About

Anthony K. Frempong-Boadu, MD, is a professor of neurosurgery and orthopedic surgery at NYU Grossman School of Medicine. He is also the Vice Chair of Professional Services in the Department of Neurosurgery and the Co-Director of the NYU Langone Spine Center. His primary interest in neurosurgery is in minimally invasive, complex, and reconstructive spinal surgery. He treats a wide range of spinal conditions including degenerative spine disease, reconstructive spine disease, oncological disease of the spinal cord and spinal column, and spine trauma. Dr. Frempong-Boadu's work involves collaboration with a diverse group of specialists at the Spine Center to develop treatment protocols, make surgical decisions, and deliver comprehensive preoperative and postoperative care. He is at the forefront of developing spinal technology, utilizing advanced navigation and imaging to enhance surgical accuracy and safety. His research includes studying the safety of antibiotic prophylaxis for surgical wounds and developing algorithms to design safe spine treatments for the aging population. He emphasizes patient education, aiming to ensure patients understand their conditions, treatment options, and expected outcomes.

Research topics

• Surgery
• Medicine
• Internal medicine
• Nuclear medicine
• Radiology

Selected publications

• 180 Optimal Neurosurgical Surgical Site Preparation: A Prospective Single-Center Study

  Neurosurgery · 2025-03-14

  article

  INTRODUCTION: Surgical site infections (SSI) can be devastating, yet optimal preparation techniques have not been clearly determined in neurosurgical patients. Furthermore, the profile and origin of pathogens that ultimately go on to cause SSI remain unclear. METHODS: This is a prospective single-center study including adult patients undergoing elective procedures. Cultures are taken before and after preparation with providone iodine (PVI), chlorhexidine gluconate (CHG), or a combination based on surgeon preference, and again from bone after exposure. Primary outcome is SSI requiring return to the OR. Secondary outcomes are the effects of preparation on surgical site cultures, and the correlation between cultures and ultimate infectious pathogens. RESULTS: The study includes 846 patients undergoing open procedures. 692 cases used CHG, 96 PVI, and 58 both. 11 SSIs required return to the OR with an infection rate of 1.3%. 6 had used CHG (0.9%), 5 PVI (5.2%) during the index surgery. 67 additional patients underwent endoscopic endonasal procedures with PVI prep and no infections. The infection rate for PVI was significantly higher than CHG (p = 0.01), even among matched procedures (p = 0.03). Among the index surgeries with complete surgical site culture data, the causative organism was never present. We found that pathogens present in the first culture but not the second were sometimes present in the third cultures, consistent with the hypothesis that there is a bacterial reservoir in hair follicles inaccessible to skin prep. CONCLUSIONS: CHG reduces the rate of SSI. The pathogens that go on to cause infection are not present on the skin at the time of surgery, and thus that causative organisms are introduced into the wound at a later time. This raises important questions about the optimal care of neurosurgical wounds postoperatively.

  PublisherDOI

• Fluoroscopy-Guided Removal of Tethered Surgical Drain via Guidewire Electrification: A Case Report

  Cureus · 2025-06-28

  articleOpen accessSenior author

  Tethered postoperative drains are not uncommon complications that often require open removal in the operating room, which can increase risks of surgical site infection as well as length of hospitalization. We present a novel method of tethered drain removal through guidewire electrification. A retained deep drain following a posterior cervical laminectomy and fusion was identified after failed manual removal. Under fluoroscopic guidance, the retaining suture was indirectly identified through the obstruction of an inserted guidewire, through which monopolar cautery was applied, breaking the suture and allowing drain removal. The original incision did not need to be re-opened. While further investigation is necessary for validation, this technique shows great promise as an alternative to open removal.

