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4. Large Language Model-Based Neurosurgical Evaluation Matrix: A Novel Scoring Criteria to Assess the Efficacy of ChatGPT as an Educational Tool for Neurosurgery Board Preparation

Author

Mannam, Sneha Sai, Subtirelu, Robert, Chauhan, Daksh, Ahmad, Hasan S., Matache, Irina Mihaela, Bryan, Kevin, Chitta, Siddharth V.K., Bathula, Shreya C., Turlip, Ryan, Wathen, Connor, Ghenbot, Yohannes, Ajmera, Sonia, Blue, Rachel, Chen, H. Isaac, Ali, Zarina S., Malhotra, Neil, Srinivasan, Visish, Ozturk, Ali K., and Yoon, Jang W.

Published
2023
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10. Global immune fingerprinting in glioblastoma patient peripheral blood reveals immune-suppression signatures associated with prognosis

Author

Alban, Tyler J, Alvarado, Alvaro G, Sorensen, Mia D, Bayik, Defne, Volovetz, Josephine, Serbinowski, Emily, Mulkearns-Hubert, Erin E, Sinyuk, Maksim, Hale, James S, Onzi, Giovana R, McGraw, Mary, Huang, Pengjing, Grabowski, Matthew M, Wathen, Connor A, Ahluwalia, Manmeet S, Radivoyevitch, Tomas, Kornblum, Harley I, Kristensen, Bjarne W, Vogelbaum, Michael A, and Lathia, Justin D

Subjects
Biomedical and Clinical Sciences, Oncology and Carcinogenesis, Immunology, Brain Disorders, Brain Cancer, Rare Diseases, Clinical Research, Neurosciences, Cancer, Aetiology, 2.1 Biological and endogenous factors, Inflammatory and immune system, Good Health and Well Being, Brain Neoplasms, Cell Line, Disease Progression, Female, Flow Cytometry, Glioblastoma, Humans, Longitudinal Studies, Male, Myeloid-Derived Suppressor Cells, Neoplasm Metastasis, Neoplasm Staging, Prognosis, Survival Analysis, Tumor Microenvironment, Brain cancer, Cancer immunotherapy, Oncology, Biomedical and clinical sciences, Health sciences
Abstract

Glioblastoma (GBM) remains uniformly lethal, and despite a large accumulation of immune cells in the microenvironment, there is limited antitumor immune response. To overcome these challenges, a comprehensive understanding of GBM systemic immune response during disease progression is required. Here, we integrated multiparameter flow cytometry and mass cytometry TOF (CyTOF) analysis of patient blood to determine changes in the immune system among tumor types and over disease progression. Utilizing flow cytometry analysis in a cohort of 259 patients ranging from benign to malignant primary and metastatic brain tumors, we found that GBM patients had a significant elevation in myeloid-derived suppressor cells (MDSCs) in peripheral blood but not immunosuppressive Tregs. In GBM patient tissue, we found that increased MDSC levels in recurrent GBM portended poor prognosis. CyTOF analysis of peripheral blood from newly diagnosed GBM patients revealed that reduced MDSCs over time were accompanied by a concomitant increase in DCs. GBM patients with extended survival also had reduced MDSCs, similar to the levels of low-grade glioma (LGG) patients. Our findings provide a rationale for developing strategies to target MDSCs, which are elevated in GBM patients and predict poor prognosis.

Published
2018

11. Use of a machine learning algorithm with a focus on spinopelvic parameters to predict development of symptomatic tethered cord after initial untethering surgery

Author

Punchak, Maria A., primary, Bond, Kamila M., additional, Wathen, Connor A., additional, Hollawell, Madison L., additional, Zhao, Chao, additional, Sarris, Christina, additional, Flanders, Tracy M., additional, Madsen, Peter J., additional, Tucker, Alexander M., additional, and Heuer, Gregory G., additional

Published
2024
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13. Determining Differences in Perioperative Functional Mobility Patterns in Lumbar Decompression Versus Fusion Patients Using Smartphone Activity Data

Author

Chauhan, Daksh, primary, Ahmad, Hasan S., additional, Hamade, Ali, additional, Yang, Andrew I., additional, Wathen, Connor, additional, Ghenbot, Yohannes, additional, Mannam, Sai, additional, Subtirelu, Robert, additional, Bashti, Malek, additional, Wang, Michael Y., additional, Basil, Gregory, additional, and Yoon, Jang W., additional

Published
2024
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14. Incidental Durotomy Repair in Lumbar Spine Surgery: Institutional Experience and Review of Literature.

