Surgery Commons^™

The Prospects Of Car T-Cell Therapies In Changing The Therapeutic Algorithm Of Neurologic Autoimmunities, Marinos C. Dalakas

Department of Neurosurgery Faculty Papers

T cells, genetically modified to express chimeric antigen receptors (CAR T), successfully used in hemato-oncologic malignancies, are showing promising and sustained benefits in refractory autoimmune neurological diseases, including Myasthenia Gravis, stiff-person syndrome, neuromyelitis optica, myositis, autoimmune neuropathies, and multiple sclerosis. Several reported patients with a steadily progressive disease and evolving disability unresponsive to available therapies, including rituximab and new biologics, after 2-3 months of treatment with CARs targeting CD19-positive, antibody-secreting, long-lived plasma cells, and plasmablasts exhibit impressive, long-lasting, and drug-free clinical improvements with the potential for immune reset shifting immunity to a healthy state without the need for continuing more …

Quality Of Robotic Segmentectomy Vs. Video-Assisted Thoracoscopic Segmentectomy In Non-Small Cell Lung Cancer: A Retrospective Cohort Study, Sneha S. Alaparthi, Anurag Ishwar, Isheeta Madeka, Annie Ho, Tyler Grenda, Nathaniel R. Evans Iii, Olugbenga T. Okusanya

Jefferson Hospital Staff Papers and Presentations

Background & Methods

• Lung cancer remains a leading cause of cancer death worldwide. Sub lobar resection (segmentectomy) has proved to be a safe and effective alternative to lobectomy in recent literature.
• Our objective is to compare quality of resection between robotic assisted (RVATS) and video assisted (VATS) thoracoscopic segmentectomy. Our hypothesis is that robotic segmentectomy will allow for an improved oncologic resection.
• Retrospective cohort study of National Cancer Database (NCDB). Patients >18 undergoing RVATS or VATS segmentectomy for clinical N0M0, ≤ 2 cm between 2010-2020.
• Quality of oncologic resection assessed with presence and number of nodes examined, margin positivity, upstaging, …

Operative Confidence In Open And Endovascular Procedures Among Vascular Surgery Graduates Reflects Procedural Exposure During Training, Jin Park, Nicola Habash, Dawn Salvatore, Michael Nooromid, Paul J. Dimuzio, Babak Abai

Department of Surgery Faculty Papers

Objective: The shift toward minimally invasive techniques has transformed vascular surgery practice and training. As endovascular procedures replace many traditional open operations, concerns have emerged about whether current training adequately prepares graduates for independent practice, particularly in complex open procedures.

Methods: A web-based survey was distributed to recent graduates of Accreditation Council for Graduate Medical Education-accredited vascular surgery training programs from 2022 and 2024. The survey assessed demographics, program characteristics, estimated case volumes, and confidence in 22 core vascular operations using a five-point Likert scale. Mann-Whitney U and Kruskal-Wallis tests, as well as multivariable logistic regression, identified factors associated with …

Determining The Optimal Management Of Geriatric Type Ii Odontoid Fractures: A Comparative Network Meta-Analysis, Shaan Patel, Shiva A. Nischal, Kush M. Kale, Stavros Matsoukas, Joshua Heller, Jack Jallo, James S. Harrop, Srinivas K. Prasad

Department of Neurosurgery Faculty Papers

UNLABELLED: Type II odontoid fractures are the most common cervical injury in geriatric populations, yet optimal management remains debated. This study compared the safety and effectiveness of non-surgical management (NSM), anterior dens screw (ADS) fixation, and posterior arthrodesis (PA) in these patients. A systematic review and frequentist network meta-analysis was conducted according to PRISMA-NMA guidelines. PubMed/MEDLINE, Embase, and CENTRAL were searched from inception to October 2025. Comparative studies including patients ≥ 60 years with Anderson-D’Alonzo type II fractures and reporting at least one primary outcome (mortality, union, stable non-union, unstable non-union) were eligible. Random-effects network models generated pooled odds ratios …

