Ronald A. Lehman's research while affiliated with CUNY Graduate Center and other places
What is this page?
This page lists the scientific contributions of an author, who either does not have a ResearchGate profile, or has not yet added these contributions to their profile.
It was automatically created by ResearchGate to create a record of this author's body of work. We create such pages to advance our goal of creating and maintaining the most comprehensive scientific repository possible. In doing so, we process publicly available (personal) data relating to the author as a member of the scientific community.
If you're a ResearchGate member, you can follow this page to keep up with this author's work.
If you are this author, and you don't want us to display this page anymore, please let us know.
It was automatically created by ResearchGate to create a record of this author's body of work. We create such pages to advance our goal of creating and maintaining the most comprehensive scientific repository possible. In doing so, we process publicly available (personal) data relating to the author as a member of the scientific community.
If you're a ResearchGate member, you can follow this page to keep up with this author's work.
If you are this author, and you don't want us to display this page anymore, please let us know.
Publications (385)
Study design:
A retrospective case series study.
Objective:
To analyze the epidemiology and burden of diagnoses of lumbar spinal conditions affecting Major League Baseball (MLB) and Minor League Baseball players.
Summary of background data:
Lumbar spinal conditions are a common cause of low back pain in the general population and can be caused...
Study design:
Single center, retrospective cohort study.
Objectives:
Little is known about the surgical outcomes and quality of life in patients with C2-sacrum posterior spinal fusion (PSF). Though it is thought to be a "final" construct, it remains unknown how patients fare postoperatively. We sought to evaluate the surgical outcomes and qualit...
Objective:
The purpose of this study is to highlight our technique for freehand placement of juxtapedicular screws along with intraoperative computed tomography (CT) and radiographic results.
Methods:
Consecutive patients with adult idiopathic scoliosis undergoing primary surgery by the senior author were identified. All type D (absent/slit like...
The anterior cervical discectomy and fusion is a common and effective treatment for degenerative cervical myelopathy, either with or without concomitant radiculopathy. In many cases, patients with degenerative cervical spondylosis can present with disease at multiple levels. With each additional level included in the procedure, rates of complicatio...
While epidural stimulation of the lumbar spinal cord has emerged as a powerful modality for recovery of movement, how it should be targeted to the cervical spinal cord to activate arm and hand muscles is not well-understood, particularly in humans. We sought to map muscle responses to posterior epidural cervical spinal cord stimulation in humans. W...
Purpose(1) To describe the use of multi-rod constructs (MRCs) in adult spinal deformity (ASD) surgery, (2) to report rod fractures occurring at MRC sites, and (3) to evaluate risk factors for rod fractures.MethodsA single-center, retrospective cohort study was conducted of patients undergoing ASD surgery with these inclusion criteria: minimum 2-yea...
Study design:
Delphi method.
Objective:
1) When should AC/AP medication be stopped before elective spine surgery?; 2) When should AC/AP medication be restarted after elective spine surgery?; 3) When, how, and in whom should VTE chemoprophylaxis be started after elective spinal surgery?
Summary of background data:
Venous thromboembolism (VTE) c...
Objective:
/Hypothesis: Patients undergoing C2-sacrum PSF have unique medical histories and multiple prior operations over an extended period.
Design:
Single center, retrospective cohort.
Methods:
Consecutive C2-sacrum PSF patients operated on by 4 surgeons at a single-center from 2015-2020 were reviewed. Demographics, comorbidities, indicatio...
Objective:
The purpose of this study was to determine the incidence, mechanism, and potential protective strategies for pelvic fixation failure (PFF) within 2 years after adult spinal deformity (ASD) surgery.
Methods:
Data for ASD patients (age ≥ 18 years, minimum of six instrumented levels) with pelvic fixation (S2-alar-iliac [S2AI] and/or ilia...
PurposeTo evaluate the incidence, risk factors, and patient-reported outcomes (PROs) of adult spinal deformity (ASD) patients with postoperative coronal malalignment.MethodsA single-institution, retrospective cohort study of ASD patients undergoing ≥ 6 level fusions from 2015 to 2019 was undertaken. The primary outcome was postoperative coronal mal...