Author

Albayar, Ahmed, Spadola, Michael, Blue, Rachel, Saylany, Anissa, Dagli, Mert Marcel, Santangelo, Gabrielle, Wathen, Connor, Ghenbot, Yohannes, Macaluso, Dominick, Ali, Zarina S., Ozturk, Ali K., and Welch, William C.

Subjects
SPINAL surgery, LITERATURE reviews, LUMBAR vertebrae, CEREBROSPINAL fluid leak, SURGICAL complications, ELECTRONIC health records
Abstract

Study Design: : Retrospective Chart Review. Objectives: Incidental durotomies (IDs) are common spine surgery complications. In this study, we present a review on the most commonly utilized management strategies, report our institutional experience with case examples, and describe a stepwise management algorithm. Methods: A retrospective review was performed of the electronic medical records of all patients who underwent a thoracolumbar or lumbar spine surgery between March 2017 and September 2019. Additionally, a literature review of the current management approaches to treat IDs and persistent postoperative CSF leaks following lumbar spine surgeries was performed. Results: We looked at 1133 patients that underwent posterior thoracolumbar spine surgery. There was intraoperative evidence of ID in 116 cases. Based on our cohort and the current literature, we developed a progressive treatment algorithm for IDs that begins with a primary repair, which can be bolstered by dural sealants or a muscle patch. If this fails, the primary repair can be followed by a paraspinal muscle flap, as well as a lumbar drain. If the patient cannot be weaned from temporary CSF diversion, the final step in controlling postoperative leak is longterm CSF diversion via a lumboperitoneal shunt. In our experience, these shunts can be weaned once the patient has no further clinical or radiographic signs of CSF leak. Conclusions: There is no standardized management approach of IDs and CSF leaks in the literature. This article intends to provide a progressive treatment algorithm and contribute to the development process of a treatment consensus. [ABSTRACT FROM AUTHOR]

Published
2024
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18. Comparison of Staged vs Same-Day Circumferential Spinal Fusions for Adult Spinal Deformity

Author

Albayar, Ahmed, primary, Santangelo, Gabrielle, additional, Spadola, Michael, additional, Macaluso, Dominick, additional, Ali, Zarina S., additional, Saifi, Comron, additional, Heintz, Jonathan, additional, Han, Xiaoyan, additional, Bilker, Warren, additional, Malhotra, Neil, additional, Welch, William C., additional, Wathen, Connor, additional, Dagli, Mert Marcel, additional, Ghenbot, Yohannes, additional, Yoon, Jang, additional, Arlet, Vincent, additional, and Ozturk, Ali K., additional

Published
2023
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21. Isolated Lymphomatoid Granulomatosis of the Central Nervous System Mimicking Trigeminal Neuropathy, Bell’s Palsy, and Glioblastoma in an Epstein-Barr-Negative Immunocompetent Host: A Case Report

Author

Ghenbot, Yohannes, primary, Arena, John, additional, Howard, Susanna, additional, Wathen, Connor, additional, Dagli, Mert Marcel, additional, Zadnik, Patricia, additional, Nasrallah, Ilya M, additional, Nelson, Ernest, additional, Pruitt, Amy, additional, and Zager, Eric, additional

Published
2023
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22. Porcine Models of Spinal Cord Injury

Author

Wathen, Connor A., primary, Ghenbot, Yohannes G., additional, Ozturk, Ali K., additional, Cullen, D. Kacy, additional, O’Donnell, John C., additional, and Petrov, Dmitriy, additional

Published
2023
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24. Intraoperative Hypotension Is Not Correlated With Acute Kidney Injury During Spinal Fusion Surgery

Author

Blue, Rachel, Gutierrez, Alexis, Ahmad, Hasan S., Alexis, Maya, Kumar, Rachit, Spadola, Michael, Wathen, Connor, Weinstein, Mitchell, and Petrov, Dmitriy