Single-Layer Spherical (Sls) Vs Single-Layer (Sl) Woven Endobridge (Web) Device In The Treatment Of Narrow-Neck Intracranial Aneurysms: A Propensity Score-Matched Analysis, Hamza Adel Salim, Vivek Yedavalli, Fathi Milhem, Nimer Adeeb, Basel Musmar, Muhammed Amir Essibayi, Motaz Daraghma, Mahmoud Dibas, Nicole M. Cancelliere, Jose Danilo Bengzon Diestro, Oktay Algin, Sherief Ghozy, Sovann V. Lay, Adrien Guenego, Leonardo Renieri, Joseph Carnevale, Guillaume Saliou, Panagiotis Mastorakos, Kareem El Naamani, Eimad Shotar, Markus Möhlenbruch, Michael Kral, Charlotte Chung, Mohamed M. Salem, Ivan Lylyk, Paul M. Foreman, Hamza Shaikh, Vedran Župančić, Muhammad U. Hafeez, Joshua Catapano, Muhammad Waqas, Muhammet Arslan, Onur Ergun, James D. Rabinov, Julian Maingard, Clemens M. Schirmer, Mariangela Piano, Anna L. Kühn, Caterina Michelozzi, Robert M. Starke, Ameer Hassan, Mark Ogilvie, Anh Nguyen, Jesse Jones, Waleed Brinjikji, Marie T. Nawka, Marios Psychogios, Christian Ulfert, Bryan Pukenas, Jan-Karl Burkhardt, Thien Huynh, Juan Carlos Martinez-Gutierrez, Sunil A. Sheth, Diana Slawski, Rabih Tawk, Benjamin Pulli, Boris Lubicz, Pietro Panni, Ajit S. Puri, Guglielmo Pero, Eytan Raz, Christoph J. Griessenauer, Hamed Asadi, Adnan Siddiqui, Elad I. Levy, Neil Haranhalli, David Altschul, Andrew F. Ducruet, Felipe C. Albuquerque, Robert W. Regenhardt, Christopher J. Stapleton, Peter Kan, Vladimir Kalousek, Pedro Lylyk, Srikanth Boddu, Jared Knopman, Stavropoula I. Tjoumakaris, Hugo H. Cuellar-Saenz, Pascal M. Jabbour, Frédéric Clarençon, Nicola Limbucci, Vitor Mendes Pereira, Aman B. Patel, Max Wintermark, Adam A. Dmytriw

Department of Neurosurgery Faculty Papers

Data on the use of Woven EndoBridge (WEB) devices in the treatment of narrow-neck intracranial aneurysms (NNA) are limited. We compared the efficacy and safety of single-layer (SL) and single-layer spherical (SLS) WEB devices in treating NNA. We conducted a multicenter retrospective analysis of adult patients with NNA (neck ≤ 4 mm and width-to-neck ratio ≥ 2) treated with SL or SLS WEB devices between January 2011 and December 2022. Patients with fusiform or blister aneurysms, adjunctive treatments, or devices other than SL or SLS were excluded. Propensity score matching was used to adjust for confounding variables. Outcomes included procedural …

Examining The Relationship Between Academic Excellence And Clinical Productivity In Orthopedic Surgery, Mohamad Y. Fares, Xiaoran Zhang, Harry H. Liu, Ana Paula Beck Da Silva Etges, Krishna Chopra, Brian Zhou, Ira Sivaram, Chrishaun Alexander, Peter Boufadel, Porter Jones, Derek A. Haas, Adam Z. Khan, Eric Wagner, Joseph A. Abboud

Rothman Institute Papers

Background/Objectives: The relationship between clinical volume and academic performance in orthopedic surgery remains understudied. The purpose of this study is to explore the characteristics of high-achieving academic orthopedic surgeons in an attempt to extrapolate patterns and trends that govern the relationship between clinical performance and academia in orthopedic surgery. Methods: The 2023 National Plan and Provider Enumeration System and Medicare claims data (2021–2022) databases were used to include all active orthopedic surgeons of different subspecialties. A publication score, based on publication volume, journal impact, and authorship position, was calculated for each included surgeon, and surgeons who scored in the top …

Improving Vaccination In People With Ckd: Report From A National Kidney Foundation Working Group, Susan F. Massengill, Kenneth A. Andreoni, Keith A. Bellovich, Cheryl Courtlandt, Vimal K. Derebail, David L. Feldman, Gia J. Oh, John W. Sleasman, Kristina A. Bryant, Improving Vaccination In Ckd Working Group

Department of Surgery Faculty Papers

People with chronic kidney disease (CKD) are particularly vulnerable to vaccine-preventable infections. Therefore, the National Kidney Foundation organized a multidisciplinary working group, including people with CKD and family care partners, to develop recommendations to improve vaccination rates, vaccination effectiveness, and health care for the CKD population. A modified Delphi process was used to achieve consensus on the recommendations. Recommendations on vaccination in CKD patients were organized into these categories: (1) patient preferences; (2) assessing the vaccination status of patients with CKD; (3) assessing vaccine response in patients with CKD; (4) vaccination of immunocompromised patients; (5) vaccination in posttransplant patients; (6) …

