.

METHODS: We retrospectively identified 275 long-segment (≥3-levels fused) PCDFs with available Neck Disability Index (NDI) scores at baseline and at 3 months postoperatively. C2 UIV (n = 67) was compared to C3/C4 UIV (n = 208). Time-driven activity-based costing was applied to identify the …