About

Michael Vives, MD is a Professor and Chief of the Spine Division in the Department of Orthopaedics at Rutgers-New Jersey Medical School. He has extensive experience in the operative and nonoperative treatment for a wide range of spinal injuries and disorders. Dr. Vives specializes in the management of disc herniations, spinal stenosis, disc degeneration, scoliosis, spinal fractures/spinal cord injury, and spinal tumors. He has expertise in emerging techniques such as disc replacement, minimally invasive surgery, and computer-guided spine surgery. His research includes studies on local insulin application effects on lumbar fusion, the use of insulin mimetics as adjuvants to spinal fusion, and the effects of 5-lipoxygenase inhibition on posterolateral spinal fusion in rat models. Dr. Vives trained at renowned spine programs, completing his residency in Orthopaedic Surgery at Thomas Jefferson University and his fellowship in Spinal Surgery at the University of California, San Diego. He earned his MD from the University of Pennsylvania, where he was elected to the medical honor society, Alpha Omega Alpha, and graduated Summa Cum Laude from The College of William and Mary, where he was elected Phi Beta Kappa. He is actively involved in scientific research, editorial boards of prominent journals, and has authored numerous peer-reviewed articles and book chapters, as well as presenting extensively at national and international meetings.

Research topics

• Computer Science
• Artificial Intelligence
• Computer vision
• Algorithm
• Radiology

Selected publications

• 35. Postoperative methylprednisolone is associated with reduced opioid use following lumbar spinal fusion: a matched cohort analysis

  The Spine Journal · 2025-10-09

  articleSenior author
  PublisherDOI

• Assessing the potential role of ChatGPT in spine surgery research

  Journal of Experimental Orthopaedics · 2024-06-13 · 11 citations

  articleOpen accessSenior author

  Purpose: Since its release in November 2022, Chat Generative Pre-Trained Transformer 3.5 (ChatGPT), a complex machine learning model, has garnered more than 100 million users worldwide. The aim of this study is to determine how well ChatGPT can generate novel systematic review ideas on topics within spine surgery. Methods: ChatGPT was instructed to give ten novel systematic review ideas for five popular topics in spine surgery literature: microdiscectomy, laminectomy, spinal fusion, kyphoplasty and disc replacement. A comprehensive literature search was conducted in PubMed, CINAHL, EMBASE and Cochrane. The number of nonsystematic review articles and number of systematic review papers that had been published on each ChatGPT-generated idea were recorded. Results: Overall, ChatGPT had a 68% accuracy rate in creating novel systematic review ideas. More specifically, the accuracy rates were 80%, 80%, 40%, 70% and 70% for microdiscectomy, laminectomy, spinal fusion, kyphoplasty and disc replacement, respectively. However, there was a 32% rate of ChatGPT generating ideas for which there were 0 nonsystematic review articles published. There was a 71.4%, 50%, 22.2%, 50%, 62.5% and 51.2% success rate of generating novel systematic review ideas, for which there were also nonsystematic reviews published, for microdiscectomy, laminectomy, spinal fusion, kyphoplasty, disc replacement and overall, respectively. Conclusions: ChatGPT generated novel systematic review ideas at an overall rate of 68%. ChatGPT can help identify knowledge gaps in spine research that warrant further investigation, when used under supervision of an experienced spine specialist. This technology can be erroneous and lacks intrinsic logic; so, it should never be used in isolation. Level of Evidence: Not applicable.