Elixhauser Comorbidity Index To Predict Perioperative Bleeding And Adverse Spine Surgery Outcomes, Mitchell K. Ng, Michael A. Mont, Mosadoluwa Afolabi, Prathiksha N V, Amitha Kumar, Stephen S. Johnston

Rothman Institute Papers

Introduction: As spine surgery volume continues to grow, ensuring patient safety and minimizing complications are increasingly critical. Disruptive bleeding—defined as hemorrhagic events requiring clinical intervention—is a significant perioperative challenge. This study aimed to: (1) quantify disruptive bleeding incidence; (2) evaluate associations between patient demographics, Elixhauser Comorbidity Index (ECI), and bleeding risk; and (3) assess the impact of disruptive bleeding on mortality, ventilator use, length of inpatient stay, 90-day readmissions, and inpatient costs. Methods: A nationwide healthcare database was used to identify patients who underwent spine surgery in 2019. Patients were subdivided by the Elixhauser Comorbidity Index (ECI) from 0 to …

Comparative Safety, Efficacy, And Predictors Of Complete Occlusion Of Flow Diverter Devices In The Treatment Of Unruptured Distal Anterior Cerebral Artery Aneurysms, Hamza Adel Salim, Luca Scarcia, Frédéric Clarençon, Orabi Hajjeh, Motaz Daraghma, Davide Simonato, Yan-Lin Li, Eimad Shotar, Kevin Premat, Pascal Jabbour, Stavropoula Tjoumakaris, Michael R. Gooch, Marios Psychogios, Nikos Ntoulias, Peter Sporns, Ajit S. Puri, Jasmeet Singh, Anna Luisa Kuhn, Ameer E. Hassan, Oktay Algin, Markus A. Möhlenbruch, Sophia Hohenstatt, Riccardo Russo, Mauro Bergui, Oded Goren, Matthew J. Kole, Nourou Dine Adeniran Bankole, Richard Bibi, Gregoire Boulouis, Takeshi Morimoto, Fumihiro Sakakibara, Raoul Pop, Ciprian Juravle, Joanna W. K. Ho, Ãngel Ferrario, Virginia Pujol Lereis, Jared Cooper, Chirag D. Gandhi, Giancarlo Salsano, Lucio Castellan, Arturo Consoli, Alessandro Sgreccia, Eytan Raz, Charlotte Chung, Julien Burel, Chrysanthi Papagiannaki, Umair Rasheed, Khawaja Muhammad Baqir Hassan, Hong Tao, Zhe Ji, Riitta Rautio, Matias Sinisalo, Maria Ruggiero, Elvis Lafe, Valerio Da Ros, Luigi Bellini, Joseph Domenico Gabrieli, Francesco Causin, Michael R. Levitt, Kate Carroll, Zachary Abecassis, Antonio Armando Caragliano, Sergio Lucio Vinci, Guillaume Bellanger, Christophe Cognard, Gaultier Marnat, Lisa Saleille, Nicola Limbucci, Francesco Capasso, Mariangela Piano, Claudia Rollo, Alexis Guedon, Francesco Arpaia, Andrea Romi, Fortunato Di Caterino, Alessandra Biondi, Erwah Kalsoum, Mykola Vyval, Adrien Guenego, Than Nguyen, Mohamad Abdalkader, Thibault Agripnidis, Aman B. Patel, Vitor Mendes Pereira, Maurizio Fuschi, Alessandro Pedicelli, Vivek Yedavalli, Max Wintermark, Andrea M. Alexandre, Adam A. Dmytriw, Creta Investigators

Department of Neurosurgery Faculty Papers

BACKGROUND: Flow diverters (FDs) are increasingly used for cerebral aneurysms, including distal anterior cerebral artery (DACA) aneurysms, but comparative data between devices in this challenging location are limited.

OBJECTIVE: To compare the safety and efficacy of Pipeline, Silk Vista Baby (SVB), and FRED Jr. FDs for unruptured DACA aneurysms and identify predictors of complete occlusion.

METHODS: We retrospectively analyzed 166 patients treated with FDs at 39 centers in 14 countries (2018–2022) from the CRETA registry. Outcomes included aneurysm occlusion (O’Kelly–Marotta [OKM] scale), complications, retreatment, modified Rankin Scale (mRS) scores, and independent predictors of complete occlusion using multivariable Cox regression.

