School of Medicine
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J. Bradley Zuchero
Assistant Professor of Neurosurgery
Current Research and Scholarly InterestsGlia are a frontier of neuroscience, and overwhelming evidence from the last decade shows that they are essential regulators of all aspects of the nervous system. The Zuchero Lab aims to uncover how glial cells regulate neural development and how their dysfunction contributes to diseases like multiple sclerosis (MS) and in injuries like stroke.
Although glia represent more than half of the cells in the human brain, fundamental questions remain to be answered. How do glia develop their highly specialized morphologies and interact with neurons to powerfully control form and function of the nervous system? How is this disrupted in neurodegenerative diseases and after injury? By bringing cutting-edge cell biology techniques to the study of glia, we aim to uncover how glia help sculpt and regulate the nervous system and test their potential as novel, untapped therapeutic targets for disease and injury.
We are particularly interested in myelin, the insulating sheath around neuronal axons that is lost in diseases like MS. How do oligodendrocytes- the glial cell that produces myelin in the central nervous system- form and remodel myelin, and why do they fail to regenerate myelin in disease? Our current projects aim to use cell biology and neuroscience approaches to answer these fundamental questions. Ultimately we hope our work will lead to much-needed therapies to promote remyelination in patients.
Assistant Professor of NeurosurgeryOn Leave from 06/06/2022 To 09/05/2022
Current Research and Scholarly InterestsMy goal is to translate research into real-world action and decision-making so that my work can impact patients and the institutions in which they receive care. With a research focus on healthcare cost and quality of care, I approach neurosurgery in a unique way—one that applies business operations, economics, and healthcare delivery principles to our field. I have pursued formal LEAN business training, and believe in the importance of working together with other departments and administrators, as well as physicians and surgeons on the hospital and national level, to effect change. During my residency, I developed and led a multi-departmental prospective study at UCSF called OR SCORE (OR Surgical Cost Reduction Project) that brought together surgeons from the neurosurgery, orthopedics and ENT departments with nurses and administrators. OR SCORE successfully reduced surgical supply costs by nearly one million dollars in its first year by providing >60 surgeons with price transparency scorecards. This work led to a first-author publication in JAMA Surgery, but more importantly, set the foundation for further quality improvement and cost reduction efforts across the UCSF hospital system.
A volunteer neurosurgical mission trip to Guadalajara, Mexico, where limited resources create an OR environment that is strikingly more frugal than the U.S., inspired me to lead another project aimed at quantifying and reducing operating room waste at UCSF. I have also conducted research looking at the safety and outcomes of overlapping surgery, as well as several projects to define the factors underlying variation in cost for neurosurgical care using UCSF’s hospital data and national databases like the National Inpatient Sample, Vizient (formerly known as University Health Consortium), and Medicare.
As a clinical fellow at Johns Hopkins, I continued and expanded these research efforts. I designed and implemented an Enhanced Recovery after Surgery (ERAS) protocol at the Johns Hopkins Bayview hospital. This protocol standardized care for our spine patients, emphasizing pre-operative rehabilitation, psychiatric and nutritional assessments, and smoking cessation, as well as intra- and post-operative multi-modal pain therapy, early mobilization, and standardized antibiotic and bowel regimens. I also collaborated with engineers in the Johns Hopkins Carnegie Center for Surgical Innovation to develop better algorithms for intra-operative CT imaging, and provided assistance with operations to a basic science study looking at the role of cerebrospinal fluid drainage and duraplasty in a porcine model of spinal cord injury.
At Stanford, I am building a research group focused on: (1) perfecting paradigms for delivery of high-end technology in spinal care, including robotics and navigation, (2) implementing cost and quality strategies in large healthcare systems, and (3) computational analysis of big-data to effect real-time risk stratification and decision making in spine surgery. I'm excited to collaborate with my peers across surgical and medical departments, as well as business and engineering colleagues.