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Browsing Scholarly Articles by Author "Aarabi, B"
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Item Open Access Correction to: Natural History, Predictors of Outcome, and Effects of Treatment in Thoracic Spinal Cord Injury: A Multi-Center Cohort Study from the North American Clinical Trials Network by Wilson, J.R. et al. J. Neurotrauma 2018;35(21):2554–2560. (DOI: 10.1089/neu.2017.5535)(Journal of Neurotrauma, 2020-03-15) Wilson, JR; Jaja, BNR; Kwon, BK; Guest, JD; Harrop, JS; Aarabi, B; Shaffrey, C; Badhiwala, JH; Toups, EG; Grossman, RG; Fehlings, MGItem Open Access Fehlings et al respond(Spine Journal, 2012-06-01) Fehlings, MG; Vaccaro, A; Wilson, JR; Kopjar, B; Harrop, JS; Aarabi, B; Shaffrey, CI; Dvorak, MF; Fisher, CG; Arnold, PM; Massicotte, EM; Lewis, SJ; Rampersaud, YRItem Open Access Spinal cord signal change on magnetic resonance imaging may predict worse clinical in-and outpatient outcomes in patients with spinal cord injury: A prospective multicenter study in 459 patients(Journal of Clinical Medicine, 2021-10-01) Jentzsch, T; Cadotte, DW; Wilson, JR; Jiang, F; Badhiwala, JH; Akbar, MA; Rocos, B; Grossman, RG; Aarabi, B; Harrop, JS; Fehlings, MGPrognostic factors for clinical outcome after spinal cord (SC) injury (SCI) are limited but important in patient management and education. There is a lack of evidence regarding magnetic resonance imaging (MRI) and clinical outcomes in SCI patients. Therefore, we aimed to investigate whether baseline MRI features predicted the clinical course of the disease. This study is an ancillary to the prospective North American Clinical Trials Network (NACTN) registry. Patients were enrolled from 2005–2017. MRI within 72 h of injury and a minimum follow-up of one year were available for 459 patients. Patients with American Spinal Injury Association impairment scale (AIS) E were excluded. Patients were grouped into those with (n = 354) versus without (n = 105) SC signal change on MRI T2-weighted images. Logistic regression analysis adjusted for commonly known a priori confounders (age and baseline AIS). Main outcomes and measures: The primary outcome was any adverse event. Secondary outcomes were AIS at the baseline and final follow-up, length of hospital stay (LOS), and mortality. A regression model adjusted for age and baseline AIS. Patients with intrinsic SC signal change were younger (46.0 (interquartile range (IQR) 29.0 vs. 50.0 (IQR 20.5) years, p = 0.039). There were no significant differences in the other baseline variables, gender, body mass index, comorbidities, and injury location. There were more adverse events in patients with SC signal change (230 (65.0%) vs. 47 (44.8%), p < 0.001; odds ratio (OR) = 2.09 (95% confidence interval (CI) 1.31–3.35), p = 0.002). The most common adverse event was cardiopulmonary (186 (40.5%)). Patients were less likely to be in the AIS D category with SC signal change at baseline (OR = 0.45 (95% CI 0.28–0.72), p = 0.001) and in the AIS D or E category at the final follow-up (OR = 0.36 (95% CI 0.16–0.82), p = 0.015). The length of stay was longer in patients with SC signal change (13.0 (IQR 17.0) vs. 11.0 (IQR 14.0), p = 0.049). There was no difference between the groups in mortality (11 (3.2%) vs. 4 (3.9%)). MRI SC signal change may predict adverse events and overall LOS in the SCI population. If present, patients are more likely to have a worse baseline clinical presentation (i.e., AIS) and in-or.Item Open Access Treatment of isolated cervical facet fractures: A systematic review(Journal of Neurosurgery: Spine, 2016-02-01) Kepler, CK; Vaccaro, AR; Chen, E; Patel, AA; Ahn, H; Nassr, A; Shaffrey, CI; Harrop, J; Schroeder, GD; Agarwala, A; Dvorak, MF; Fourney, DR; Wood, KB; Traynelis, VC; Yoon, ST; Fehlings, MG; Aarabi, BOBJECTIVE: In this clinically based systematic review of cervical facet fractures, the authors' aim was to determine the optimal clinical care for patients with isolated fractures of the cervical facets through a systematic review. METHODS: A systematic review of nonoperative and operative treatment methods of cervical facet fractures was performed. Reduction and stabilization treatments were compared, and analysis of postoperative outcomes was performed. MEDLINE and Scopus databases were used. This work was supported through support received from the Association for Collaborative Spine Research and AOSpine North America. RESULTS: Eleven studies with 368 patients met the inclusion criteria. Forty-six patients had bilateral isolated cervical facet fractures and 322 had unilateral isolated cervical facet fractures. Closed reduction was successful in 56.4% (39 patients) and 63.8% (94 patients) of patients using a halo vest and Gardner-Wells tongs, respectively. Comparatively, open reduction was successful in 94.9% of patients (successful reduction of open to closed reduction OR 12.8 [95% CI 6.1-26.9], p < 0.0001); 183 patients underwent internal fixation, with an 87.2% success rate in maintaining anatomical alignment. When comparing the success of patients who underwent anterior versus posterior procedures, anterior approaches showed a 90.5% rate of maintenance of reduction, compared with a 75.6% rate for the posterior approach (anterior vs posterior OR 3.1 [95% CI 1.0-9.4], p = 0.05). CONCLUSIONS: In comparison with nonoperative treatments, operative treatments provided a more successful outcome in terms of failure of treatment to maintain reduction for patients with cervical facet fractures. Operative treatment appears to provide superior results to the nonoperative treatments assessed.