RESULTS: …

P-15 Peptide Enhanced Bone Graft In Transforaminal Lumbar Interbody Fusion: A Randomized, Controlled, Investigational Device Exemption Study Demonstrating Improved Composite Clinical Success, James Harrop, John E. O'Toole, Michael P. Steinmetz, Rick C. Sasso, Christopher D. Chaput, K. Brandon Strenge, Greg Maislin, Jeffrey P. Mullin, Thomas B. Freeman, Anthony Guanciale, Howard Lantner, Michael E. Janssen, David G. Schwartz, John M. Small, Wellington K. Hsu, Paul M. Arnold

Department of Orthopaedic Surgery Faculty Papers

STUDY DESIGN: Prospective, multicenter, single-blind, randomized, controlled pivotal study.

OBJECTIVE: To evaluate whether P-15L (PearlMatrix P-15 Peptide Enhanced Bone Graft) is noninferior in effectiveness to local autograft when applied in single-level instrumented transforaminal lumbar interbody fusion (TLIF).

SUMMARY OF BACKGROUND DATA: P-15L, an FDA-designated Breakthrough Drug-Device, is a composite drug-device combination bone graft containing P-15, a 15-amino acid polypeptide, which enhances cell binding, proliferation, and differentiation, resulting in bone formation.

MATERIALS AND METHODS: Skeletally mature patients, aged 22 to 80 years, with degenerative disc disease (DDD) were randomized 1:1 to P-15L (investigational) or to the local autograft (control) during single-level …

Reliability Of Existing Measures And Classification Systems For Trochlear Dysplasia, Sean R. Waldron, Nihar S. Shah, Matthew W. Veerkamp, Brendan A. Williams, John A. Schlechter, Lauren H. Redler, Matthew D. Ellington, Shital N. Parikh

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Patellofemoral instability (PFI) is common in adolescent patients and can lead to a reduction in quality of life and function, as well as long-term arthritis. Treatment of PFI involves assessing and, at times, surgically correcting underlying anatomic abnormalities. Trochlear dysplasia is the most common anatomic risk factor present in PFI.

PURPOSE: To determine the interrater reliability of existing measures and classification systems for the assessment of trochlear dysplasia.

STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 3.

METHODS: As part of the PRISM (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) patellar instability Research Interest Group (RIG) project, a …

Patient Geographical Area As A Risk Factor For Postoperative Outcomes Following Lumbar Fusion Surgery, Brady Stillman, Bs

Alpha Omega Alpha Research Symposium

Introduction: Rural communities have limited spine surgery care, which disproportionately affects older adults. Research has evaluated how hospital location affects patient outcomes; however, minimal work has investigated the impact of home location. This work’s purpose was evaluating the impact of patient geographical classification (rural/suburban/urban) on lumbar fusion outcomes.

Methods: Adult patients who underwent elective lumbar fusion (2017-2022) at a single tertiary center were identified via Structured Query Language search. Patient demographic/surgical characteristics, surgical outcomes, and patient-reported outcome measures (PROMs) were collected. Rural/urban/suburban was assigned by zip code.

Results: 461 patients were included (11.9% urban [U], 78.3% suburban [S], 9.8% rural …

Survival Impact Of Intraoperative Co2 Dysregulation In Patients Undergoing Pancreaticoduodenectomy For Pancreatic Ductal Adenocarcinoma, Ashley Wetzel, Andrea Feci, Joseph Gorman, Isabel Lavine, Edoardo Manca, Richard Zheng, Md, Nader Hanna, Md, Harish Lavu, Md, Charles J. Yeo, Md, Avinoam Nevler, Md

Alpha Omega Alpha Research Symposium Posters

Purpose: Pancreatic ductal adenocarcinomas (PDAC) are aggressive malignancies with poor prognoses. Emerging evidence suggests tissue hypercapnia (elevated CO₂) promotes aggressive, treatment resistant tumor biology. End-tidal CO₂ (ETCO₂) offers a composite measure of ventilation, systemic perfusion, and tissue CO₂ production. During curative-intent pancreaticoduodenectomy, we hypothesized that intraoperative ETCO₂ could serve as a marker of tissue CO₂ dyscapnia; both low levels indicating decreased circulatory reserves and high levels indicating tissue hypercapnia may result in worse outcomes.