  PublisherOA PDFDOI

• Risk factors for metastatic disease at presentation with chordoma and its prognostic value

  North American Spine Society Journal (NASSJ) · 2024-11-06 · 2 citations

  articleOpen accessSenior author

  Background: Chordoma is a rare bone cancer arising from the embryonic notochord with special predilection to the axial skeleton. The locally destructive nature and metastatic potential of chordomas can lead to devastating outcomes in terms of survival. The purpose of this study was to examine potential risk factors predictive of metastatic disease at presentation and prognostic factors in patients with metastasis. Methods: SEER was used to classify each patient as having metastatic or localized disease at the time of diagnosis. Patient-specific and tumor characteristics were analyzed to determine which factors were predictive of an increased rate of metastatic disease at presentation. These factors were analyzed using univariate as well as a multivariate logistic regression model. Prognostic factors for survival were analyzed using the Kaplan-Meier estimates with log-rank tests, and Cox proportional hazards models. Results: We identified 1,241 cases of chordoma affecting the axial skeleton, and 117 (9.4%) of the patients presented with metastatic disease. The most common locations for metastasis at presentation were lung (6.0%), followed by bone (5.1%) and liver (3.4%). Based on the unadjusted logistic regression analysis, patients had the highest odds of metastatic disease at presentation if they had a tumor located in the sacrococcygeal area (OR = 1.72; 95% CI, 1.11-2.68; p = .015), a tumor with a dedifferentiated histological subtype (OR = 7.42; 95% CI, 2.31-23.79; p = .001) and a tumor size greater than 10 cm (OR = 4.57; 95% CI, 2.52-8.28; p = .009). Only the histological subtype remained significant when combined in a multivariate model controlling for age, sex, race, tumor location, histology, and size. For patients with recorded tumor size information (n = 858), the odds of metastasis at presentation increased by 12.2% with each additional centimeter of tumor size (OR = 1.122; 95% CI, 1.072-1.175; p < .0001). However, this lost significance in the multivariate model. Advanced age (hazard ratio, 2.06; 95% confidence interval, (1.18-3.60); p = .011) and dedifferentiated subtype (hazard ratio, 4.7; 95% confidence interval, (1.33-16.8); p = .02) were significant prognostic factors for survival in patients with metastatic chordoma. Conclusions: Chordoma patients with dedifferentiated histological subtype were more likely to have metastatic disease at presentation. Advanced age and dedifferentiated histological subtype were independent predictors of increased mortality in patients with metastatic chordoma. Identification of this high-risk group may help providers in counseling their patients regarding the likelihood of discovering metastatic disease at the time of diagnosis of chordoma and predicting long term prognosis.

  PublisherOA PDFDOI

• Current Concepts in the Orthopaedic Management of Duchenne Muscular Dystrophy

  JAAOS Global Research and Reviews · 2024-07-01 · 3 citations

  articleOpen access

  Duchenne muscular dystrophy (DMD), a genetic condition marked by progressive muscle degeneration, presents notable orthopaedic challenges, especially scoliosis, which deteriorates patients' quality of life by affecting sitting balance and complicating cardiac and respiratory functions. Current orthopaedic management strategies emphasize early intervention with corticosteroids to delay disease progression and the use of surgical spinal fusion to address severe scoliosis, aiming to enhance sitting balance, alleviate discomfort, and potentially extend patient lifespan. Despite advancements, optimal management requires ongoing research to refine therapeutic approaches, ensuring improved outcomes for patients with DMD. This review synthesizes recent findings on surgical and nonsurgical interventions, underscoring the importance of a multidisciplinary approach tailored to the dynamic needs of patients with DMD.

  PublisherDOI

• Evaluating the Readability of Patient Education Materials for Anterior Vertebral Body Tethering, Distraction-Based Methods, and Posterior Spinal Fusion for the Treatment of Pediatric Spinal Deformity