Subjects
Complications, Orthopedics and Sports Medicine, Surgery
Abstract

BACKGROUND: Intraoperative hypotension (IOH) has been found to be associated with organ damage, including cardiac injury and acute kidney injury (AKI). However, to our knowledge, this relationship has not been studied in a neurosurgery-specific patient population. In this report, we review our institutional experience to understand the magnitude of association between IOH in spinal fusion operations and incidence of postoperative AKI. METHODS: This retrospective cohort study included 910 patients who underwent posterior spinal fusion procedures performed in the prone position. Intraoperative variables collected and analyzed include minute-by-minute mean arterial pressure (MAP) from an arterial catheter, intermittent blood pressure cuff readings, volume of administered intravenous fluids, urine output, and all relevant vitals and administered medications. The electronic medical record was queried for additional patient data. IOH was defined as MAP 10 minutes, and total IOH time) and any outcome metrics, including AKI, except for vasopressor usage and estimated blood loss. Patient age at surgery was not associated with any outcome variables. The lack of association between IOH and AKI contrasts with existing literature; this could be due to underlying differences in our patient population or could highlight a more complex relationship between IOH and AKI than previously understood. CONCLUSION: Occurrence and duration of IOH were not associated with AKI, postoperative ileus, troponin leak, length of stay, or any other major outcome variables in spinal fusion patients. CLINICAL RELEVANCE: These findings depart from previous literature showing a correlation between IOH and AKI and provide level 3 evidence clinically relevant to spinal surgery. Further research is needed to better understand the exact nature of this relationship. LEVEL OF EVIDENCE: 3.

Published
2022

32. Comparison of Single-Level Posterior Cervical Foraminotomy to Anterior Cervical Discectomy and Fusion for Radiculopathy

Author

Santangelo, Gabrielle, primary, Wathen, Connor, additional, Macaluso, Dominick, additional, Dagli, Mert Marcel, additional, Ali, Zarina S., additional, Malhotra, Neil R., additional, Casper, David S., additional, Spadola, Michael, additional, Ghenbot, Yohannes, additional, Thakkar, Khush, additional, Maze, Gabriella, additional, Welch, William C., additional, and Ozturk, Ali K., additional

Published
2023
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37. List of Contributors of Volume 3

Author

Abell, Thomas, primary, Abraham, William T., additional, Alabbad, Ali, additional, Al-Kaisy, Adnan, additional, Andréll, Paulin, additional, Andrew McKinley, Richard, additional, Angeli, Claudia A., additional, Ardell, Jeffrey L., additional, Arnold, Anthony, additional, Audu, Musa, additional, Baker, Kenneth B., additional, Barolat, Giancarlo, additional, Baskin, Jonathan Z., additional, Benderro, Girriso F., additional, Bennett, Maria E., additional, Bikson, Marom, additional, Bouton, Chad E., additional, Buckley, Una, additional, Carvalho, Sandra, additional, Cavuoto, James, additional, Chae, John, additional, Chen, Jiande D.Z., additional, Chen, Shuo, additional, Cohn, Joshua A., additional, Creasey, Graham H., additional, Czura, Christopher J., additional, Damato, Elizabeth G., additional, de Groat, William C., additional, Decker, Michael J., additional, DiMarco, Anthony F., additional, Dipietro, Laura, additional, Dmochowski, Roger R., additional, Dorman, Michael F., additional, Duarte, Rui V., additional, Durand, Dominique M., additional, Elizabeth Germany, Robin, additional, Emala, Charles, additional, Errico, J.P., additional, Faltys, Michael, additional, Franke, Manfred, additional, Fregni, Felipe, additional, French, Melanie, additional, Fritz, Jason R., additional, Gassler, John P., additional, Gonzalez Calle, Alejandra, additional, Harkema, Susan J., additional, Hassouna, Magdy, additional, Horsch, Svante, additional, Humayun, Mark S., additional, Huston, Jared M., additional, Jin, Haifeng, additional, Kapural, Leonardo, additional, Kaufman, Melissa R., additional, Kilgore, Kevin L., additional, Knutson, Jayme S., additional, Kobetic, Rudi, additional, Kowalski, Krzysztof E., additional, Kowalik, Casey G., additional, Krames, Elliot S., additional, Leite, Jorge, additional, Levine, Yaakov A., additional, Li, Yanmei, additional, Loudin, James, additional, Lu, Peter L., additional, Machado, Andre G., additional, Makowski, Nathaniel S., additional, Malde, Sachin, additional, Michael Ackermann, D., additional, Milam, Douglas F., additional, Mogilner, Alon Y., additional, Mousa, Hayat M., additional, Moynahan, Megan, additional, Murray, Drew, additional, Olofsson, Peder S., additional, Onders, Raymond P., additional, Peckham, P. Hunter, additional, Perryman, Laura, additional, Piedimonte, Fabian, additional, Prager, Joshua P., additional, Rejc, Enrico, additional, Reynolds, William S., additional, Sahai, Arun, additional, Salavatian, Siamak, additional, Schiefer, Matthew A., additional, Schneider, Marabel, additional, Schulte, Stefan, additional, Selkirk, Stephen, additional, Simis, Marcel, additional, Simon, Bruce, additional, Simon, Jesse, additional, Snyder, Jon, additional, Staats, Peter, additional, Strohl, Kingman P., additional, Thibaut, Aurore, additional, Thomson, Simon J., additional, Triolo, Ronald J., additional, Tyler, Dustin J., additional, Unal, Gozde, additional, Vasquez, Alejandra, additional, Wagner, Timothy, additional, Wathen, Connor A., additional, Weiland, James D., additional, Wilson, Blake S., additional, Wilson, Richard D., additional, Yao, Shukun, additional, Yin, Jieyun, additional, Yoruk, Ayhan, additional, and Zitnik, Ralph, additional