Methods: We conducted a retrospective review (2017-2023) of 343 patients undergoing pancreaticoduodenectomy for PDAC. Intraoperative ETCO₂ data …

Evaluating The Impact Of Bard1 Isoform Targeting On Pdac Growth And Response To Olaparib, Lily Zekavat, Samuel Zion, Boxuan Wei, Avinoam Nevler, Aditi Jain

Alpha Omega Alpha Research Symposium Posters

Background

• BRCA-Associated Ring Domain 1 (BARD1), a heterodimeric binding partner of the tumor suppressor BRCA1, plays an essential role in homologous recombination-mediated DNA repair. Mutations in BARD1 increase cancer susceptibility and result in a molecular phenotype that predicts sensitivity to poly (ADP-ribose) polymerase inhibition (PARPi), including Olaparib.
• Several alternatively spliced isoforms of BARD1, including BARD1δ and BARD1φ, have also been implicated in tumor progression. These isoforms, characterized by deletion of exons 2-6 and 3-6, respectively, lack the RING domain required for BRCA1 interaction (Figure 1). 
• Upregulation of BARD1 isoforms is associated with poor prognosis in several tumor types. However, the …

Factors Associated With Upstaging In Patients With Resectable Non-Small Cell Lung Cancer: A Modern Institutional Sample, Sneha Alaparthi, Hamza Rshaidat, Luke Meredith, Scott H. Koeneman, Christina Grindley, Jacob Heilizer, Purab Kothari, Prarthna Chandar, Tyler Grenda, Nathaniel R. Evans Iii, Olugbenga T. Okusanya

Department of Surgery Faculty Papers

BACKGROUND: There is significant value in predicting and better assessing patients who are at risk of post-surgery upstaging in lung cancer. The objective of this study is to review patients who were upstaged following resection and evaluate their clinical and demographic data to elucidate which factors portend an increased risk of pathologic upstaging at our institution (the Thomas Jefferson University Hospital).

METHODS: A retrospective review of institutional data was performed between 2011 and 2023. Patients with stage I-II non-small cell lung cancer (NSCLC) were included. Patients were excluded if they received neoadjuvant systemic therapy, including chemotherapy and/or immunotherapy, and were …

Development Of Dirofilaria Immitis Adult Worms In Nsg Mice, Detection Of Parasite-Derived Microrna And Comparative Analysis Of Laboratory Isolates, Mohini Nakhale, Jessica A. Hess, Ellie Oliver, Nathan M. Ryan, Kirsten Mallon, Omair Sultan, Elinor Willis, Esha Banerjee, Enrico Radaelli, Charles-Antoine Assenmacher, Michael Povelones, Duncan Wells, Russ Morphew, Jennifer Willingham-Lane, Christine Henderson, John Harrington, Paul Mcveigh, David Abraham

Department of Surgery Faculty Papers

Global efforts to control heartworm disease are challenged by increasing drug resistance and inadequate early detection methods, which hinder the effective diagnosis and treatment of Dirofilaria immitis infection. This study presents an in vivo model for investigating D. immitis development and host-parasite interactions. The growth and migration of the D. immitis JYD-34 isolate were analyzed in immunodeficient NSG mice over 177 days, revealing parasite migration to the heart and lungs, which mirrors infection dynamics in the natural canine host. Pathophysiological examination of host tissues revealed early adult-stage worms elicited minimal inflammation. However, with chronicity, mild pulmonary hemosiderin accumulation was observed. …

Factors Influencing Match Success In Integrated Vascular Surgery Residency Programs From 2019 To 2023, Antony A. Fuleihan, Melissa C. Xu, Scott H. Koeneman, Paul J. Dimuzio, Babak Abai, Michael Nooromid

Department of Surgery Faculty Papers

INTRODUCTION: Integrated vascular surgery residency (IVSR) programs have grown increasingly competitive. However, the factors influencing successful matching remain unclear. This study evaluates the impact of medical school and applicant characteristics on IVSR match outcomes.

METHODS: A list of ACGME-accredited IVSRs was obtained from the Society for Vascular Surgery, and resident data from the 2019-2023 match cycles were collected from publicly available sources. Applicant characteristics consisted of additional graduate degrees, Alpha Omega Alpha (AOA) status, and research productivity. Medical school characteristics consisted of ranking, research funding, vascular surgery interest group (VSIG) presence, and vascular surgery faculty size. Logistic regression models were …

Upper Hemisternotomy Vs. Full Sternotomy For Hemiarch And Proximal Aortic Replacement, Jeffrey A. Zucker, Vishal N. Shah, Joshua R. Chen, Christopher Pritting, Colin King, Jacqueline Mcgee, Megary Mccoy, Konstadinos A. Plestis

Department of Surgery Faculty Papers

Introduction: Hemiarch replacement with proximal aortic replacement is seldom performed via upper hemisternotomy (UHS). We report our surgical technique and postoperative outcomes in 11 patients who underwent UHS for hemiarch and proximal aortic replacement, compared with 15 patients who underwent the procedure via full sternotomy (FS).