  PublisherOA PDFDOI

• Augmenting Large Language Models With Automated, Bibliometrics-Powered Literature Search for Knowledge Distillation: A Pilot Study for Common Spinal Pathologies

  Neurosurgery · 2025-01-16 · 8 citations

  article

  BACKGROUND AND OBJECTIVES: Scholarly output is accelerating in medical domains, making it challenging to keep up with the latest neurosurgical literature. The emergence of large language models (LLMs) has facilitated rapid, high-quality text summarization. However, LLMs cannot autonomously conduct literature reviews and are prone to hallucinating source material. We devised a novel strategy that combines Reference Publication Year Spectroscopy-a bibliometric technique for identifying foundational articles within a corpus-with LLMs to automatically summarize and cite salient details from articles. We demonstrate our approach for four common spinal conditions in a proof of concept. METHODS: Reference Publication Year Spectroscopy identified seminal articles from the corpora of literature for cervical myelopathy, lumbar radiculopathy, lumbar stenosis, and adjacent segment disease. The article text was split into 1024-token chunks. Queries from three knowledge domains (surgical management, pathophysiology, and natural history) were constructed. The most relevant article chunks for each query were retrieved from a vector database using chain-of-thought prompting. LLMs automatically summarized the literature into a comprehensive narrative with fully referenced facts and statistics. Information was verified through manual review, and spine surgery faculty were surveyed for qualitative feedback. RESULTS: Our tandem approach cost less than $1 for each condition and ran within 5 minutes. Generative Pre-trained Transformer-4 was the best-performing model, with a near-perfect 97.5% citation accuracy. Surveys of spine faculty helped refine the prompting scheme to improve the cohesion and accessibility summaries. The final artificial intelligence-generated text provided high-fidelity summaries of each pathology's most clinically relevant information. CONCLUSION: We demonstrate the rapid, automated summarization of seminal articles for four common spinal pathologies, with a generalizable workflow implemented using consumer-grade hardware. Our tandem strategy fuses bibliometrics and artificial intelligence to bridge the gap toward fully automated knowledge distillation, obviating the need for manual literature review and article selection.

  PublisherDOI

• Use of Preoperative Spinal Angiography in Severe Spinal Deformity Patients Who Require Thoracic 3 Column Osteotomy: A Case Series and Review of the Literature

  Operative Neurosurgery · 2025-01-29

  article

  BACKGROUND AND OBJECTIVES: Three-column osteotomy (3CO) offers substantial spinal deformity correction. Thoracic neurovascular bundle sacrifice is often required, and anterior spinal artery (ASA) perfusion can be compromised. Spinal angiography allows localization of variable ASA vascular contribution. This study's objective was to describe a series of patients who underwent preoperative spinal angiography and discuss the impact on surgical planning and execution of thoracic 3CO for deformity correction. METHODS: Patients who underwent preoperative spinal angiograms and thoracic 3CO for deformity correction were reviewed. Preoperative, angiographic, and postoperative information was recorded. A literature review on preoperative spinal angiography in deformity surgery was performed. RESULTS: Eight patients were identified: single-level pedicle subtraction osteotomies (1), single-level vertebral column resections (2), and multilevel vertebral column resections (5). The average age was 40.0 years, and 75.0% were female. Thoracic scoliosis ranged from 0 to 105° preoperatively and 0 to 45.1° postoperatively. Thoracic kyphosis ranged from 29° to 120° preoperatively and 20.6° to 54.9° postoperatively. Twelve ASA supply vessels were identified bilaterally in 6 patients. Four patients had nontraditional ASA supply at T4 (1), T6 (1), and L2 (2), and 4 had multiple ASA feeders. Based on angiographic results, osteotomy site was changed (1), and neurovascular bundles were spared (2), a 37.5% rate of surgical plan alteration. There were no permanent neuromonitoring changes or postoperative neurologic deficits. No articles reported on using spinal angiography specifically for deformity surgery. CONCLUSION: Spinal angiography is low risk and provides critical information regarding ASA supply to potentially mitigate ischemic risk during neurovascular bundle takedown during thoracic 3CO. Further case series are warranted to evaluate the benefits in larger populations, but its clinical applications appear practical.

