Visiting Instructor/Lecturer, Neurosurgery
Visting Instructor, Neurosurgery, Stanford University (2021 - Present)
Clinical Instructor of Neurosurgery, Boston University School of Medicine (2020 - 2021)
Neurosurgery Clinical House Staff, Boston Medical Center / Boston University (2017 - 2021)
MD, Aga Khan University, Medicine (2014)
Utilization of lateral anterior lumbar interbody fusion for revision of failed prior TLIF: illustrative case.
Journal of neurosurgery. Case lessons
2022; 3 (23): CASE2296
BACKGROUND: The use of the lateral decubitus approach for L5-S1 anterior lumbar interbody fusion (LALIF) is a recent advancement capable of facilitating single-position surgery, revision operations, and anterior column reconstruction. To the authors' knowledge, this is the first description of the use of LALIF at L5-S1 for failed prior transforaminal lumbar interbody fusion (TLIF) and anterior column reconstruction. Using an illustrative case, the authors discuss their experience using LALIF at L5-S1 for the revision of pseudoarthrosis and TLIF failure.OBSERVATIONS: The patient had prior attempted L2 to S1 fusion with TLIF but suffered from hardware failure and pseudoarthrosis at the L5-S1 level. LALIF was used to facilitate same-position revision at L5-S1 in addition to further anterior column revision and reconstruction by lateral lumbar interbody fusion at the L1-2 level. Robotic posterior T10-S2 fusion was then added to provide stability to the construct and address the patient's scoliotic deformity. No complications were noted, and the patient was followed until 1 year after the operation with a favorable clinical and radiological result.LESSONS: Revision of a prior failed L5-S1 TLIF with an LALIF approach has technical challenges but may be advantageous for single position anterior column reconstruction under certain conditions.
View details for DOI 10.3171/CASE2296
View details for PubMedID 35733821
Impact of socio-economic factors on radiation treatment after resection of metastatic brain tumors: trends from a private insurance database.
Journal of neuro-oncology
BACKGROUND: Stereotactic radiosurgery (SRS) to the surgical bed of resected brain metastases is now considered the standard of care due to its advantages over whole brain radiation therapy (WBRT). Despite the upward trend in SRS adoption since the 2000s, disparities have been reported suggesting that socio-economic factors can influence SRS utilization.OBJECTIVE: To analyze recent trends in SRS use and identify factors that influence treatment.METHODS: We conducted a retrospective cohort study with the Optum Commercial Claims and Encounters Database and included all patients from 2004 to 2021 who received SRS or WBRT within 60days after resection of tumors metastatic to the brain.RESULTS: A total of 3495 patients met the inclusion and exclusion criteria. There were 1998 patients in the SRS group and 1497 patients in the WBRT group. SRS use now supersedes WBRT by a wide margin. Lung, breast and colon were the most common sites of primary tumor. Although we found no significant differences based on race among the treatment groups, patients with annual household income greater than $75,000 and those with some college or higher education are significantly more likely to receive SRS (OR 1.44 and 1.30; 95% CI 1.18-1.76 and 1.08-1.56; P=0.001 and 0.005, respective). Patients with Elixhauser Comorbidity Index of three or more were significantly more likely to receive SRS treatment.CONCLUSION: The use of post-surgical SRS for brain metastasis has increased significantly over time, however education and income were associated with differential SRS utilization.
View details for DOI 10.1007/s11060-022-04031-6
View details for PubMedID 35596873
Commentary: Robotic Nerve Sheath Tumor Resection With Intraoperative Neuromonitoring: Case Series and Systematic Review.
Operative neurosurgery (Hagerstown, Md.)
View details for DOI 10.1227/ons.0000000000000164
View details for PubMedID 35316253