Methods: A UHS was performed at the right third or fourth intercostal space. Cardiopulmonary bypass (CPB) was established via the distal ascending aorta or right axillary artery and right common femoral vein. After aortic cross-clamping (ACC), the heart was arrested with single-dose antegrade crystalloid cardioplegia. After proximal aortic replacement, hypothermic circulatory arrest (HCA) between …

Post-Traumatic Rupture Of Primary Solid Pseudopapillary Epithelial Neoplasm (Spen) Of The Pancreas In A Male Adolescent: A Case Report, Paulo Castro, Heather Hartman, Yashasvi Shukla, Michael Moore, Dennis Drehner, Harish Lavu

Department of Surgery Faculty Papers

Introduction Solid pseudopapillary epithelial neoplasm (SPEN) is a rare pancreatic tumor that typically presents in adult women and is usually asymptomatic. Case presentation A 12-year-old male presented to the emergency department with worsening abdominal pain one day after suffering mild abdominal trauma during a soccer match. Physical exam showed diffuse abdominal tenderness and guarding. CT abdomen with IV contrast showed a heterogeneous, round structure adjacent to the pancreatic tail with mass effect upon the spleen. MRI abdomen revealed a “claw sign” of pancreatic tissue surrounding the structure, suggesting a an underlying pancreatic mass with capsular rupture measuring 8.3 x 8.1 …

Real-World Multicenter Assessment Of Sustained Clinical Outcomes After Digital Deep Brain Stimulation, Alireza Gharabaghi, Sergiu Groppa, Elena Casas, Alfons Schnitzler, Laura Muñoz-Delgado, Vicky L. Marshall, Jessica Karl, Lin Zhang, Ramiro Alvarez, Mary S. Feldman, Michael J. Soileau, Lan Luo, Benjamin L. Walter, Chengyuan Wu, Hong Lei, Damian M. Herz, Devyani Nanduri, Claudia A. Salazar, Corneliu Luca, Daniel Weiss

Department of Neurosurgery Faculty Papers

Remote, internet-based deep brain stimulation programming for Parkinson's disease accelerates clinical benefits postoperatively by improving access to therapy adjustments compared to in-clinic optimization. After completion of the initial digital programming phase, we show that clinical outcomes, quality of life, and safety remain sustained over at least twelve months under routine care conditions. Embedding a randomized trial within a larger cohort study enables long-term, real-world evaluation, offering a scalable and pragmatic model for assessing complex digital interventions in routine clinical care. (NCT05269862 registered on 2022-03-08 and NCT04071847 registered on 2019-08-28).

Perioperative Fluid Management In Pancreaticoduodenectomy In The Era Of Goal-Directed Fluid Therapy: A Review Of The Literature, Meghan D Grim, Richard Zheng, Nader Hanna, Harish Lavu, Charles J. Yeo, Avinoam Nevler

Department of Surgery Faculty Papers

BACKGROUND: Pancreaticoduodenectomy (PD) is the only curative option for localized pancreatic head and periampullary malignancies. However, PD is associated with significant perioperative morbidity. Perioperative fluid management has emerged as an important modifiable factor influencing surgical outcomes in PD.

METHODS: In this qualitative review, PubMed/Medline searches were performed between March and August 2025 to review the terms "pancreaticoduodenectomy," "fluid management," "Enhanced Recovery After Surgery," "complications," and related terms.

RESULTS: Historically, liberal fluid administration was favored to compensate for third-space losses, but contemporary evidence has linked excessive fluid volumes to complications, such as postoperative pancreatic fistula, anastomotic edema, and increased inflammatory responses. …

High-Dose Oral Pyrophosphate Inhibits Connective Tissue Calcification In Abcc6 Null Mice But May Affect Bone Structure, Ibtesam Rajpar, Nicholas Yancy, Jacob Beiriger, Christina Shao, Syed Naqvi, Deana Mancuso, Fatemeh Niaziorimi, Ryan E Tomlinson, Koen Van De Wetering

