Scott L Zuckerman

Scott L Zuckerman
Vanderbilt University | Vander Bilt · Department of Neurological Surgery

About

293
Publications
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4,189
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Publications

Publications (293)
Article
Objective We conducted a systematic review and meta-analysis to: 1) compare time from traumatic spinal injury (TSI) to operating room (OR) in high-income countries (HICs) versus low-middle-income countries (LMICs), and 2) evaluate hospital length of stay (LOS) in HICs versus LMICs. Methods A systematic literature search was performed in accordance...
Article
Objective: Adolescents sustaining sport-related concussion often experience difficulties with the return-to-learn (RTL) process. Whereas the initial symptom burden has predicted prolonged RTL, no studies have established a relationship between acute cognitive symptoms and RTL duration. The authors sought to evaluate the relationship between initia...
Article
Limited evidence exists concerning how a diagnosis of attention-deficit hyperactivity disorder and/or learning disabilities (ADHD/LD) modifies recovery and behavior following sport-related concussion (SRC). To understand how ADHD/LD modifies the post-SRC experience, we conducted a retrospective cohort study of concussed young athletes through phone...
Article
Study design: Retrospective Review. Objective: To compare outcomes at 3 and 12-months for patients with lumbar spondylolisthesis treated with direct decompression (DD) versus indirect decompression (ID) techniques. Summary of background data: Debate persists regarding the optimal surgical strategy to treat lumbar spondylolisthesis. Novel techn...
Article
Study design: Retrospective review of prospectively collected data. Objective: To evaluate the impact of frailty and sarcopenia on outcomes after lumbar spine surgery. Summary of background data: Elderly patients are commonly diagnosed with degenerative spine disease requiring surgical intervention. Frailty and sarcopenia result from age-relat...
Article
Study design: Retrospective cohort study. Objectives: The objectives were to: (1) characterize the changes in coronal vertical axis (CVA) after adult spinal deformity (ASD) surgery from immediate postoperative to 2-years postoperative, and (2) assess for predictors of CVA change from immediate postoperative to 2-years postoperative. Summary of...
Article
Purpose: To determine the variables associated with additional concussion clinic visits before discharge to athletic trainer (AT). Methods: This retrospective cohort study was performed at a multi-disciplinary sports concussion center. Patients were eligible if they were ages 12–23, sustained a SRC and were seen by a clinic provider between 11/01/2...
Article
Background context: Multiple sclerosis (MS) is an autoimmune, neurodegenerative disease that can lead to significant functional disability. Improving treatment regimens have extended life expectancy and led to an increase in the number of elective spine surgeries for degenerative conditions in the MS population. Recent literature has reported mixe...
Article
Study design: Retrospective analysis on prospectively collected data. Objective: Determine the effectiveness of elective spine surgery in patients with Parkinson's Disease (PD). Background context: PD has become increasingly prevalent in an aging population. While surgical treatment for degenerative spine pathology is often required in this po...
Article
Study design: Retrospective analysis on prospectively collected data. Objective: Construct a clinical prediction model for 90-day mortality in elderly patients with traumatic spine injuries. Summary of background data: Spine trauma in the elderly population is increasing. Comparing elderly spine trauma patients to younger patients with similar...
Article
Concussion is a heterogeneous injury that relies predominantly on subjective symptom reports for patient assessment and treatment. Developing an objective, biologic test could aid phenotypic categorization of concussion patients, leading to advances in personalized treatment. This prospective multi-center study employed saliva micro-ribonucleic aci...
Article
Background: Three-dimensional (3D) imaging represents a novel way to assess surgical derotation maneuvers in adolescent idiopathic scoliosis (AIS). Objective: To assess the following in patients with AIS undergoing derotation surgery with Lenke type 1/2 curves using 3D imaging: (1) the primary outcome of thoracic apical vertebral rotation (T-AVR...
Article
Objective: When treating patients with adult spinal deformity (ASD), radiographic measurements evaluating coronal alignment above C7 are lacking. The current objectives were to: 1) describe the new orbital-coronal vertical axis (ORB-CVA) line that evaluates coronal alignment from cranium to sacrum, 2) assess correlation with other radiographic var...
Article
Background Context Diabetes mellitus (DM) is a well-established risk factor for suboptimal outcomes following cervical spine surgery. Hemoglobin A1C (HbA1c), a surrogate for long-term glycemic control, is a valuable assessment tool in diabetic patients. Purpose In patients undergoing elective cervical spine surgery, we sought to identify optimal H...
Article
Study Design Retrospective Cohort Study. Objectives Using natural language processing (NLP) in combination with machine learning on standard operative notes may allow for efficient billing, maximization of collections, and minimization of coder error. This study was conducted as a pilot study to determine if a machine learning algorithm can accura...