Published
2018
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38. Contributors

Author

Abecassis, Isaac Josh, primary, Agarwal, Vijay, additional, Agarwalla, Pankaj K., additional, Ahuja, Christopher S., additional, Alalade, Andrew Folusho, additional, Alli, Saira, additional, Aquilina, Kristian, additional, Armonda, Rocco A., additional, Baird, Lissa, additional, Bales, James W., additional, Bambakidis, Nicholas C., additional, Barrow, Daniel L., additional, Bauer, David F., additional, Beecher, Jeffrey S., additional, Bell, Randy S, additional, Belli, Antonio, additional, Benzel, Edward C., additional, Bonow, Robert H., additional, Bracale, Umberto Marcello, additional, Browd, Samuel R., additional, Bulsara, Ketan, additional, Cadotte, David W., additional, Cappabianca, Paolo, additional, Cavallo, Luigi Maria, additional, Chan, Alvin Y., additional, Chen, Roc Peng, additional, Chiarelli, Peter A., additional, Choudhri, Omar, additional, Chowdhary, Michelle, additional, Chu, Jason, additional, Cirivello, Michael J., additional, de Araújo Coimbra, Pablo Picasso, additional, Collins, Kelly L., additional, Daartz, Juliane, additional, de Divitiis, Oreste, additional, Deinsberger, Wolfgang, additional, Dekker, Simone E., additional, Dewan, Michael C., additional, Di Maio, Salvatore, additional, Ding, Dale, additional, Ellenbogen, Richard G., additional, Ene, Chibawanye, additional, Fehlings, Michael, additional, de Carvalho, Flávio Leitão, additional, Fink, James R., additional, Fink, Kathleen R. Tozer, additional, Fridley, Jared, additional, Ghobrial, George M., additional, Gleeson, Michael, additional, Goel, Atul, additional, Gokaslan, Ziya L., additional, Goodrich, James Tait, additional, Grant, Gerald A., additional, Gross, Bradley A., additional, Gruss, Joseph, additional, Halasz, Lia, additional, Hanak, Brian W., additional, Hankinson, Todd C., additional, Harrop, James S., additional, Heilman, Carl B., additional, Heller, Robert S., additional, Hoffer, S. Alan, additional, Hofstetter, Christoph P., additional, Hyam, Jonathan A., additional, Impastato, Kate, additional, Isik, Semra, additional, James, Greg, additional, Jha, R. Tushar, additional, Jones, Kristen E., additional, Jowdy, Patrick K., additional, Kalb, Samuel, additional, Keating, Robert F., additional, Kelly, Cory M., additional, Kitchen, Neil D., additional, Ko, Andrew L., additional, Koch, Matthew J., additional, Kondziolka, Douglas, additional, Kuo, Chao-Hung, additional, Larson, A. Noelle, additional, Lawton, Michael T., additional, Lee, Amy, additional, Levitt, Michael R., additional, Levy, Elad I., additional, Loeffler, Jay S., additional, Lucas, Timothy H, additional, Magge, Suresh N., additional, Marchan, Edward M., additional, Marsh, Henry, additional, Mason, Alexander M., additional, Mastorakos, Panagiotis, additional, McCracken, D. Jay, additional, Midha, Rajiv, additional, Morton, Ryan P., additional, Mueller, Kyle, additional, Mullin, Jeffrey P., additional, Nadi, Mustafa, additional, Nakaji, Peter, additional, Nerva, John D., additional, Niazi, Toba N., additional, Ojemann, Jeffrey G., additional, Oyelese, Adetokunbo, additional, Oyesiku, Nelson M., additional, Patel, Anoop P., additional, Peterson, Eric C., additional, Polly, David W., additional, Quach, Helen, additional, Rajan, Shobana, additional, Ravanpay, Ali, additional, Robinson, Leslie C., additional, Rocha, Ricardo, additional, Royce, Trevor J., additional, Rutka, James T., additional, Sekhar, Laligam N., additional, Selman, Warren, additional, Shah, Ashish H., additional, Shallwani, Hussain, additional, Sharma, Deepak, additional, Sharma, Mohan Raj, additional, Silbergeld, Daniel L., additional, Silva, Dulanka, additional, da Silva, Harley Brito, additional, Silveira, Luke, additional, Smith, Edward, additional, Solari, Domenico, additional, Soliman, Hesham, additional, Somma, Teresa, additional, Starke, Robert M., additional, Straus, David C., additional, Teo, Charles, additional, Toma, Ahmed, additional, Tseng, Yolanda D., additional, Tubbs, R. Shane, additional, Vakharia, Kunal, additional, Villa, Alessandro, additional, Wait, Scott D., additional, Walcott, Brian P., additional, Wathen, Connor, additional, Wellons, John C., additional, Wilson, Mark, additional, Wolf, Amparo, additional, Xu, Linda, additional, Yang, Tong, additional, Young, Christopher C., additional, and Zrinzo, Ludvic, additional

