Publications by authors named "Raj S Lavadi"

Article Synopsis
  • - AtlasGPT is a generative model designed for neurosurgery that adjusts its responses based on the user's level of expertise, but it's unclear if all users can understand its outputs properly.
  • - A study evaluated the readability of AtlasGPT's responses from four user perspectives (surgeon, resident, medical student, and patient) using readability analysis tools and statistical tests.
  • - Results showed that patient-targeted content was harder to read than preferred levels, while medical student responses were slightly easier, highlighting a need for improvement to meet readability standards set by U.S. authorities.
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Article Synopsis
  • - The study investigated spinal and paraspinal injuries related to golf, analyzing emergency department data from 2003 to 2023 to understand the associated risks and outcomes.
  • - A total of 69,153 emergency visits were estimated for golf-related spine injuries, with the majority of injured individuals being males aged around 52.8 years, and lumbar injuries making up 76.9% of cases.
  • - Strains were the most common diagnosis, and while the overall injury frequency remained stable, the average age of those injured has increased significantly over the years.
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Background: Proper documentation is essential for patient care. The popularity of artificial intelligence (AI) offers the potential for improvements in neurosurgical note-writing. This study aimed to assess how AI can optimize documentation in neurosurgical procedures.

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Article Synopsis
  • Spinal cord hypoperfusion negatively impacts recovery after severe spinal cord injuries, and new guidelines advocate for cerebrospinal fluid (CSF) drainage to help mitigate this issue shortly after the injury.* -
  • The study compared two CSF drainage methods in patients with varying degrees of spinal cord injury: one that drains only when spinal cord perfusion pressure (SCPP) falls below 65 mmHg (reactive) and another that drains a small amount of CSF every hour (empiric).* -
  • Results showed that empiric CSF drainage significantly reduced the occurrence of critical hypoperfusion under 50 mmHg, suggesting a more proactive approach is beneficial for patient outcomes.*
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Article Synopsis
  • The study investigates the "July Effect," which suggests that the influx of inexperienced physicians in July could lead to worse patient outcomes, focusing on traumatic brain injury (TBI) cases in teaching hospitals.
  • Using nationwide data, researchers compared patient outcomes based on admission month and found July admissions had a decreased likelihood of death and complications.
  • The results showed no significant effect of July admissions on length of stay or routine discharge rates for TBI patients undergoing surgery.
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Background: Vertebral osteomyelitis and discitis (VOD), an infection of intervertebral discs, often requires spine surgical intervention and timely management to prevent adverse outcomes. Our study aims to develop a machine learning (ML) model to predict the indication for surgical intervention (during the same hospital stay) versus nonsurgical management in patients with VOD.

Methods: This retrospective study included adult patients (≥18 years) with VOD (ICD-10 diagnosis codes M46.

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Background: Hip-spine syndrome (HSS) was first described in 1983 to describe the symptomatology resulting from concomitant lumbar degenerative stenosis and hip osteoarthritis. Numerous studies have sought to understand the underlying pathology and appropriate management of this syndrome. The purpose of this article is to review the literature for the specific imaging characteristics and the optimal surgical treatment of HSS.

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Spinal serotonin enables neuro-motor recovery (i.e., plasticity) in patients with debilitating paralysis.

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Article Synopsis
  • Correctly choosing the uppermost instrumented vertebra (UIV) during surgery for adult spinal deformity (ASD) significantly affects patient outcomes and quality of life.
  • Factors influencing UIV selection include preoperative spinal alignment, patient health conditions, and the surgeon's experience and available resources.
  • Research indicates that optimizing UIV selection can improve deformity correction and lower the risk of complications like proximal junctional kyphosis, although the impact on postoperative quality of life remains unclear.
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Objective: Depression has been implicated with worse immediate postoperative outcomes in adult spinal deformity (ASD) correction, yet the specific impact of depression on those patients undergoing minimally invasive surgery (MIS) requires further clarity. This study aimed to evaluate the role of depression in the recovery of patients with ASD after undergoing MIS.

Methods: Patients who underwent MIS for ASD with a minimum postoperative follow-up of 1 year were included from a prospectively collected, multicenter registry.

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Objective: Cervical spondylotic myelopathy (CSM) can cause significant difficulty with driving and a subsequent reduction in an individual's quality of life due to neurological deterioration. The positive impact of surgery on postoperative patient-reported driving capabilities has been seldom explored.