Department of Orthopaedic Surgery Faculty Papers

Pseudoxanthoma elasticum (PXE) is a rare inherited disorder marked by abnormal calcium phosphate deposition in soft connective tissues, particularly the skin, arteries, and eyes. It is caused by inactivating mutations in the ABCC6 gene, which encodes a hepatic efflux transporter. Loss of ABCC6 function leads to reduced plasma levels of pyrophosphate (PPi), a key inhibitor of calcification, thereby promoting ectopic mineralization. Oral PPi therapy has emerged as a potential treatment, but its effectiveness is uncertain. Most ingested PPi is hydrolyzed in the gut to inorganic phosphate, which may worsen calcification. Moreover, its impact on mineralized tissues remains largely unexplored. Abcc6−/− …

Regional Anesthesia Utilizing Liposomal Bupivacaine, With Or Without Dexamethasone, Provides Excellent Pain Control And Minimizes Opioid Consumption Following Anterior Cruciate Ligament Reconstruction, William L. Johns, Armen Voskeridjian, Benjamin Miltenberg, Rahul Muchintala, Christopher C. Dodson, Steven B. Cohen, John Salvo, Matthew Sherman, Michael G. Ciccotti, Sommer Hammoud

Rothman Institute Papers

BACKGROUND: Perioperative nerve blocks are commonly used for regional analgesia with anterior cruciate ligament (ACL) reconstruction (ACLR). Liposomal bupivacaine (LB) is a long-acting anesthetic agent providing up to 72 hours of nerve blockade. It is theorized that the addition of dexamethasone to LB (LB+dex) may prolong the analgesic duration.

PURPOSE: To characterize pain control and opioid consumption with adductor canal block (ACB), interspace between the popliteal artery and capsule of the posterior knee (iPACK), and suprasartorial infiltration (SSI) regional anesthetic techniques utilizing LB after ACLR and to compare LB versus LB+dex.

STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. …

Optimal Timing Of Cranioplasty Post-Decompressive Craniectomy In Traumatic Brain Injury: A Systematic Review, Meta-Analysis, And Overview Of Ongoing Trials, Ashviniy Thamilmaran, Shaan Patel, Shiva A. Nischal, Honey Panchal, Kush Kale, Pious D. Patel, Jack Jallo, James S. Harrop

Department of Neurosurgery Faculty Papers

BACKGROUND: The optimal timing of cranioplasty (CP) following decompressive craniectomy (DC) for the management of traumatic brain injury (TBI) remains debated. Prior studies comparing early CP (EC) and late CP (LC) report conflicting outcomes, compounded by inconsistent timing thresholds and limited attention to effect modifiers such as implant material.

OBJECTIVE: To perform a systematic review and meta-analysis comparing outcomes of EC (≤ 90 days) versus LC (> 90 days) after DC for TBI, with particular evaluation of ultra-EC (<  35 days) and implant material.

METHODS: MEDLINE, Embase, and CENTRAL were electronically searched from inception to April 2025, supplemented by manual screening of references and grey …

Medicaid Expansion And Breast Cancer Care And Outcomes-What Lies Ahead?, Meghan H. Maceyko, Oluwadamilola M. Fayanju

Department of Surgery Faculty Papers

No abstract provided.

Thoracolumbar Fractures: Historical Systems And Advancements With The Ao Spine Classification, Barry Ting Sheen Kweh, Alex R. Vaccaro, Gregory D. Schroeder, Jose A. Canseco, Maximilian Reinhold, Mohamed M. Aly, Sebastian Bigdon, Mohammad El-Skarkawi, Richard J. Bransford, Andrei Fernandes Joaquim, Harvinder Singh Chhabra, Emiliano Vialle, Rishi M. Kanna, Charlotte Dandurand, Cumhur Öner, Jin Wee Tee

Rothman Institute Papers

Study Design: Systematic Review. Objective: To describe the historical classifications of thoracolumbar injuries and their evolution into the AO Spine Thoracolumbar Injury Classification System. Methods: A systematic review of MEDLINE, EMBASE and Cochrane Databases was performed in keeping with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Results: 445 articles were crystallized to 14 included studies. Simple categorization systems offered by Bohler or Watson-Jones merely identify fracture morphology. Holdsworth and Denis conveyed a sense of the stability of injuries by noting columns of stability, but still failed to take into consideration important factors such as neurological status or …

Large Language Models Improve Readability Of Patient Education Materials On Vascular Conditions, Melissa Chen Xu, Nicola Habash, Justin Do, Jiaying Bi, Dawn Salvatore, Paul J Dimuzio, Michael Nooromid, Babak Abai