Published
2018
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43. Incidental Durotomy Repair in Lumbar Spine Surgery: Institutional Experience and Review of Literature

Author

Albayar, Ahmed, primary, Spadola, Michael, additional, Blue, Rachel, additional, Saylany, Anissa, additional, Dagli, Mert Marcel, additional, Santangelo, Gabrielle, additional, Wathen, Connor, additional, Ghenbot, Yohannes, additional, Macaluso, Dominick, additional, Ali, Zarina S., additional, Ozturk, Ali K., additional, and Welch, William C., additional

Published
2022
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46. Neural Injury at the Molecular Level

Author

Mullin, Jeffrey P., primary, Wathen, Connor, additional, Walsh, Kevin M., additional, Kim, David H., additional, Vaccaro, Alexander R., additional, Henderson Sr., Fraser C., additional, and Benzel, Edward C., additional

Published
2017
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47. Contributors

Author

Abbed, Khalid M., primary, Abdullah, Kalil G., additional, Ackerman, Paul D., additional, Alapan, Yunus, additional, Alentado, Vincent J., additional, Alvin, Matthew D., additional, Ames, Christopher P., additional, Anand, Neel, additional, Anderson, Paul A., additional, Angelov, Lilyana, additional, Anissipour, Alireza K., additional, Anson, John A., additional, Apfelbaum, Ronald I., additional, Archdeacon, Michael, additional, Arnold, Paul M., additional, Arun, Mike W.J., additional, Arzi, Harel, additional, Awad, Ahmed J., additional, Awad, Basem I., additional, Bahuleyan, Biji, additional, Bain, Mark D., additional, Baird, Lissa C., additional, Baisden, Jamie, additional, Baldwin, Nevan G., additional, Ball, Perry A., additional, Balsara, Karl E., additional, Baron, Eli M., additional, Batjer, H. Hunt, additional, Bauer, Andrew M., additional, Bauer, Thomas W., additional, Beckman, Joshua M., additional, Bell, Gordon R., additional, Bellabarba, Carlo, additional, Bennett, E. Emily, additional, Benzel, Edward C., additional, Bergey, Darren L., additional, Bhalla, Tarun, additional, Bierbrauer, Karin S., additional, Bilsky, Mark, additional, Birk, Harjus, additional, Bisson, Erica F., additional, Bono, Christopher, additional, Bransford, Richard J., additional, Brodke, Darrel S., additional, Brooks, Nathaniel, additional, Brotea, Cristian, additional, Brougham, Jared R., additional, Browd, Samuel R., additional, Buckley, Robert T., additional, Burch, Shane, additional, Butler, John, additional, Bydon, Mohamad, additional, Casha, Steven, additional, Ceuppens, Jeroen, additional, Chan, Andrew K., additional, Chen, Thomas C., additional, Cheng, Joseph, additional, Chou, Dean, additional, Choudhri, Tanvir, additional, Clark, Aaron J., additional, Conley, Adam M., additional, Cooper, Paul R., additional, Coric, Domagoj, additional, Corriveau, Mark, additional, Côté, Ian P., additional, Coumans, Jean-Valery C.E., additional, Crawford, Charles H., additional, Curry, William T., additional, Daffner, Scott D., additional, Dalbayrak, Sedat, additional, DeMicco, Russell C., additional, Deutsch, Harel, additional, Dhall, Sanjay S., additional, DiAngelo, Denis J., additional, Dickman, Curtis A., additional, Dodwad, Shah-Nawaz M., additional, Duarte, Siena M., additional, Ebrahim, Zeyd, additional, Eckardt, Gerald W., additional, Ehni, Bruce L., additional, Eichholz, Kurt M., additional, Eichler, Marc, additional, Elbabaa, Samer K., additional, Elder, Benjamin D., additional, Elder, James B., additional, Ellenbogen, Richard G., additional, Epstein, Nancy, additional, Errico, Thomas J., additional, Esquenazi, Yoshua, additional, Fahim, Daniel K., additional, Farag, Ehab, additional, Farley, Chad W., additional, Fehlings, Michael G., additional, Feigenbaum, Frank, additional, Fenton, Eoin, additional, Ferrara, Lisa A., additional, Fessler, R. David, additional, Fessler, Richard G., additional, Finn, Michael A., additional, Finnan, Ryan, additional, Fischgrund, Jeffrey