Posts by Joseph H. Schwab, MD, MS
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Neighborhood Vulnerability Index Identifies Spine Clinic Patients With Limited Health Literacy
Amanda Lans, MD, MS, Joseph H. Schwab, MD, MS, and colleagues found that the Area Deprivation Index, which reflects 17 sociodemographic categories and can be derived from an individual patient's address, identified spine clinic patients at higher risk of having limited health literacy.
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Two Mass General Research Groups Share Resources, Lab Space and a Vision for the Future
Massachusetts General Hospital's Foot and Ankle Research and Innovation Lab (FARIL) and the SORG Research Group have combined their diverse, international teams to conduct clinical research and develop medical devices and AI-based clinical decision support tools for use in the field of orthopedic surgery and beyond.
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Web Tool Predicts Six-Week Survival After Spinal Metastasis Treatment With Surgery or Radiation
Based on a study of 4,304 patients from five institutions, Aditya Karhade, MD, MBA, Joseph Schwab, MD, MS, and colleagues developed and externally validated a model for predicting six-week mortality after surgery or radiation therapy for spinal metastases. It's been incorporated into an open-access web calculator.
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Adding High-Dose Radiation to Surgery Confers Survival Benefit in Patients With Chordoma
Daniel G. Tobert, MD, Joseph H. Schwab, MD, MS, and colleagues demonstrated that adding photon and/or proton radiation therapy (≥70 Gy) to surgical excision of chordoma was associated with 72% less risk of death and 77% less risk of local recurrence within five years.
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Predictive Utility of Natural Language Processing Algorithms for Posterior Lumbar Fusion Patients
Aditya V. Karhade, MD, MBA, Joseph H. Schwab, MD, MS, and colleagues found free-text discharge summary notes have the greatest utility in a natural language processing algorithm for predicting the risk of readmission after posterior lumbar fusion. Progress notes had the least utility.
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Estimating the Survival of Patients With Spinal Metastasis
Using an online survey, Quirina Thio, Joseph Schwab, MD, and colleagues documented poor agreement between surgeons who were asked to estimate survival for 12 patients with spinal metastasis. There was also a substantial discrepancy between the surgeons' estimates and the patients' actual survival.
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Prophylactic Stabilization of Impending Fracture Improves Survival in Patients With Long Bone Metastases
Orthopedic oncology researchers at Massachusetts General Hospital found that, for patients who have a long bone metastatic lesion at substantial risk of fracture, prophylactic fixation is associated with a 28% greater chance of one-year survival and other benefits, versus stabilizing a completed pathological fracture.
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Value-based Health Care: Positioning Spine Surgery Centers for Success
Aditya V. Karhade, MD, MBA, Christopher M. Bono, MD, Joseph H. Schwab, MD, MS, of the Department of Orthopaedic Surgery, and colleagues review recent progress in each of the six core areas of value-based health care and suggest how spine surgery centers can remain competitive in the years ahead.
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NASS 2021: Controversies and Current Issues in Spinal Cord Tumors
As part of the North American Spine Society (NASS) 2021 annual conference, Joseph H. Schwab, MD, chief of the Orthopaedic Spine Center, discussed controversies and current issues in spinal cord tumors.
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Nutritional, Physiological Factors Affect Wound Infection After Surgery for Lower-Extremity Soft Tissue Sarcoma
Researchers from the Orthopaedic Oncology Service found that low albumin, poor nutrition, elevated postoperative glucose and tobacco use are risk factors for wound infection and the need for additional surgery after resection of lower-extremity soft tissue sarcoma.
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Applications of Augmented and Virtual Reality in Spine Surgery
Massachusetts General Hospital researchers from the Spine Service in the Department of Orthopaedic Surgery explain how augmented and virtual reality are already finding a place in spine surgery, with potential integration with artificial intelligence, robotic surgery, gaming and wearables.
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Osteoporosis Is Underrecognized, Undertreated Among Adults with Spinal Deformity Undergoing Long Fusion
In a retrospective study, spinal surgeons from Massachusetts General Hospital determined that one-third of adults scheduled for long thoracolumbar spinal fusions had osteoporosis before surgery, with two-thirds of those patients receiving no pharmacologic treatment.