Minimally invasive spine surgery reduces tissue dissection and retraction, decreasing the morbidity associated with traditional open spine surgery by decreasing blood loss, blood transfusion, complications, and pain. One of the key challenges with a minimally invasive approach is achieving consistent posterior fusion. Although advantageous in all f...
BACKGROUND CONTEXT
Disc degeneration (DD) is associated with elevated levels of pro-inflammatory cytokines, such as TNFα. We have previously shown that pro-inflammatory stimulation of healthy bovine nucleus pulposus (NP) cells leads to significant changes in cellular biomechanics and cell shape, in a mechanism dependent on actomyosin contractility....
BACKGROUND CONTEXT
The aim of complex spinal deformity correction is to restore both sagittal and coronal balance of the spine. Many studies have shown adverse clinical outcomes related to under and over corrected sagittal and coronal deformities. With proper surgical planning, such under and over correction can be mitigated and patient outcomes ca...
BACKGROUND CONTEXT
Research has suggested substantial disparities in the care of uninsured patients, manifesting as greater delays in care, fewer procedures conducted and greater postoperative complication rates when compared to insured patients. The manifestation of such disparities in the acute trauma setting pertaining to the spine is less under...
Purpose:
Restoring coronal alignment in spine deformity patients has been shown to play an important role in improving patient reported outcomes (PRO). Recently, the "kickstand rod" (KSR) technique was developed as a novel coronal correction method in complex spine deformity cases. The goal of the present study was to assess outcomes of this techn...
Background:
Lumbar spinal stenosis (LSS) is a common reason for spine surgery in which ligamentum flavum is resected. Transthyretin (TTR) amyloid is an often unrecognized and potentially modifiable mechanism for LSS that can also cause TTR cardiac amyloidosis. Accordingly, older adult patients undergoing lumbar spine (LS) surgery were evaluated fo...
OBJECTIVE
There is a paucity of literature on pelvic fixation failure after adult spine surgery in the early postoperative period. The purpose of this study was to determine the incidence of acute pelvic fixation failure in a large single-center study and to describe the lessons learned.
METHODS
The authors performed a retrospective review of adul...
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...
Purpose:
Assess whether a novel deformity angular ratio (DAR) calculated using preoperative three-dimensional computed tomography (3D CT) is more accurate than total DAR (T-DAR) radiographic measurements at predicting intraoperative neuromonitoring (IONM) events during vertebral column resection (VCR).
Methods:
Consecutive, unique patients under...
Study Design
Retrospective Cohort Study.
Objectives
Few previous studies have examined the relationship between preoperative disability and patient outcomes after complex adult spinal deformity surgery. In this study, we hypothesized that patients with worse preoperative disability would be more likely achieve a clinically significant improvement...
Study Design: Cadaveric specimens.
Objective: To perform a pathomorphological analysis of the degree of facet joint (FJ) degeneration utilizing fresh cadaveric models and correlating these structural changes with imaging findings.
Methods: L1-L5 FSU including all tissue between the anterior longitudinal ligament to the posterior spinal structures w...
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...
Objective:
Posterior costotransversectomy in the thoracic spine is commonly used for degenerative diseases, tumors, trauma, and other operative indications. It involves resection of the rib head after the ligamentous complexes have been disconnected from the transverse process and lateral vertebral body. The current literature provides only vague...
Objectives
This current systematic review sought to identify and evaluate all current research-based spine surgery applications of AI/ML in optimizing preoperative patient selection, as well as predicting and managing postoperative outcomes and complications.
Methods
A comprehensive search of publications was conducted through the EMBASE, Medline,...
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...
Background:
Private equity acquisition of medical specialty practices has increased in recent years. With the projected increase in the volume of elective, ambulatory orthopaedic procedures, especially in the outpatient setting, private equity firms are increasingly investing in orthopaedic practices. The purpose of this cross-sectional study was...
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...
Study Design
Narrative Review
Objectives
The objective of this study was to compare publication status of clinical trials in adult spine surgery registered on ClinicalTrials.gov by funding source as well as to identify other trends in clinical trials in adult spine surgery.
Methods
All prospective, comparative, therapeutic (intervention-based) tr...
Revision spine surgery can often be very challenging—with altered anatomic landmarks, the presence of a fusion mass, and surrounding scar tissue, the risk for complications is inevitably elevated. Pedicle screw placement is especially difficult, requiring fine movements and precise trajectories—this becomes even more difficult in revision cases whe...