S., additional, Foley, Kevin T., additional, Fontes, Ricardo B.V., additional, Francis, Todd B., additional, Freedman, Brett A., additional, Frost, Frederick, additional, George, John, additional, German, John W., additional, Gerszten, Peter C., additional, Ghobrial, George M., additional, Ghogawala, Zoher, additional, Gibson, Justin L., additional, Gillis, Christopher C., additional, Goel, Vijay K., additional, Goffin, Jan, additional, Gokaslan, Ziya L., additional, Gollogly, Sohrab, additional, Goodwin, C. Rory, additional, Goulart, Carlos R., additional, Goz, Vadim, additional, Gozal, Yair M., additional, Graham, Randall B., additional, Grant, Gerald A., additional, Guan, Jian, additional, Gulec, Ilker, additional, Gussous, Yazeed M., additional, Guyer, Richard D., additional, Gwinn, David, additional, Ha, Sung, additional, Hadar, Eldad, additional, Haldeman, Clayton L., additional, Halim, Alexander Y., additional, Hamilton, Kimberly M., additional, Hammer, Christine L., additional, Hanbali, Fadi, additional, Hann, Shannon W., additional, Harms, Jurgen, additional, Harrop, James S., additional, Hart, Blaine L., additional, Hart, David J., additional, Harwell, Daniel, additional, Hayek, Reyaad A., additional, Heary, Robert F., additional, Henderson, Fraser C., additional, Hitchon, Patrick W., additional, Hoh, Daniel J., additional, Holman, Paul J., additional, Hosono, Noboru, additional, Houseman, Clifford, additional, Houten, John K., additional, Hsieh, Joseph C., additional, Hsu, Wellington K., additional, Huang, Meng, additional, Hurlbert, R. John, additional, Hwang, Lee, additional, Hwang, Steven, additional, İnceoğlu, Serkan, additional, Infinger, Libby Kosnik, additional, de Oliveira, Tatiana von Hertwig Fernandes, additional, Jalan, Devesh, additional, Jha, Neilank, additional, Johnson, J. Patrick, additional, Jones, Charles I., additional, Jones, G. Alexander, additional, Jones, Michael, additional, Juthani, Rupa G., additional, Kager, Christopher D., additional, Kalani, Maziyar A., additional, Kalani, M. Yashar S., additional, Kalfas, Iain H., additional, Kalra, Ricky R., additional, Karimi, Reza J., additional, Kashlan, Osama, additional, Kasliwal, Manish K., additional, Kaul, Vikas, additional, Kaushal, Mayank, additional, Kenning, Tyler J., additional, Khairi, Saad, additional, Khalaf, Tagreed, additional, Khalil, Jad G., additional, Khoo, Larry T., additional, Kiapour, Ali, additional, Kim, Daniel H., additional, Kim, David H., additional, Kimmell, Kristopher T., additional, Kirshblum, Steven, additional, Kitab, Sameer A., additional, Klimo, Paul, additional, Klineberg, Eric O., additional, Koski, Tyler R., additional, Kosztowski, Thomas A., additional, Kowalski, Robert J., additional, Krishnaney, Ajit A., additional, Krupa, Kelly, additional, Krupa, Kristin, additional, Kshettry, Varun R., additional, Kukreja, Sunil, additional, Kuntz, Charles, additional, Kurpad, Shekar N., additional, Kusuma, Srinivasu, additional, LaBagnara, Michael, additional, La Marca, Frank, additional, Laufer, Ilya, additional, Lavelle, Elizabeth Demers, additional, Lavelle, William F., additional, Lawrence, W. Thomas, additional, Lebl, Darren R., additional, Lee, Bryan S., additional, Lee, Sun-Ho, additional, Lenke, Lawrence G., additional, Leon, Steven P., additional, Li, Amy, additional, Li, Yiping, additional, Lieberman, Isador H., additional, Liu, James K.C., additional, Lo, Victor P., additional, Lollis, S. Scott, additional, Lopez-Gonzalez, Miguel, additional, Lubelski, Daniel, additional, Luciano, Mark G., additional, Machado, Andre G., additional, Maddela, Raghu, additional, Madineni, Ravichandra A., additional, Madura, Casey, additional, Maiman, Dennis J., additional, Malone, David G., additional, Mammis, Antonios, additional, Marawar, Satyajit, additional, Marcotte, Nicolas, additional, Maroon, Joseph C., additional, Martin, Michael D., additional, Martinez-del-Campo, Eduardo, additional, Massicotte, Eric M., additional, Mattei, Tobias