  The International Journal of Spine Surgery · 2024-04-01 · 3 citations

  articleOpen access

  <h3>Background</h3> The Internet is an important source of information for patients, but its effectiveness relies on the readability of its content. Patient education materials (PEMs) should be written at or below a sixth-grade reading level as outlined by agencies such as the American Medical Association. This study assessed PEMs’ readability for the novel anterior vertebral body tethering (AVBT), distraction-based methods, and posterior spinal fusion (PSF) in treating pediatric spinal deformity. <h3>Methods</h3> An online search identified PEMs using the terms “anterior vertebral body tethering,” “growing rods scoliosis,” and “posterior spinal fusion pediatric scoliosis.” We selected the first 20 general medical websites (GMWs) and 10 academic health institution websites (AHIWs) discussing each treatment (90 websites total). Readability tests for each webpage were conducted using Readability Studio software. Reading grade levels (RGLs), which correspond to the US grade at which one is expected to comprehend the text, were calculated for sources and independent <i>t</i> tests compared with RGLs between treatment types. <h3>Results</h3> The mean RGL was 12.1 ± 2.0. No articles were below a sixth-grade reading level, with only 2.2% at the sixth-grade reading level. AVBT articles had a higher RGL than distraction-based methods (12.7 ± 1.6 vs 11.9 ± 1.9, <i>P</i> = 0.082) and PSF (12.7 ± 1.6 vs 11.6 ± 2.3, <i>P</i> = 0.032). Materials for distraction-based methods and PSF were comparable (11.9 ± 1.9 vs 11.6 ± 2.3, <i>P</i> = 0.566). Among GMWs, AVBT materials had a higher RGL than distraction-based methods (12.9 ± 1.4 vs 12.1 ± 1.8, <i>P</i> = 0.133) and PSF (12.9 ± 1.4 vs 11.4 ± 2.4, <i>P</i> = 0.016). <h3>Clinical Relevance</h3> Patients’ health literacy is important for shared decision-making. Assessing the readability of scoliosis treatment PEMs guides physicians when sharing resources and discussing treatment with patients. <h3>Conclusion</h3> Both GMWs and AHIWs exceed recommended RGLs, which may limit patient and parent understanding. Within GMWs, AVBT materials are written at a higher RGL than other treatments, which may hinder informed decision-making and patient outcomes. Efforts should be made to create online resources at the appropriate RGL. At the very least, patients and parents may be directed toward AHIWs; RGLs are more consistent. <h3>Level of Evidence</h3> 3.

  PublisherOA PDFDOI

• Factors Associated With Unplanned Readmissions and Prolonged Length of Stay in Patients Undergoing Primary Fusion for Congenital Scoliosis

  The International Journal of Spine Surgery · 2024-08-01 · 2 citations

  articleOpen accessSenior author

  <h3>Background</h3> Approximately 50% of patients with congenital scoliosis will require surgical treatment to prevent further progression. Outcomes following congenital scoliosis are sparse in the literature. The purpose of this study was to identify independent risk factors associated with unplanned readmission and prolonged length of stay (LOS) in patients undergoing primary surgical treatment for congenital scoliosis. <h3>Methods</h3> The National Surgical Quality Improvement Database-Pediatric was queried for database years 2016–2018 to identify patients with congenital scoliosis who underwent primary posterior fusion of the spine. Patient demographics, comorbidities, and operative variables, such as the number of levels fused and the American Society of Anesthesiologists (ASA) classificaiton, were collected. Univariate and multivariate analyses of patient factors were performed to test for association with readmission within 30 days and prolonged LOS (&gt;4 days). <h3>Results</h3> Eight hundred sixteen patients were identified. The average age was 11.3 ± 4.02 years, and the mean postoperative LOS was 4.64 ± 3.71 days. Forty-three patients (5.40%) were readmitted, and 73 patients (8.96%) had prolonged LOS. Independent risk factors associated with prolonged LOS included chronic lung disease (<i>P</i> &lt; 0.001), presence of a tracheostomy (<i>P</i> &lt; 0.001), structural central nervous system abnormality (<i>P</i> = 0.039), oxygen support (<i>P</i> &lt; 0.001), and number of levels fused (<i>P</i> = 0.008). The factors independently associated with unplanned readmission were fusion to the pelvis (<i>P</i> = 0.004) and LOS &gt;4 days (<i>P</i> = 0.008). <h3>Conclusions</h3> Prolonged LOS and readmission are widely being used as quality and performance metrics for hospitals. Congenital scoliosis, which often progresses rapidly resulting in significant deformity, frequently requires surgery at an earlier age than idiopathic and neuromuscular deformity. Nevertheless, 30-day outcomes for surgical intervention have not been thoroughly studied. The present study identifies risk factors for prolonged LOS and readmission, which can facilitate preoperative planning, patient/family counseling, and postoperative care. <h3>Clinical Relevance</h3> Congenital scoliosis management poses certain challenges that may be mitigated by understanding the risk factors for adverse outcomes following primary fusion surgery.