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Minimal Clinically Important Differences for Lower Extremity Metastatic Surgery
Orthopaedic oncology researchers at Massachusetts General Hospital worked with Dutch colleagues to conduct the first study to establish minimal clinically important differences on PROMIS questionnaires for patients treated for completed or impending pathological fractures due to lower-extremity metastases.
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Novel Technique Reconstructs Lumbar Spine After Spondylectomy of Malignant Tumor
Surgeons at Massachusetts General Hospital have devised a method—the addition of a femoral allograft sleeve—to strengthen the reconstruction of the lumbar spine after resection of a malignant tumor.
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Natural Language Processing Useful for Surveillance of Infections After Spine Surgery
A natural language processing algorithm developed with supervised machine learning was accurate for automated surveillance of infections requiring reoperation after lumbar discectomy.
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Minor Complications Associated with Increased Mortality Risk After Surgery for Metastases in Long Bones
After surgery for metastatic disease in a long bone, both minor and major complications are associated with increased mortality within a year. Certain preoperative factors identify those at highest risk.
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Quality of Life, Physical Function Are Impaired Long After Surgery for Spinal Chondrosarcoma
Surgery for spinal chondrosarcoma has long-lasting effects on all dimensions of quality of life: physical function, pain and mental health.
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High Rate of Fatal Pulmonary Embolism Noted In Patients Undergoing Spine Surgery for Metastases
A retrospective study demonstrated an 11% incidence of symptomatic venous thromboembolism—including a 1.3% rate of fatal pulmonary embolism—within 90 days after surgery for spine metastases
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Web Calculator Predicts Discharge Destination After Lumbar Spinal Stenosis Surgery
Orthopedic surgeons at Massachusetts General Hospital have developed a machine learning algorithm, now available as a web-based calculator, that preoperatively predicts the discharge of a patient to a rehabilitation or nursing facility after surgery for lumbar spinal stenosis.
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Web-based App Predicts Need for Non-Home Discharge After Spondylolisthesis Surgery
In a proof-of-principle study, orthopedic surgeons at Massachusetts General Hospital developed a web-based calculator that identifies which patients undergoing spondylolisthesis surgery will need to have non-home discharge.
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Machine Learning and Artificial Intelligence in Spine Fracture Management
In spine fracture management, there is a growing interest in using machine learning or artificial intelligence to predict fractures, which has implications for advancing clinical care.
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AAOS 2019: A Media Roundup
Health care professionals at this year’s AAOS discussed research findings, novel treatment approaches and innovations on the podium and in the hallways. These conversations generated press across trade publications.
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Research Advances from Mass General Orthopaedics
Researchers from the Department of Orthopaedics discuss the clinical and translational work they are doing at Massachusetts General Hospital.
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Five Sessions to see at #AAOS2019
The AAOS Annual Meeting is a global exchange for orthopaedic scientists and clinicians. Specialists from Massachusetts General Hospital will present and debate leading research and innovative treatment approaches in orthopaedic care.
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New Scale Allows Grading of Cord Compression From Spinal Epidural Abscess
Orthopedic surgeons at Massachusetts General Hospital have developed the first detailed system for grading spinal cord compression secondary to spinal epidural abscess, which could allow greater consistency in reporting associations between cord compression and neurological deficits.
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The Value of Immunotherapy in Spinal Oncology
In this video, Joseph Schwab, MD, discusses the field of cancer immunology, which is guiding a lot of the orthopedic research at Massachusetts General Hospital, and his research on HLA expression on cell surfaces and to discover new immunotherapy targets.
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New Nomogram Helps Clinicians Choose Initial Treatment of Spinal Epidural Abscess
For patients with spinal epidural abscess, the initial choice between surgery and nonoperative management is crucial, as failure of nonoperative treatment can have dire consequences. Orthopedic surgeons at Massachusetts General Hospital developed a nomogram to help clinicians identify patients at high risk of failure from initial non-operative management.
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Forthcoming App Will Estimate Survival of Patients with Operable Cancer Metastatic to Spine
For individual patients with operable cancer that has metastasized to the spine, a new nomogram accurately estimates 3- and 12-month survival to help orthopedic oncologists choose the best surgical approach. The nomogram will soon be available as a website and mobile app.