A., additional, Maurer, Paul K., additional, Mayer, Eric A.K., additional, del Valle, Miguel Mayol, additional, Mazanec, Daniel J., additional, McCormick, Paul C., additional, McCormick, William, additional, Medress, Zachary A., additional, Mendel, Ehud, additional, Metkar, Umesh S., additional, Miele, Vincent J., additional, Mohyeldin, Ahmed, additional, Monsef, Jad Bou, additional, Moore, Timothy A., additional, Morisue, Hikaru, additional, Morone, Peter, additional, Mroz, Thomas E., additional, Mullin, Jeffrey P., additional, Murtagh, F. Reed, additional, Murtagh, Ryan D., additional, Naderi, Sait, additional, Nagaraj, Usha D., additional, Nalley, Charles C., additional, Nanda, Anil, additional, Nasca, Richard J., additional, Nater, Anick, additional, Neal, Matthew T., additional, Nockels, Russ P., additional, Norwig, John A., additional, Ondoma, Solomon M., additional, Oni-Orisan, Akinwunmi, additional, Oren, Jonathan H., additional, Orning, Jennifer, additional, Orr, R. Douglas, additional, Orrico, Katie, additional, Osorio, Joseph A., additional, Otero-Lopez, Ernesto, additional, O'Toole, John, additional, Park, Paul, additional, Parmar, Vikas, additional, Pashman, Robert S., additional, Patel, Rakesh D., additional, Patel, Smruti K., additional, Perez-Cruet, Mick J., additional, Perin, Noel I., additional, Pettigrew, David B., additional, Phillips, H. Westley, additional, Placide, Rick, additional, Porensky, Paul, additional, Prager, Joshua P., additional, Prasad, Srinivas, additional, Prasarn, Mark L., additional, Ramakrishnan, Rakesh, additional, Ramayya, Ashwin G., additional, Rampersaud, Y. Raja, additional, Rasmussen, Peter A., additional, Ratliff, John K., additional, Rauschning, Wolfgang, additional, Rechtine, Glenn R., additional, Recinos, Pablo F., additional, Resnick, Daniel K., additional, Rhee, Jay, additional, Rhines, Laurence D., additional, Riccio, Alexander R., additional, Richardson, Marlin Dustin, additional, Richter, Bertram, additional, Riesenburger, Ron, additional, Riew, K. Daniel, additional, Rogers, Matthew, additional, Saavedra, Fanor M., additional, Safain, Mina G., additional, Saigal, Rajiv, additional, Sawin, Paul D., additional, Scheer, Justin K., additional, Scheidler, Joshua, additional, Schippert, David W., additional, Schlenk, Richard, additional, Schmidt, Bradley, additional, Schmidt, Meic H., additional, Sciubba, Daniel M., additional, Shaffrey, Christopher I., additional, Shaffrey, Mark E., additional, Shah, Anoli, additional, Sharan, Alok, additional, Sharan, Ashwini D., additional, Shedid, Daniel, additional, Shook, Steven, additional, Silverstein, Michael P., additional, Simpson, Venita M., additional, Sin, Anthony, additional, Singh, Harminder, additional, Smith, Donald A., additional, Smith, Gabriel A., additional, Smith, Justin S., additional, Smith, Kyle A., additional, Sonntag, Volker K.H., additional, Soriano-Baron, Hector, additional, Spetzler, Robert F., additional, Spiker, W. Ryan, additional, Staub, Blake, additional, Steinmetz, Michael P., additional, Stillerman, Charles B., additional, Strayer, Andrea, additional, Subramaniam, Gandhivarma, additional, Sukkarieh, Hamdi G., additional, Sumich, Andrew, additional, Sun, Derrick Y., additional, Sunna, Tarek P., additional, Sure, Durga R., additional, Tallarico, Richard A., additional, Tan, Lee A., additional, Tatsui, Claudio E., additional, Techy, Fernando, additional, Theodore, Nicholas, additional, Theologis, Alexander A., additional, Thomas, Nicholas W.M., additional, Thorp, Brian D., additional, Tintle, Scott, additional, Tjoumakaris, Stavropoula, additional, Tobler, William D., additional, Togawa, Daisuke, additional, Traul, David, additional, Traynelis, Vincent C., additional, Tritle, A. 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Published
2017
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48. Gamma Knife radiosurgery for trigeminal neuralgia provides greater pain relief at higher dose rates