  PublisherOA PDFDOI

• Enhanced Risk Stratification for Short-Term Complications Following Vertebral Augmentation for Osteoporotic Vertebral Compression Fractures

  The International Journal of Spine Surgery · 2023-07-17 · 2 citations

  articleOpen accessSenior author

  <h3>Background</h3> For patients with back pain from osteoporotic vertebral compression fractures (VCFs), vertebral augmentation remains the most utilized surgical intervention. Previous studies report 30-day readmission and mortality rates of up to 10% and 2%, respectively. These studies, however, have included patients with pathologic fractures and combined patients in different admission settings. We undertook the current study to address such shortcomings, which make risk stratification and appropriate counseling difficult. <h3>Methods</h3> Four consecutive years of the National Surgical Quality Improvement Program database were queried. Patients who underwent vertebral augmentation for osteoporotic VCFs were divided into 3 groups: (1) outpatient group (defined as patients with same-day discharge), (2) inpatient group (defined as those who were admitted postoperatively), and (3) preprocedure hospitalized group (defined as those who were already inpatient or were at acute/intermediate care facilities and transferred). Postoperative 30-day complications and readmission rates were compared between different groups and examined using multivariate analyses. <h3>Results</h3> A total of 1023 patients underwent outpatient surgery; 503 were admitted on the day of surgery; and 149 patients were already in-hospital or were transferred from other facility. Mortality rates were 0.68%, 0.60%, and 2.68%, and readmission rates were 6.26%, 6.76%, and 12.8%, for outpatient, inpatient, and preprocedure hospitalization cohorts, respectively. Multivariate analyses identified preprocedure hospitalization as an independent risk factor for urinary tract infection (UTI; OR = 3.98, 95% CI = 1.41–11.20, <i>P</i> = 0.028), pneumonia (OR = 19.69, 95% CI = 3.81–101.65, <i>P</i> &lt; 0.001), readmission (OR = 1.86, 95% CI = 1.06–3.26, <i>P</i> = 0.032), and mortality (OR = 4.49, 95% CI = 1.22–16.53, <i>P</i> = 0.024). <h3>Conclusion</h3> Our findings suggest that published rates of complications and mortality are substantially impacted by the cohort of patients who are already hospitalized or transferred from other facilities. Such patients are at a higher risk of UTI, pneumonia, readmission, and mortality. Conversely, we show that a relatively healthy patient being offered outpatient same-day augmentation has a readmission risk 40% lower and a mortality risk 3 times lower than previously reported. <h3>Level of Evidence</h3> 3.

  PublisherOA PDFDOI

• 38. Use of the Geriatric Nutritional Risk Index to assess risk for postoperative complications following posterior cervical decompression/fusion

  The Spine Journal · 2023-08-21 · 2 citations

  articleSenior author
  PublisherDOI

• Incidence and risk factors for surgical site infection (SSI) after primary hip hemiarthroplasty: an analysis of the ACS-NSQIP hip fracture procedure targeted database