  PublisherDOI

• What’s the harm? Evaluating complications associated with salvaged red blood cell transfusion in spinal deformity surgery: a nonrandomized controlled trial

  Journal of Neurosurgery Spine · 2025-09-12

  article

  OBJECTIVE: Salvaged red blood cells (sRBCs) are frequently used in spine surgery, despite concerns about their quality and efficacy as a blood substitute. This study aimed to evaluate the association of sRBC transfusion with postoperative complications in spinal deformity surgery. METHODS: This single-center, prospective, nonrandomized controlled trial included patients undergoing posterior-based multilevel thoracolumbar instrumented fusion for spinal deformity from June 2022 to July 2023. Participants were grouped based on whether they received an sRBC transfusion. Postoperative complications were analyzed using frequentist methods, with and without propensity score matching (PSM), and a series of five Bayesian models of varying complexity that included hierarchical structures and covariates. Model comparison followed by weighted model averaging based on predictive performance was performed to integrate the results from the different models into a composite model. RESULTS: After PSM (specifically matching surgical invasiveness and blood loss), sRBC transfusion was associated with increased odds of infection (OR 3.77, 95% CI 0.99-14.33; p = 0.046), acute kidney injury (OR 3.36, 95% CI 1.37-8.22; p = 0.007), liver injury (OR 3.52, 95% CI 1.64-7.54; p < 0.001), pulmonary complications (OR 2.26, 95% CI 1.13-4.53; p = 0.025), and thrombocytopenia (OR 9.02, 95% CI 2.54-32.0; p < 0.001). The composite Bayesian model yielded consistent results, with additional associations noted for cardiac events (OR 2.18, 95% highest density interval [HDI] 1.36-3.03) and coagulopathy (OR 3.13, 95% HDI 1.85-4.50). In contrast, allogeneic RBC transfusion was only associated with infection (OR 1.65, 95% HDI 1.04-2.59) and pulmonary complications (OR 1.73, 95% HDI 1.08-2.89). CONCLUSIONS: Salvaged RBC transfusion in complex spine surgery was found to be independently associated with increased risks of various complications. These findings reinforce concerns about the safety of sRBC transfusion, suggesting a need for caution in their use in this setting.

  PublisherDOI

• Are postoperative prophylactic antibiotics necessary in patients undergoing cervical spine surgery? A propensity matched analysis

  Journal of Orthopaedic Reports · 2025-03-03

  articleOpen access

  Several studies have evaluated the duration and effectiveness of prophylactic antibiotics; however, questions remain about its continued use in the postoperative setting. The objective of this study is to assess the benefit of postoperative antibiotics in patients undergoing inpatient cervical spine surgery. Inpatient cervical spine procedures were evaluated from 2011 to 2018 with minimum of one-year follow-up. Patients received cefazolin, or if a severe allergy was documented, vancomycin or clindamycin was administered. Patients were stratified into two groups: 1) those receiving preoperative antibiotics and 24 hours of postoperative antibiotics, and 2) those receiving only preoperative antibiotics with no postoperative antibiotics. One-to-one nearest neighbor propensity matching was used between patients who did and did not receive postoperative antibiotics. 1,290 cervical spine procedures were evaluated and 231 met criteria for inclusion. 53.2% of patients did not receive postoperative antibiotics and 46.8% of patients did. The infection rate was 1.9% in the postoperative antibiotic group and 2.3% in the no postoperative antibiotic group, which was not statistically significant. Increased CCI score was associated with an increased risk of postoperative infection. Propensity-matched analysis demonstrated no difference in infection rates between the two groups. In patients undergoing inpatient cervical spine surgery, there was no difference in the rate of surgical site infections between patients who received postoperative antibiotics and those that did not. Future studies should clarify which patients, if any, would benefit from postoperative antibiotic prophylaxis. • Cervical spine surgery is an invasive surgery with postoperative courses often affected by complications, including infection. • Patients receiving antibiotics did not have decreased risk of surgical site infection compared to those not receiving postoperative antibiotics. • Future studies should further delve into appropriate antibiotic use for patients undergoing cervical spine surgery to better identify patients that would benefit from a postoperative regimen.

  PublisherDOI

• What Are We Transfusing? Evaluating the Quality and Clinical Utility of Intraoperatively Salvaged Red Blood Cells in Spinal Deformity Surgery: A Nonrandomized Controlled Trial