Author

Yang, Andrew I., Mensah-Brown, Kobina G., Shekhtman, Emily F., Kvint, Svetlana, Wathen, Connor A., Hitti, Frederick L., Alonso-Basanta, Michelle, Avery, Stephen M., Dorsey, Jay F., and Y.K. Lee, John

Subjects
Clinical Investigation
Abstract

In Gamma Knife (GK) radiosurgery, dose rate decreases during the life cycle of its radiation source, extending treatment times. Prolonged treatments influence the amount of sublethal radiation injury that is repaired during exposure, and is associated with decreased biologically-equivalent dose (BED). We assessed the impact of treatment times on clinical outcomes following GK of the trigeminal nerve - a rare clinical model to isolate the effects of treatment times. This is a retrospective analysis of 192 patients with facial pain treated across three source exchanges. All patients were treated to 80 Gy with a single isocenter. Treatment time was analyzed in terms of patient anatomy-specific dose rate, as well as BED calculated from individual patient beam-on times. An outcome tool measuring pain in three distinct domains (pain intensity, interference with general and oro-facial activities of daily living), was administered before and after intervention. Multivariate linear regression was performed with dose rate/BED, brainstem dose, sex, age, diagnosis, and prior intervention as predictors. BED was an independent predictor of the degree of improvement in all three dimensions of pain severity. A decrease in dose rate by 1.5 Gy/min corresponded to 31.8% less improvement in the overall severity of pain. Post-radiosurgery incidence of facial numbness was increased for BEDs in the highest quartile. Treatment time is an independent predictor of pain outcomes, suggesting that prescription dose should be customized to ensure iso-effective treatments, while accounting for the possible increase in adverse effects at the highest BEDs.

Published
2022

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