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New Tools Assess Risk of Motor Deficit, Short-term Mortality in Patients with Spinal Epidural Abscess
Orthopedic surgeons at Massachusetts General Hospital have developed tools to help clinicians predict pretreatment motor deficit and 90-day mortality in individual patients with a spinal epidural abscess.
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Pioneering Machine Learning Tools to Inform Decision Making in Spine Surgeries
To mitigate inborn human biases in decision-making, Joseph Schwab, MD, and colleagues are at the forefront of pioneering the use of machine learning algorithms to help patients understand the risks and outcomes of their surgeries.
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B7-H3 Identified as Potential Target for Treatment of Giant Cell Lesions of Bone
In an award-winning study, researchers at Mass General show for the first time that giant cell lesions may escape immune surveillance because of the inhibitory effect of immune modulating protein B7-H3.
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Personalized Risk and Outcome Assessment Benefits through Machine Learning
Joseph Schwab, MD, discusses how the Mass General Spine Center is utilizing machine learning algorithms to help patients understand their risks and outcomes for surgical procedures with a personalized approach.
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Modified Approach to En Bloc Spondylectomy for Spinal Tumors Protects Great Vessels
In the surgical management of primary spinal tumors, there is trend toward the use of total en bloc spondylectomy (TES). Surgeons at Massachusetts General Hospital have developed a modified two-stage approach to TES to reduce the risk of damage to neurovascular structures.
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Adding Fusion to Decompression for Synovial Facet Cysts Does Not Influence Symptom Recurrence
Synovial cysts are often associated with spinal instability. Adding fusion to decompression surgery might improve outcomes, but previous studies of that approach have yielded contradictory results. Massachusetts General Hospital surgeons examined hundreds of patient records to find answers.
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Spinal Cord Injury Common After Traumatic Spinal Fracture in Patients with AS or DISH
Orthopedic surgeons at Mass General found spinal cord injury (SCI) to be a common and serious complication of traumatic spinal fracture in patients with ankylosing spondylitis (AS) or diffuse idiopathic skeletal hyperostosis (DISH).
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Length of Activity Restriction After Lumbar Discectomy Does Not Affect Recovery
How soon after lumbar discectomy can patients return to full activity? Mass General surgeons were involved in the first prospective, randomized, controlled trial to examine this question.
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Analysis of Metastatic Spine Disease Questionnaires
A Mass General study found that metastatic spine patients are best evaluated using PROMIS survey results for function and pain, and SOSG-OQ survey results for quality of life.
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Minimally Invasive Spine Surgery: Enhancing Clinical Outcomes
Less invasive spine procedures can reduce adverse events and improve clinical outcomes, taking advantage of new imaging technologies and protocols.
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How Prevalent is Spinal Epidural Lipomatosis on Magnetic Resonance Imaging?
First large-scale study of spinal MRIs reveals a prevalence of spinal epidural lipomatosis (SEL) of 2.5%.
Biography
Dr. Schwab is a board certified orthopaedic surgeon who received his residency training from the Mayo Clinic where he was awarded the P.J. Kelly award for outstanding basic science research. He has sub-specialty fellowship training in spine surgery from The Hospital for Special Surgery and orthopaedic oncology from Memorial Sloan Kettering Cancer Center.
Dr. Schwab earned a BA from Miami University in Oxford, Ohio majoring in Religion. He earned his MD from Chicago Medical School where he was a member of the Alpha Omega Alpha honor society, as well as a Master's degree in Clinical Pathology.
Dr. Schwab recently earned his second Master's degree from Harvard/MIT School of Health sciences and Technology as part of the Clinical Investigator Training Program (CITP). The program is designed to train young investigators in the science of translational research and clinical trials.
Dr. Schwab plans on utilizing his CITP training to conduct clinical trials in his areas of clinical interest. He has an active practice that includes the management of benign and malignant bone tumors as well as maladies of the spine such as cervical spinal stenosis, cervical myelopathy, lumbar stenosis, lumbar spondylolisthesis, herniated discs and adult scoliosis.