Publications by authors named "Vaccaro A"
Study Design: Retrospective cohort.
Objective: To analyze the annual trends in the most prevalent topics, journals, and geographic regions of the top 100 spine surgery articles, as determined by altmetric attention scores (AASs). We also describe the relationship between AAS and traditional article metrics.
Background And Objectives: A few studies have compared the value (outcomes per dollar spent) provided by transforaminal endoscopic discectomy (TED) vs microdiscectomy (MD) for lumbar disc herniations. Here, we attempt to address this gap using a novel Operative Value Index (OVI), which combines a procedure-specific patient-reported outcome with intraoperative cost data based on time-driven activity-based costing.
Methods: MD (n = 95) and TED (n = 23) performed by neurosurgeons at our institution from 2017 to 2022 were retrospectively identified.
Article Synopsis
- A retrospective cohort study aimed to compare three socioeconomic status (SES) indexes and their association with outcomes after anterior cervical discectomy and fusion (ACDF) or lumbar fusion.
- The study involved identifying adult patients who underwent these surgeries at a medical center from 2014 to 2020, analyzing their preoperative conditions and outcomes based on SES classifications derived from community-level indexes.
- Results indicated that while patients from lower SES communities had worse preoperative outcomes, the community-wide SES indexes were ineffective in predicting surgical outcomes post-surgery.
Study Design: Retrospective cohort.
Objective: To explore the relationship between symptomatic pseudoarthrosis requiring revision after lumbar fusion and antidepressant use.
Summary Of Background Data: Approximately 25% of patients undergoing spine surgery are taking antidepressants.
Background Context: Previous research has demonstrated an association between socioeconomic status (SES) and patient health, specifically noting that patients of lower SES have poor health outcomes. Understanding how social factors, including socioeconomic status (SES), relate to disparities in health outcomes is critical to closing gaps in equitable care to patients. While several studies have examined the effect of SES on postoperative spine outcomes, there is limited spine literature evaluating SES in the context of barriers to spine care.
View Article and Find Full Text PDFReturning to activity after spinal deformity surgery is vital for patient recovery and long-term health, yet there is significant variability in postoperative protocols among surgeons worldwide. This paper aims to define guidelines for returning to activity across diverse patient groups: early onset scoliosis (EOS), adolescent idiopathic scoliosis (AIS), young adults, adult spinal deformity (ASD), elite athletes, and general sports participants. This paper provides guidelines to foster a unified approach to postoperative care, improving outcomes and ensuring patients can safely and effectively resume their activities.
View Article and Find Full Text PDFArticle Synopsis
- The study investigates the effects of face masks on emotion recognition, especially during the COVID-19 pandemic, using a task that assessed responses to both masked and unmasked faces showing emotions like fear, sadness, and anger.
- Participants included 119 college students, 30 children, and 31 fathers, with some undergoing neuroimaging while performing the task; results showed less accurate emotion recognition for masked faces, particularly sad ones.
- Neural responses indicated greater activation in areas of the brain associated with emotion processing when viewing sad masked faces, and among fathers, this activation correlated with stress and depression; overall findings highlight the impact of mask-wearing on emotional understanding across various age groups.
The central nervous system (CNS) constitutes a tightly regulated milieu, where immune responses are strictly controlled to prevent neurological damage. This poses considerable challenges to the therapeutic management of CNS pathologies, such as autoimmune disorders and cancer. Tertiary lymphoid structures (TLS) are ectopic, lymph node-like structures containing B- and T-cells, often associated with chronic inflammation or cancer, which have been shown to be detrimental in autoimmunity but beneficial in cancer.
View Article and Find Full Text PDFObjective: A quarter of spine surgery patients take antidepressants. Basic science research has suggested serotonergic antidepressants impair platelet function. This has been supported by only a small number of works in the setting of spine surgery.
View Article and Find Full Text PDFObjective: Venous thromboembolism (VTE) is a serious postoperative adverse event after spine surgery. In patients with pain refractory to typical multimodal analgesia regimens after spine surgery, whom are often chronic opioid users, perioperative ketamine is an alternative analgesic that has grown in popularity. The aim of this study is to assess the risk of VTE in chronic opioid users undergoing spine surgery.
View Article and Find Full Text PDFBackground: The purpose of this study is to determine the impact of community-level socioeconomic status (SES) on surgical outcomes and patient-reported outcome measures (PROMs) following revision lumbar fusion.
Methods: Adult patients who underwent revision lumbar fusion surgery from 2011-2021 were grouped by Distressed Community Index (DCI) into Prosperous, Comfortable, Mid-tier, and At-Risk/Distressed cohorts. Demographics, surgical information, and PROMs were compared based on DCI community status.
Accurate precipitation measurement is critical for managing flood and drought risks. Traditional meteorological tools, such as rain gauges and remote sensors, have limitations in resolution, coverage, and cost-effectiveness. Recently, the opportunistic use of microwave communication signals has been explored to improve precipitation estimation.
View Article and Find Full Text PDFThe prevalence of depression and anxiety in patients with metastatic disease to the spine.
J Craniovertebr Junction Spine
September 2024
Article Synopsis
- The study highlights that about 20% of patients with metastatic spine disease experience depression, while approximately 17% struggle with anxiety, emphasizing the need for mental health awareness in this population.