Article
Objective: This study had 3 objectives: 1) to describe pelvic obliquity (PO) and leg-length discrepancy (LLD) and their relationship with coronal malalignment (CM); 2) to report rates of isolated PO and PO secondary to LLD; and 3) to assess the importance of preoperative PO and LLD in postoperative complications, readmission, reoperation, and pati...
Chapter
When an athlete has a neurologic medical condition, the decision to allow sports participation is often complex. Neurosurgeons are often asked to evaluate athletes with neurological issues in order to better inform decisions about sports participation. Neurosurgeons play an important role in leading these discussions and arriving at a final decisio...
Chapter
Although far less common than sport-related concussion (SRC), sport-related structural brain injuries (SRSBI) have potential to cause permanent neurologic deficits and/or death. SRSBI differs from SRC by the presence of positive imaging findings of intracranial trauma. Cases of SRSBI are medical emergencies and may require neurosurgical interventio...
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Full-text available
Purpose In a population of asymptomatic volunteers across 5 countries, we sought to: (a) establish normative values of the Odontoid-Central Sacral Vertical Line (OD-CSVL) across patient factors, and (b) assess correlations of OD-CSVL with other radiographic parameters. Methods A prospective, cross-sectional study of asymptomatic adult volunteers,...
Article
Study design: Retrospective cohort study. Objective: a) Compare operative variables, complications, and patient-reported outcomes (PROs) in patients with an upper instrumented vertebrae (UIV) of C2 vs. C3/4, and b) assess outcomes based on C2 screw type. Summary of background data: When performing elective posterior cervical laminectomy and fu...
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Full-text available
Objective The goals of this study were to assess the ability of salivary non-coding RNA (ncRNA) levels to predict post-concussion symptoms lasting ≥ 21 days, and to examine the ability of ncRNAs to identify recovery compared to cognition and balance. Methods RNA sequencing was performed on 505 saliva samples obtained longitudinally from 112 indivi...
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Full-text available
IntroductionNeurologic complications after complex adult spinal deformity (ASD) surgery are important, yet outcomes are heterogeneously reported, and long-term follow-up of actual lower extremity motor function is unknown.Objective To prospectively evaluate lower extremity motor function scores (LEMS) before and at 5 years after surgical correction...
Article
Degenerative lumbar spondylosis is a common indication for patients undergoing spine surgery. As healthcare costs rise, measuring quality of life (QOL) gains after surgical procedures is critical in assessing value. We set out to: 1) compare baseline and postoperative EuroQol-5D (EQ-5D) scores for lumbar spine surgery and common surgical procedures...
Article
Pseudarthrosis of the cervical spine represents a common and challenging problem for spine surgeons. Rates vary greatly from as low as 0%-20% to >60% and depend heavily on patient factors, approach, and number of levels. While some patients remain asymptomatic from pseudarthrosis, many require revision surgery due to instability, continued neck pai...
Article
Ankylosing spondylitis (AS) is an inflammatory disorder leading to ossification of joints and ligaments, resulting in autofusion throughout the spinal column. In patients with fixed, kyphotic cervical deformities, which cause an impaired horizontal gaze and severe neck pain, surgical intervention is warranted. Although several articles have describ...
Article
OBJECTIVE The authors’ objectives were: 1) to evaluate the incidence and risk factors of iatrogenic coronal malalignment (CM), and 2) to assess the outcomes of patients with all three types of postoperative CM (iatrogenic vs unchanged/worsened vs improved but persistent). METHODS A single-institution, retrospective cohort study was performed on ad...
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Full-text available
Objective: To evaluate the effect of coronal alignment on: (1) surgical invasiveness and operative complexity and (2) postoperative complications. Methods: A retrospective, cohort study of adult spinal deformity patients was conducted. Alignment groups were: (1) neutral alignment (NA): coronal vertical axis (CVA) ≤ 3 cm and sagittal vertical axi...
Chapter
The Pediatric Collections: Sports Medicine Playbook will increase pediatric providers’ understanding of the injuries that young athletes may incur – including their history, treatment, and prevention. Each section includes a unique expert introduction and they cover such topics as the benefits of physical activity, injuries, and concerns including...
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Full-text available
Background: Cervical spine trauma (CST) leads to devastating neurologic injuries. In a cohort of CST patients from a major East Africa referral center, we sought to (a) describe presentation and operative treatment patterns, (b) report predictors of neurologic improvement, and (c) assess predictors of mortality. Methods: A retrospective, cohort...
Article
Context: Care-seeking behaviors for sport-related concussion (SRC) are not consistent across demographic subgroups. These differences may not only stem from health inequities but can further perpetuate disparities in care for SRCs. Objective: To determine whether racial differences exist in the care pathway from injury to SRC clinic within adolesce...