Department of Surgery Faculty Papers

Objective: Patient education materials frequently exceed the recommended sixth-grade reading level. Although large language models (LLMs) have shown inconsistent accuracy in medical query responses, they have demonstrated promise in simplifying complex text. This capability has not yet been studied in vascular patient education materials. This study evaluates whether ChatGPT-4o and Gemini 1.5 Pro can improve the readability of Society for Vascular Surgery (SVS) patient education flyers. Methods: SVS health flyers were selected based on five common vascular conditions: abdominal aortic aneurysm, carotid artery disease, deep vein thrombosis, peripheral artery disease, and varicose veins. Each flyer was submitted to ChatGPT-4o and …

Cervical Laminectomy For Degenerative Cervical Myelopathy: Is There A Role In The Modern Day? A Systematic Review And Meta-Analysis, Christopher S. Lozano, Armaan K. Malhotra, Husain Shakil, Vishwathsen Karthikeyan, Neevya Balasubramaniam, Uzondu Agochukwu, Ankit I. Mehta, Aditya Vedantam, C. Rory Goodwin, Nathan Evaniew, Aminul I. Ahmed, Ricardo Rodrigues-Pinto, Michael Fehlings, James S. Harrop, Shekar N. Kurpad, Jefferson R. Wilson

Department of Neurosurgery Faculty Papers

Study DesignSystematic Review and Meta-Analysis.ObjectivesTo compare clinical outcomes in degenerative cervical myelopathy (DCM) patients treated with laminectomy alone (LA) vs laminectomy with fusion (LF) and determine post-laminectomy kyphosis incidence.MethodsWe searched PubMed, Scopus, Embase, Web of Science, and MEDLINE from inception-September 2024 for studies comparing LA and LF for DCM. Outcomes assessed included post-laminectomy kyphosis, neurological recovery outcomes, patient-reported outcomes (PROs), and complication rates. Meta-analyses were performed using random-effects models.ResultsTwenty-seven studies including 3286 patients (2272 LA and 1014 LF), met the inclusion criteria. The pooled incidence of post-laminectomy kyphosis in the LA patients was 2.02 events per 100 person-years (95% CI: …

Histopathological Effects Of The Intrathecal Chondroitinase Abc Administration In Spinal Cord Injured Rats: A Systematic Review, Mohammad Amin Habibi, Ali Anjomshoa, Mohsen Sadeghi-Naini, Zahra Ghodsi, Samuel Berchi Kankam, Erfan Razavi, Armin Aryannejad, Seyed Mohammad Piri, Akam Ramezani, Rasha Atlasi, Kawthar Mohamed, Sina Shoo, Meysam Kaveh, Akbar Fotouhi, Arman Zeinaddini, James S. Harrop, Alex R. Vaccaro, Michael G. Fehlings, Vafa Rahimi-Movaghar

Department of Orthopaedic Surgery Faculty Papers

Introduction: Chondroitinase ABC (ChABC) has been considered a potential treatment for spinal cord injury (SCI). We aim to identify and evaluate the histopathological effects of intrathecal ChABC administration in SCI rat models.

Methods: We searched PubMed/MEDLINE, Scopus, Web of Science, Embase, and Cochrane Library for studies published from the inception of each database until November 22, 2022.

Results: Of 3857 screened citations, 17 studies met eligibility criteria and were entered into the qualitative analysis. Sixteen studies were of high quality, and one study was of medium quality. The four main rat strains used in studies were Sprague-Dawley, Wistar, Lister hooded, …

Synergizing Digital And Print: Leveraging Spine Surgeons' Social Media To Transform Publishing And Society Interaction, Benedikt W. Burkhardt, Kai-Uwe Lewandrowski, Choll W. Kim, Morgan P Lorio, Oscar L. Alves, Rossano Kepler Alvim Fiorelli, Sergio Luis Schmidt, Hansen A. Yuan, Alex R. Vaccaro

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Social media has fundamentally altered how information is created, disseminated, and consumed, with growing impact on spine surgeons and professional societies. Traditional academic publishing remains the standard for research validation, but digital platforms now shape much of the real-time dialogue in spine care.

OBJECTIVE: To explore strategies for integrating spine surgeons' social media presence with traditional publishing channels to enhance knowledge dissemination, support clinical innovation, and improve member engagement within spine societies.

METHODS: This perspective reviews current patterns of social media use among spine surgeons, focusing on platforms such as X (formerly Twitter), Instagram, and LinkedIn. It analyzes benefits …