Methods: The CSM module of the Quality Outcomes Database was utilized.

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Background: Preoperative symptom severity in cervical spondylotic myelopathy (CSM) can be variable. Radiomic signatures could provide an imaging biomarker for symptom severity in CSM. This study utilizes radiomic signatures of T1-weighted and T2-weighted magnetic resonance imaging images to correlate with preoperative symptom severity based on modified Japanese Orthopaedic Association (mJOA) scores for patients with CSM.

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Introduction: Traumatic optic neuropathy (TON) is the optic nerve injury secondary to brain trauma leading to visual impairment and vision loss. Current clinical visual function assessments often fail to detect TON due to slow disease progression and clinically silent lesions resulting in potentially delayed or missed treatment in patients with traumatic brain injury (TBI).

Methods: Diffusion basis spectrum imaging (DBSI) is a novel imaging modality that can potentially fill this diagnostic gap.

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Study Design: Retrospective review of a prospectively maintained database.

Objective: Assess differences in preoperative status and postoperative outcomes among patients of different educational backgrounds undergoing surgical management of cervical spondylotic myelopathy (CSM).

Summary Of Background Data: Patient education level (EL) has been suggested to correlate with health literacy, disease perception, socioeconomic status (SES), and access to health care.

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Artificial intelligence and machine learning (ML) can offer revolutionary advances in their application to the field of spine surgery. Within the past 5 years, novel applications of ML have assisted in surgical decision-making, intraoperative imaging and navigation, and optimization of clinical outcomes. ML has the capacity to address many different clinical needs and improve diagnostic and surgical techniques.

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Article Synopsis
  • The study examines how social media, specifically Instagram and Twitter, is used by patients with spinal cord injuries (SCI) to share their experiences and connect with others.
  • Researchers analyzed over 270,000 Instagram posts and 117 tweets related to SCI to identify common themes, such as positivity, wheelchair appearance, and recovery.
  • The findings suggest that social media serves as a vital support tool for SCI patients, highlighting positivity and awareness, which are important for their overall treatment.
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Background: A clinical concern exists that pediatric patients with whiplash-associated disorder (WAD) might have missed structural injuries or, alternatively, subsequently develop structural injuries over time, despite initially negative imaging findings. The primary objective of this study is to assess follow-up imaging usage for pediatric patients presenting with WAD.

Methods: A retrospective review of 444 pediatric patients presenting to a level 1 pediatric trauma hospital from January 1, 2010 to December 31, 2019 was performed.

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Art in neurosurgery has been a critical part of the discipline for centuries. Numerous cultures, such as ancient India, China, and Egypt, and more contemporary scientists, such as Leonardo da Vinci, Max Brödel, and Norman Dott, have significantly contributed to medical illustration. Today, advancements in three-dimensional technology have allowed for the creation of detailed neuroanatomy models for surgical planning and education.

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Non-invasive imaging biomarkers are useful for prognostication in patients with traumatic brain injury (TBI) at high risk for morbidity with invasive procedures. The authors present findings from a scoping review discussing the pertinent biomarkers. Embase, Ovid-MEDLINE, and Scopus were queried for original research on imaging biomarkers for prognostication of TBI in adult patients.

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Purpose: Circumferential minimally invasive scoliosis surgeries are often staged, wherein anterior and/or lateral lumbar interbody fusion is followed by percutaneous posterior fixation days later. This study examines the impact on outcomes when posterior augmentation was delayed due to unexpected medical issues following the first stage, anterolateral procedure.

Methods: A retrospective review was conducted of all patients undergoing minimally invasive circumferential deformity corrections from 2006 to 2019.

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Spatial computing (SC) in a surgical context offers reconstructed interactive four-dimensional models of radiological imaging. Preoperative and postoperative assessment with SC can offer more insight into personalized surgical approaches. Spine surgery has benefitted from the use of perioperative SC assessment.

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Introduction: Lateral anterior column release (ACR) is a minimally invasive option for the correction of sagittal plane deformity. To assemble a homogeneous picture of published research on ACR, an advanced bibliometric analysis was conducted to compile the top-ten most-cited articles on the topic of ACR.

Methods: A keyword search using the Thomson Reuters Web of Knowledge was conducted to identify articles discussing the role of lateral ACR.

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