Objective:
Pedicle screw insertion for stabilization after lumbar fusion surgery is commonly performed by spine surgeons. With the advent of navigation technology, the accuracy of pedicle screw insertion has increased. Robotic guidance has revolutionized the placement of pedicle screws with 2 distinct radiographic registration methods, the scan-an...
PurposeMultiple-rod constructs (MRCs) are often used in deformity correction for increased stability and rigidity. There are currently no reports showing minimally invasive placement of MRCs in adult deformity surgery and its technical feasibility through preoperative software planning.Methods
Data were collected retrospectively from medical record...
Study design:
Expert Consensus Study.
Objectives:
This expert panel was created to establish best practice guidelines to identify and treat patients with poor bone health prior to elective spinal reconstruction.
Summary of background data:
Currently, no guidelines exist for the management of osteoporosis and osteopenia in patients undergoing s...
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...
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...
Study design/methods
Review article.
Objectives
The goal of this article is to review the available evidence for computerized navigation and robotics as an accuracy improvement tool for spinal deformity surgery, as well as to consider potential complications, impact on clinical outcomes, radiation exposure, and costs.
Summary of background data/r...
Objective:
Lumbosacral fractional curves in adult spinal deformity (ASD) patients often have sharp coronal curves resulting in significant pain and imbalance. Postoperative stretch neuropraxia after fractional curve correction can lead to discomfort and unsatisfactory outcomes. The goal of this study was to use radiographic measures to increase un...
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...
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...
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...
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...
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...
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...
Background:
Current literature on robot-assisted S2 alar-iliac (S2AI) screw placement shows favorable outcomes and screw accuracy; however, the data is limited by a few retrospective, single-surgeon studies. To the author's knowledge, this is the first multicenter study which evaluates the accuracy of robot-assisted S2AI screws.
Methods:
Adult (...
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...
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...
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...
The unique anatomy at L5-S1 presents different challenges and considerations to be made when compared to other areas in the lumbar spine. In this way, the oblique lumbar interbody fusion (OLIF) is more closely related to a supine anterior lumbar interbody fusion (ALIF) except that the former is performed in a lateral position down a smaller minimal...
Study design:
Cross-sectional Study.
Objective:
The purpose of this study is to develop and validate a machine learning algorithm for the automated identification of ACDF plates from smartphone images of AP cervical spine radiographs.
Summary of background data:
Identification of existing instrumentation is a critical step in planning revision...
INTRODUCTION
Oblique lumbar interbody fusion (OLIF) at L5-S1, also known as a lateral decubitus anterior lumbar interbody fusion (ALIF) or anterior-to-psoas (ATP) approach, is a technique that provides a minimally invasive corridor to a key segment in the spine for degenerative conditions and deformity correction. However, the evaluation of complic...
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...
Study design:
A retrospective case series study.
Objective:
To analyze the epidemiology of diagnoses of degenerative cervical and lumbar spinal conditions among Major League Baseball (MLB) and Minor League Baseball (MiLB) players.
Summary of background data:
Repetitive high-energy forces in professional baseball players may predispose them to...
Single position lateral fusion reduces the need for a secondary surgery and robotic guidance allows for potentially higher accuracy of screw placement. We expand the role of robotics with a simultaneous workflow where 2 surgeons can work in single position surgery and discuss the technical feasibility of placement of S2-alar-iliac (S2AI) screws in...
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...
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...
Study design:
Multicenter cohort.
Objective:
To compare the robot time/screw, radiation exposure, robot abandonment, screw accuracy, and 90-day outcomes between robot-assisted percutaneous and robot-assisted open approach for short lumbar fusion (1-and 2-level).
Summary of background data:
There is conflicting literature on the superiority of...
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...
Background
Robot-assisted platforms in spine surgery have rapidly developed into an attractive technology for both the surgeon and patient. Although current literature is promising, more clinical data is needed. The purpose of this paper is to determine the effect of robot-related complications on clinical outcomes
Methods
This multicenter study i...
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...