  Neurosurgery · 2024-08-01 · 11 citations

  article

  BACKGROUND AND OBJECTIVES: Intraoperative red blood cell (RBC) salvage is frequently used in contemporary spine surgery, despite clinical concern in its efficacy as a surrogate for blood-banked allogeneic packed RBCs (pRBCs). During spine surgery, salvaged RBCs (sRBCs) are exposed to injurious high-heat electrocautery, prolonged stasis, and abrasive pharmaceuticals, potentially making sRBCs a poor blood substitute. We therefore sought to scientifically and objectively define the quality of sRBCs in the context of complex spine surgery. METHODS: This is a single-center, prospective, nonrandomized controlled trial of patients undergoing posterior-based multilevel thoracolumbar instrumented fusion for spinal deformity with planned use of intraoperative RBC salvage between June 2022 and July 2023. Surgeries were performed by fellowship-trained spinal neurosurgeons and orthopedic surgeons. The participants were split based on transfusion of sRBCs (given sufficient yield) vs no sRBC transfusion. Primary outcomes were RBC electrolyte composition, indices, deformability, and integrity, which were evaluated in comparison blood samples: Baseline, pRBC, and sRBC. Secondary outcomes were related to clinical effects of sRBC transfusion. Morphological assessment used Stimulated Raman Histology and machine learning. Deformability was assessed using ektacytometry. RESULTS: A total of 174 patients were included. The mean age was 50.2years ±25.4, 58.6% was female, the mean level fused was 10.0 ± 3.9, and 58.0% received sRBCs (median 207.0 mL). sRBCs differed significantly on standard laboratory measures, had a high proportion (30.7%) of shrunken and irregularly spiculated morphologies, and demonstrated abnormal deformability and relaxation kinetics. The hemolysis index was significantly elevated in sRBCs (2.9 ± 1.8) compared with Baseline samples and pRBCs ( P < .01). Transfusion of sRBCs was associated with suboptimal resuscitation and provided no practical clinical benefit. CONCLUSION: RBCs salvaged during posterior thoracolumbar spine surgery are irreversibly injured, with hemolysis index exceeding Food and Drug Administration and Council of Europe transfusion standards in all samples, questioning their efficacy and safety as a blood substitute.

  PublisherDOI

• Vertebral Column Subluxation in Neurofibromatosis Type 1–Associated Dystrophic Scoliosis: A Report of Two Cases and Narrative Review

  Operative Neurosurgery · 2024-09-20

  review

  BACKGROUND AND OBJECTIVE: Neurofibromatosis-1 (NF1) dystrophic scoliosis is a challenging disease to manage surgically, with multiplanar curves progressing rapidly and unpredictably. Conservative management with bracing is often unsuccessful, and many patients necessitate instrumented fusion to halt progression of their curves. In rare cases, patients can present with spontaneous vertebral subluxation, significantly complicating the surgical management of this already complex disease process. The objective here was to describe 2 cases of vertebral subluxation in NF1-associated dystrophic scoliosis along with their surgical corrections and clinical courses. METHODS: A retrospective review of 2 cases at the authors' institution was performed to describe their preoperative symptom complexes, surgical corrections, and postoperative courses. A narrative review of the literature surrounding NF1-associated dystrophic scoliosis and subluxation is also presented. RESULTS: Two cases of vertebral subluxation at T4-5 and C7-T1 are presented. Both patients had significant dystrophic features throughout their spines, and halo-gravity traction was unsuccessful in 1 patient and led to vertebral and subclavian artery injuries in the other. One patient underwent an uncomplicated deformity correction with partial vertebral column resection to facilitate his deformity correction. The other patient, after her vascular injuries, ultimately suffered a spinal cord injury after a fall and underwent emergent instrumentation, decompression, and partial vertebral column resection at the site of subluxation, with improvement in her neurological function afterward. CONCLUSION: Dystrophic scoliosis in NF1 remains a difficult disease to treat, and deformity correction in patients with subluxation is particularly complex. These cases here highlight the unpredictability and possible complications of halo-gravity traction, need for good fixation to facilitate subluxation reduction, high chance of hardware complications and proximal or distal failure, and importance of cooperative management of these patients in conjunction with other surgical services.