- Data was collected from patients over 18 years old who underwent treatment for metastatic spinal disease from 2017 to 2022, revealing a significant number of both depression and anxiety diagnoses among them.
- The findings suggest that spine surgeons should actively screen for mental health issues in patients with spinal metastases to ensure timely referrals for psychological support.
Study Design: Retrospective cohort study.
Objective: To compare peri- and postoperative infection rates among patients with mild to moderate penicillin allergies who receive cefazolin vs vancomycin as prophylaxis for lumbar fusion. Additionally, we sought to determine if patients receiving cefazolin exhibited any clinical symptoms suggestive of drug-induced hypersensitivity reactions, and to compare those rates to patients who received vancomycin.
Article Synopsis
- - The study investigated the safety and feasibility of a new spinal electrical stimulation technology called RISES, which allows real-time adjustments to stimulation settings while collecting various data.
- - Four participants with spinal cord injuries (SCIs) were tested, and results showed no serious adverse effects, with stable skin integrity, vital signs, and pain levels; however, fatigue increased post-stimulation.
- - The trial compared open-loop and closed-loop stimulation methods, finding that while open-loop sessions had longer stimulation durations, there were no significant differences in setup time or other health measures between the two methods.
Article Synopsis
- This study examined trends in spinal cord injury (SCI) admissions in the U.S. over the past decade, focusing on patients under and over 70 years old.
- Data from 8,137 patients revealed that while falls decreased among the elderly, vehicle accidents increased, showing a shift in causes of SCI.
- Notably, while complete injuries diminished overall and recovery rates improved for certain injuries, the mortality rates for elderly patients dropped significantly in both hospital stays and one-year follow-ups.
Article Synopsis
- Total disc replacement (TDR) is an alternative to anterior cervical discectomy and fusion (ACDF), and this study compares their costs as we shift towards value-based healthcare.
- Using time-driven activity-based costing (TDABC), researchers reviewed the costs of both procedures, analyzing direct and indirect costs through observation and data collection from various departments.
- The results showed that TDRs had significantly higher total intraoperative costs ($12,026) compared to ACDFs ($6,776), with the majority of the cost difference attributed to more expensive supply items, particularly implants.
Feelings are Messy: The Feelings We Study in Affective Science Should Be Too.
Affect Sci
September 2024
Affective science has taken up the challenge of building a bridge between basic affective science and practical applications. The articles in the Future of Affective Science issue lay out methodological and conceptual frameworks that allow us to expand affective science into real-world settings and to handle naturalistic methods. Along with these advances, accomplishing this goal will require additionally refocusing the types of experiences we study, and the measures of experience we are interested in.
View Article and Find Full Text PDFBrain activity associated with emotion regulation predicts individual differences in working memory ability.
Cogn Affect Behav Neurosci
October 2024
Article Synopsis
- Previous research suggests a link between working memory and emotion regulation, but evidence on their overlapping neural mechanisms has been inconsistent.
- This study aimed to predict participants' working memory abilities based on brain activity patterns during emotion regulation, particularly in the dorsal lateral prefrontal cortex (dlPFC).
- Results showed a positive relationship between activity in the right dlPFC and working memory performance, indicating shared cognitive processes and neural mechanisms between emotion regulation and working memory.
Race, Ethnicity, and Gender Representation Among US Academic Spine Surgeons.
J Am Acad Orthop Surg
October 2024
Background: Although diversity has improved across certain orthopaedic subspecialties, enhancing diversity within spine surgery has remained a challenge. We aimed to investigate the current state of sex, racial, and ethnic diversity among academic orthopaedic spine surgeons in the United States.
Methods: In January 2024, a cross-sectional analysis of orthopaedic spine surgery faculty in the United States was conducted using the Doximity database to identify eligible surgeons.
Article Synopsis
- Lumbar disc herniation (LDH) involves the displacement of disc material, causing symptoms like radiculopathy and significant healthcare utilization.
- Current treatments include epidural steroid injections (ESIs) and lumbar discectomy, but ESIs have limited long-term benefits and potential risks, while discectomy can lead to complications and recurrent issues.
- Emerging treatments in development aim to provide better, less invasive options for LDH, including sustained-release ESIs and new methods to reduce disc material without surgery.
Article Synopsis
- The study evaluated the reliability of the AO Spine-DGOU Osteoporotic Fracture classification system using a cross-sectional survey with 23 trauma experts rating 33 cases at two different times.
- The calculated kappa statistics indicated moderate inter-rater agreement and substantial intra-rater reproducibility, suggesting that while raters differed slightly, individual consistency was high.
- The findings highlight the importance of training in improving the reliability of the classification system for identifying fracture patterns and guiding treatment.
Background Context: Lumbar spinal fusion is an increasingly common operation to treat symptoms related to degenerative disorders of the spine including radiculopathy and pain. As the volume of spine surgeries grows, it is becoming increasingly common for procedures to take place in nontertiary care centers, including orthopaedic specialty hospitals (OSH). While previous research demonstrates that surgical outcomes at an OSH are noninferior to those at a tertiary referral center (TRC), the implications of this difference on patient-reported outcome measures (PROMs) have not been sufficiently assessed.
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