Background
Unplanned readmissions and reoperations are known to be associated with undesirable costs and potentially inferior outcomes in complex adult spinal deformity (ASD) surgery. A paucity of literature exists on the impact of readmissions/reoperations on patient-reported outcomes (PRO) in this population.Methods
Consecutively treated adult pa...
Background:
As part of a market-driven response to the increasing costs of hospital-based surgical care, an increasing volume of orthopaedic procedures are being performed in ambulatory surgery centers (ASCs). The purpose of the present study was to identify recent trends in orthopaedic ASC procedure volume, utilization, and reimbursements in the...
Study design:
Retrospective Cohort Database Study.
Objective:
To investigate trends in utilization and demographics in Spinal Deformity Surgery.
Summary of background data:
The aging population in the United States will likely result in increased incidence of adult degenerative scoliosis. With a national focus on resource utilization and value...
Background:
As the opioid epidemic in the United States has continued to gain momentum in recent years, the current study aims to explore the efficacy of ketamine in a traditionally challenging setting regarding pain control, and contribute toward developing an opioid-free intraoperative pain protocol in spinal deformity surgery.
Methods:
Fifty-...
Objective
To examine the complications and patient-reported outcomes after robot-assisted short-segment lumbar fusion surgery.
Methods
We reviewed a consecutive group of adult patients(≥18 years old) with lumbar degenerative disease who underwent a robot-assisted short lumbar fusion (1-, 2-level) between 2017-2019. The minimum follow-up was 1-year...
Background:
Generally, most spine surgeons agree that increased segmental motion viewed on flexion-extension radiographs is a reliable predictor of instability; however, these views can be limited in several ways and may underestimate the instability at a given lumbar segment.
Methods:
Consecutively collected adult (≥18 years old) patients with...
Background:
Coronal malalignment in adult spinal deformity (ASD) has a close relationship with patient clinical outcomes. The purpose of this study is to evaluate the relationship between intra- and postoperative coronal radiographic parameters. A novel parameter, the central sacral pelvic line (CSPL), and its relation to the central sacral vertic...
Study design:
Retrospective cohort.
Objective:
Provide a comparison of surgical approach in the treatment of degenerative cervical myelopathy in patients with OPLL.
Methods:
A national database was queried to identify adult (≥18 years) patients with OPLL, who underwent at least a 2-level cervical decompression and fusion for cervical myelopath...
Robotic-assisted spine surgery has a number of potential advantages, including more precise pre-operative planning, a high degree of accuracy in screw placement, and significantly reduced radiation exposure to the surgical team. While the current primary goal of these systems is to improve the safety of spine surgery by increasing screw accuracy, t...
Study Design
Retrospective study.
Objective
To examine the associated indications, procedures, and postoperative outcomes after revision ACDA.
Methods
We utilized a national database to identify adult(≥18 years) patients who underwent either a primary ACDA or removal of ACDA over a 10-year period(2008-2017). An in-depth assessment of the reasons...
The use of robotic guidance for spinal instrumentation is promising for its ability to offer the advantages of precision, accuracy, and reproducibility. This has become even more important in the era of lateral interbody surgery because spinal robotics opens up the possibility of a straightforward workflow for single-position surgery in the lateral...
Study design
Retrospective cohort study.
Objective
Respiratory compromise (RC) is a rare but catastrophic complication of anterior cervical spine surgery (ACSS) commonly due to compressive fluid collections or generalized soft tissue swelling in the cervical spine. Established risk factors include operative duration, size of surgical exposure, mye...
The advantages of anterior, muscle-sparing interbody fusion for the management of degenerative scoliosis have been well defined in the literature. These include both direct and indirect decompression, restoration of disk/foraminal height and spinal biomechanics, correction of sagittal balance, and improved fusion rates. The continued evolution of m...
Operative management of adult spinal deformity (ASD) has been increasing in recent years secondary to an aging society. The advance of intraoperative image guidance, such as the development of navigation and robotics systems has contributed to the growth and safety of ASD surgery. Currently, intraoperative image guidance is mainly used for pedicle...
Osteoporosis is common, affecting more than 40 million people, and is associated with increased fracture risk, loss of independence, chronic pain, and disability. Osteoporosis is underdiagnosed and undertreated even after fracture where secondary fracture prevention has been shown to be cost effective in reducing further fracture risk and mortality...