  PublisherDOI

• Developing an Automated Registry (Autoregistry) of Spine Surgery Using Natural Language Processing and Health System Scale Databases

  Neurosurgery · 2023-06-22 · 8 citations

  articleCorresponding

  BACKGROUND AND OBJECTIVES: Clinical registries are critical for modern surgery and underpin outcomes research, device monitoring, and trial development. However, existing approaches to registry construction are labor-intensive, costly, and prone to manual error. Natural language processing techniques combined with electronic health record (EHR) data sets can theoretically automate the construction and maintenance of registries. Our aim was to automate the generation of a spine surgery registry at an academic medical center using regular expression (regex) classifiers developed by neurosurgeons to combine domain expertise with interpretable algorithms. METHODS: We used a Hadoop data lake consisting of all the information generated by an academic medical center. Using this database and structured query language queries, we retrieved every operative note written in the department of neurosurgery since our transition to EHR. Notes were parsed using regex classifiers and compared with a random subset of 100 manually reviewed notes. RESULTS: A total of 31 502 operative cases were downloaded and processed using regex classifiers. The codebase required 5 days of development, 3 weeks of validation, and less than 1 hour for the software to generate the autoregistry. Regex classifiers had an average accuracy of 98.86% at identifying both spinal procedures and the relevant vertebral levels, and it correctly identified the entire list of defined surgical procedures in 89% of patients. We were able to identify patients who required additional operations within 30 days to monitor outcomes and quality metrics. CONCLUSION: This study demonstrates the feasibility of automatically generating a spine registry using the EHR and an interpretable, customizable natural language processing algorithm which may reduce pitfalls associated with manual registry development and facilitate rapid clinical research.

  PublisherDOI

• Carbon fiber–reinforced PEEK spinal implants for primary and metastatic spine tumors: a systematic review on implant complications and radiotherapy benefits

  Journal of Neurosurgery Spine · 2023-06-24 · 31 citations

  review

  OBJECTIVE: By minimizing imaging artifact and particle scatter, carbon fiber-reinforced polyetheretherketone (CF-PEEK) spinal implants are hypothesized to enhance radiotherapy (RT) planning/dosing and improve oncological outcomes. However, robust clinical studies comparing tumor surgery outcomes between CF-PEEK and traditional metallic implants are lacking. In this paper, the authors performed a systematic review of the literature with the aim to describe clinical outcomes in patients with spine tumors who received CF-PEEK implants, focusing on implant-related complications and oncological outcomes. METHODS: A systematic review of the literature published between database inception and May 2022 was performed in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The PubMed database was queried using the terms "carbon fiber" and "spine" or "spinal." The inclusion criteria were articles that described patients with CF-PEEK pedicle screw fixation and had a minimum of 5 patients. Case reports and phantom studies were excluded. RESULTS: This review included 11 articles with 326 patients (237 with CF-PEEK-based implants and 89 with titanium-based implants). The mean follow-up period was 13.5 months, and most tumors were metastatic (67.1%). The rates of implant-related complications in the CF-PEEK and titanium groups were 7.8% and 4.7%, respectively. The rate of pedicle screw fracture was 1.7% in the CF-PEEK group and 2.4% in the titanium group. The rates of reoperation were 5.7% (with 60.0% because of implant failure or junctional kyphosis) and 4.8% (all because of implant failure or junctional kyphosis) in the CF-PEEK and titanium groups, respectively. When reported, 72.5% of patients received postoperative RT (41.0% stereotactic body RT, 30.8% fractionated RT, 25.6% proton, 2.6% carbon ion). Four articles suggested that implant artifact was reduced in the CF-PEEK group. Local recurrence occurred in 14.4% of CF-PEEK and 10.7% of titanium-implanted patients. CONCLUSIONS: While CF-PEEK harbors similar implant failure rates to traditional metallic implants with reduced imaging artifact, it remains unclear whether CF-PEEK implants improve oncological outcomes. This study highlights the need for prospective, direct comparative clinical studies.

  PublisherDOI

Frequent coauthors

• M. Burhan Janjua

  Washington University in St. Louis

  30 shared

• Ali A. Baaj

  University of Arizona

  27 shared

• Jeffrey P. Greenfield

  Cornell University

  27 shared

• Peter L. Zhou

  University of Toronto

  25 shared

• Thomas J. Errico

  Miami Children's Hospital

  19 shared

• Robert E. Isaacs

  Duke Medical Center

  18 shared

• Michael L. Smith

  Northwell Health

  17 shared

• Robert E. Elliott

  17 shared

Labs

• NYU Langone Spine CenterPI

Awards & honors

• Named One of America’s Top Doctors by Castle Connolly for 5+…