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Full-text available
Objective To compare the patient-reported outcomes (PROs) between patients undergoing multilevel lumbar fusion with robot-assisted vs. freehand techniques. Methods This was a single-institution cohort study of adult patients (≥18 years old) undergoing robot-assisted spine surgery from 2016 to 2018 with minimum 2-year follow-up. A propensity-score...
Article
BACKGROUND CONTEXT The lumbosacral fractional curve is often more challenging to correct vs the thoracolumbar/lumbar (TL/L) curve during adult spinal deformity (ASD) surgery, with implications for postoperative coronal alignment. PURPOSE In patients undergoing ASD surgery, the lumbosacral fractional (LSF) curve significantly impacts preop & postop...
Article
BACKGROUND CONTEXT Proximal junctional kyphosis (PJK) after spine deformity surgery is a frequent complication with multiple etiologies ranging from patient factors to surgical techniques. The paraspinal musculature at the upper instrumented vertebrae (UIV) is an understudied potential risk factor for PJK. This study classifies the paraspinal fat a...
Article
BACKGROUND CONTEXT LIV Selection in AdIS patients fused short of the sacrum is still debatable. Multiple radiographic methods have been devised to determine LIV, however, there is no universal standard. The TV rule for LIV determination has previously been described as providing acceptable LIV positioning on long-term follow-up in Adolescent Idiopa...
Article
BACKGROUND CONTEXT Achieving optimal coronal alignment can be a formidable challenge in adult spinal deformity surgery, and how pelvic obliquity and leg length discrepancy relate to coronal malalignment remains poorly studied. PURPOSE Pelvic obliquity (PO) and leg length discrepancy (LLD) are associated with preoperative and postoperative coronal...
Article
BACKGROUND CONTEXT As new robot technology continues to be introduced into practice, it is important for the surgeon to know how these new advances are influencing screw accuracy and outcomes. This is the first and largest multicenter study comparing two robot systems (Renaissance and Mazor X). PURPOSE To compare the screw accuracy, robot reliabil...
Article
BACKGROUND CONTEXT Conventional adult spinal deformity (ASD) measurements evaluate coronal alignment from C7-sacrum. Little is known about coronal alignment from the skull. PURPOSE Assess coronal alignment evaluated from the skull and correlations with preoperative/postoperative measurements and function. STUDY DESIGN/SETTING Retrospective cohort...
Article
BACKGROUND CONTEXT We established the first intraoperative parameter that directly correlates with postoperative proximal junctional kyphosis (PJK). C2 pelvic angle (C2PA) is a novel, intraoperative radiographic parameter used to assess for potential development of PJK. Intraoperative C2PA >15° is a critical angle with 2.5 times the relative risk f...
Article
BACKGROUND CONTEXT Physician Review Websites (PRWs) are frequently utilized by patients to make health care decisions. Despite their common use for this purpose, their utility as a health care decision-making tool remains unclear. Poor clinical performance does not appear to translate into poor online reviews as physicians in the lowest quartile of...
Article
BACKGROUND CONTEXT Intraoperative fluid management is a vital component in adult spinal deformity (ASD) surgery that is not standardized nor has consensus on the ideal management. Increased intraoperative use of crystalloids and colloids is correlated with an increased risk for developing postoperative complications, especially pulmonary complicati...
Article
BACKGROUND CONTEXT Although there has been a growing amount of literature that suggests robots are safe and can achieve comparable outcomes to conventional techniques, much of this literature is limited by small sample sizes and single-surgeon or single center series. Furthermore, it is unclear what the impact of robotic technology has made on oper...
Article
BACKGROUND CONTEXT Robot-assisted spine surgery continues to rapidly develop as evidenced by the growing literature in the last few years. Numerous reports demonstrate excellent pedicle screw accuracy and early studies have explored the impact of robot-assisted spine surgery on reducing radiation exposure, length of hospital stay, operative time, a...
Article
BACKGROUND CONTEXT In recent years, there has been a growing interest among spine surgeons in robot-assisted surgery. One of the first FDA-approved robot-assisted systems was the SpineAssist (Mazor Robotics) in 2004. Since that time, Mazor has released next generation systems, such as the Renaissance (2011) and Mazor X (2016). Although robot-assist...
Article
BACKGROUND CONTEXT Little is known regarding the incidence and risk factors for postop CM after ASD surgery. PURPOSE A subset of patients undergoing adult spinal deformity (ASD) surgery will have postoperative coronal malalignment (CM) with suboptimal outcomes. STUDY DESIGN/SETTING Retrospective cohort. PATIENT SAMPLE A total of 243 adult spinal...
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Full-text available
Background: Golf is a commonly played sport among older adults, and degenerative and/or deformity spine pathology can severely impact older individuals' ability to play golf. In a cohort of self-identified, avid golfers undergoing degenerative or deformity spine surgery, we report their: (I) presentation, (II) operative treatment, and (III) return...