  Arthroplasty · 2023-01-03 · 15 citations

  articleOpen access

  Abstract Introduction Primary hip hemiarthroplasty (HHA) is frequently utilized to treat geriatric hip fractures, which are associated with significantly higher morbidity and mortality. While not particularly common, surgical site infection (SSI) is a major complication that frequently requires revision surgery in a frail population. The objective of this study was to determine the incidence of and risk factors for SSI after HHA in hip fracture patients. Materials and methods This retrospective cohort study was performed using the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database. Geriatric patients (65+) who underwent HHA for non-pathologic, traumatic hip fractures between 2016–2017 were included. Demographic variables, comorbidities, operative variables, and complications were compared between "SSI" and "non-SSI" groups. Multivariate regression identified independent risk factors for postoperative SSI. Significance was set at P = 0.05. Results A total of 6169 patients were included. The overall incidence of SSI was 1.3%. SSI was significantly associated with body mass index (BMI), preoperative functional status, congestive heart failure, chronic corticosteroid use, intraoperative time, sepsis, wound dehiscence, readmission within 30-days, and reoperation. On multivariate analysis, chronic steroid use (OR: 2.30, 95% CI: 1.13–4.70), BMI ≥ 35 kg/m 2 (OR: 3.59, 95% CI: 1.57–8.18), and intraoperative time ≥120 mins (OR: 2.15, 95% CI: 1.08–4.27) were found to be independent risk factors. Conclusions Postoperative SSI is a serious complication that is responsible for prolonged hospital stays, increased mortality, and greater healthcare costs. Here, we identified multiple risk factors for SSI after primary HHA in the US elderly population.

  PublisherOA PDFDOI

• Use of the Geriatric Nutritional Risk Index to Assess Risk for Postoperative Complications Following Posterior Cervical Decompression/Fusion

  The International Journal of Spine Surgery · 2023-10-26 · 19 citations

  articleOpen accessSenior author

  <h3>Background</h3> Posterior cervical decompression with or without fusion (PCD/F) is used to manage degenerative spinal conditions. Malnutrition has been implicated for poor outcomes in spine surgery. The aim of this study was to assess the ability of the Geriatric Nutritional Risk Index (GNRI) as a risk calculator for postoperative complications in patients undergoing PCD/F. <h3>Methods</h3> The 2006 to 2018 American College of Surgeons National Surgery Quality Improvement Program Database was queried for patients undergoing PCD/F. Nutritional status was categorized as normal (GNRI greater than 98), moderately malnourished (GNRI 92–98), or severely malnourished (GNRI less than or equal to 92). Complications within 30 days of surgery were compared among the groups. Preoperative data that were statistically significant (<i>P</i> &lt; 0.05) upon univariate χ² analysis were included in the univariate then multivariate binary regression model to calculate adjusted ORs. All ORs were assessed at the 95% CI. <h3>Results</h3> Of the 7597 PCD/F patients identified, 15.6% were severely malnourished and 19.1% were moderately malnourished. Severe and moderate malnourishment were independent risk factors for mortality (OR = 3.790, 95% CI 2.492–5.763, <i>P</i> &lt; 0.001; OR = 2.150, 95% CI 1.351–3.421, <i>P</i> = 0.011). Severe malnourishment was an independent risk factor for sepsis/septic shock (OR = 3.448, 95% CI 2.402–4.948, <i>P</i> &lt; 0.001). <h3>Conclusions</h3> In elderly patients undergoing PCD/F, severe malnutrition, as defined by the GNRI, was an independent risk factor for mortality and sepsis/septic shock. <h3>Clinical Relevance</h3> The GNRI may be more useful than other indices for risk stratification in elderly patients because it accounts for confounding variables such as hydration status and paradoxical malnourishment in obese patients. <h3>Level of Evidence</h3> 3

  PublisherOA PDFDOI

Frequent coauthors

• Colin B. Harris

  Rutgers New Jersey Medical School

  35 shared

• John I. Shin

  Mass General Brigham

  32 shared

• Saad B. Chaudhary

  Icahn School of Medicine at Mount Sinai

  31 shared

• Ari R. Berg

  Rutgers, The State University of New Jersey

  30 shared

• Sheldon S. Lin

  28 shared

• Ilker Hacihaliloglu

  26 shared

• John D. Koerner

  Rothman Orthopaedics

  23 shared

• Ashok Para

  Rutgers, The State University of New Jersey

  21 shared

Education

• M.D.

  University of Pennsylvania School of Medicine

  1995

• B.S., Biology

  College of William and Mary

  1991