Article
Objective Burnout is experienced by up to two-thirds of neurosurgery residents. Team sport participation as an adolescent protects against adverse mental health outcomes in adulthood. The objective of this study was to determine whether high school or collegiate team sport participation is associated with improved psychological well-being during ne...
Article
Objective: Young American athletes, at risk of sport-related concussion (SRC), represent many races; however, it is unknown how race may influence the experience and outcome of SRC. The authors' objective was to compare White and Black athletes' recovery and subjective experiences after SRC. Methods: A retrospective study was performed using the...
Article
BACKGROUND Neurosurgery residency programs are tasked with imparting large volumes of both clinical knowledge and technical skill to trainees in limited time. Many investigators have described local practices, which may offer evidence-based interventions in neurosurgical residency education, but this literature has not been systematically reviewed....
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Full-text available
Study Design Multi-center, prospective, observational cohort. Objective To compare myelopathic vs. non-myelopathic ambulatory patients in short- and long-term neurologic function, operative treatment, and patient-reported outcomes. Methods Pediatric deformity patients from 16 centers were enrolled with the following inclusion criteria: aged 10-21...
Article
Purpose: Recognizing sport-related concussion (SRC) is challenging and relies heavily on subjective symptom reports. An objective, biologic marker could improve recognition and understanding of SRC. There is emerging evidence that salivary micro-ribonucleic acids (miRNAs) may serve as biomarkers of concussion; however, it remains unclear whether co...
Article
Full-text available
Study Design Prospective single-cohort analysis. Objectives To compare the outcomes/complications of 2 robotic systems for spine surgery. Methods Adult patients (≥18-years-old) who underwent robot-assisted spine surgery from 2016-2019 were assessed. A propensity score matching (PSM) algorithm was used to match Mazor X to Renaissance cases. Preope...
Article
Background Context Adult spinal deformity (ASD) surgeries are complex, involving long operative times and surgical morbidity. It is currently unclear how the invasiveness of ASD surgery compares to other major operations. Purpose To: a) develop a quantitative metric of surgical morbidity and invasiveness, and b) compare this score between ASD surg...
Article
Objective In a cohort of elite rowers requiring lumbar spine surgery, we report information regarding: 1) presentation, 2) operative treatment, and 3) return to play (RTP). Methods All competitive rowers undergoing spine surgery at a single academic institution from 2015-2020 were collected. Three rowers underwent spine surgery during the allotted...
Article
Study design: Retrospective cohort analysis using the American College of Surgeons National Surgical Quality Improvement Program database. Objective: The objective of this study was to investigate the incidence and risk factors of perioperative complications and mortality in patients undergoing adult spinal deformity (ASD) surgery. Summary of b...
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Full-text available
Study Design Retrospective case series. Objective To determine predictive factors of overall survival (OS) and local recurrence (LR), report complications, and assess the impact of complications on survival, recurrence, and function in patients undergoing en bloc resection of sacral chordoma. Methods This retrospective case series was obtained fr...
Article
Full-text available
Background: Accurate radiographic assessment of adolescent idiopathic scoliosis (AIS) is crucial to achieving surgical correction, yet pelvic rotation may alter measurements. In Lenke Type 1/2 AIS patients, we conducted a pilot study to assess how pelvic rotation (i.e., the patient's position in the X-ray scanner) affected sagittal, coronal, and r...
Article
Full-text available
Objective Evaluate clinical improvement as measured by patient-reported outcomes (PROs) during the 1 to 2-year interval. Study Design Retrospective Cohort. Methods A single-institution registry of ASD patients undergoing surgery was queried for patients with ≥6 level fusions. Demographics and radiographic variables were collected. PROs collected...
Article
Background Context Robot-assisted spine surgery continues to rapidly develop as evidenced by the growing literature in recent years. In addition to demonstrating excellent pedicle screw accuracy, early studies have explored the impact of robot-assisted spine surgery on reducing radiation time, length of hospital stay, operative time, and perioperat...
Article
Objective: To identify risk factors and generate hypotheses for pediatric persistent postconcussion symptoms (PPCS). Setting: A regional healthcare system in the Southeastern United States. Participants: An electronic health record-based algorithm was developed and validated to identify PPCS cases and controls from an institutional database of...
Article
The major focus of realignment in adult spinal deformity (ASD) surgery has been on the sagittal plane, and less emphasis has been given to the coronal plane. In light of this overlooked area within ASD surgery, we aimed to refocus the narrative on coronal alignment in ASD surgery. The objectives of the current narrative review were to (1) define co...
Article
BACKGROUND AND IMPORTANCE Lumbar hyperlordosis in ambulatory children is an uncommon but potentially problematic spinal deformity, and the operative management has not been comprehensively described. CLINICAL PRESENTATION We report the case of a 14-yr-old girl presenting with severe progressive lumbar hyperlordosis (−122°) and sagittal imbalance (...