Nathaniel P. Brooks Lab

Current Projects

Cranial Decompression (Robert Sterner)

Currently, we are examining the association of time to cranial decompression following head trauma on neurological outcomes.

Traumatic Brain Injury (Megan Nedden)

We are working on a retrospective chart review for patients with a traumatic brain injury (TBI) requiring a decompressive craniectomy. Specifically, we are looking to see if having a decompressive craniectomy within 24 hours of the TBI improves a patient’s neurological outcomes. This is part of the Shapiro Summer Research program at UWSMPH.

Complications Associated with Endoscopic Spine Surgery (Delaney Kramar)

We are investigating complications associated with endoscopic spine surgery. It is a retrospective chart review that will provide observational data on the complications found in a group of patients over 18 who underwent this type of procedure. With this project we intend to add more information to the limited existing studies on complications associated with endoscopic spine surgery.

Spinal Oncology (James Liu)

Spinal metastasis accounts for 5% to 10% of cancer patients. While surgical treatment for metastatic epidural spinal cord compression has traditionally been palliative with a life expectancy of 3 months, improved treatment and early detection has resulted in life expectancy increases. This raises questions of which factors may increase risk for spinal tumors and the long-term outcome of patients who have undergone metastatic spinal surgery. Here we conduct a retrospective analysis of 230 spinal tumor patients who have undergone surgery with a special focus on 43 metastatic patients. Our goal is to examine the relationship between demographics, comorbidities, surgical metrics, tumor pathology vs. spinal metastasis occurrence, morbidity, mortality, and neurological outcome.

Past Projects

Traumatic Spinal Cord Injury (Robert Sterner)

Traumatic spinal cord injury (tSCI) is a devastating event that can result in permanent disability or loss of function. To date, the optimal timing of surgical decompression in tSCI patients remains controversial. Our project aims to examine the neurological outcomes of  tSCI patients undergoing: (1) early versus late surgical decompression (<12 hours) versus (>12 hours) and (2) transport in (<6 hours) versus (>6 hours). This study suggested an association of decompression within 12 hours and short transport times (<6 hours) with significant improvements in neurological outcomes. These results were published in Spine. 

Prophylactic anticoagulation in head trauma patients (Daniel L. Traverzo)

We worked on a study which reviewed the association of prophylactic anticoagulation in head trauma patients at UW Hospital and how it affected hematoma progression. Prophylactic anticoagulation is thought to be a potential cause of worsening intracranial hemorrhage in patients administered prophylactic doses of anticoagulation after trauma. It is not well studied how the timing of administration of prophylactic anticoagulation affects intracranial hemorrhage in head trauma patients, which was the basis of the study. This was part of the Shapiro Summer Research program at UWSMPH.

Low-Cost Endoscopic Spine Simulator (James Liu + Paul Page)

Minimally invasive endoscopic techniques in spine surgery continue to gain in popularity. Unfortunately, there is a long learning period for novice endoscope users to acquire basic skills, and complex training simulators are frequently cost-prohibitive. A low-cost endoscopic spine training model was created utilizing a budget of less than 65 USD and tested on a cohort of surgical trainees following a training curriculum consisting of five tasks designed to mimic standard techniques frequently utilized in endoscopic spine surgery. Our study demonstrated the feasibility of a low-cost endoscopic spine trainer as well as its efficacy in improving basic endoscopic skills in trainees. These results were published in Cureus.

Current Members

	Nathaniel P. Brooks, MD, Director/Principal Investigator, brooks@neurosurgery.wisc.edu, PubMed Link, Medical College of Wisconsin, M.D., University of Wisconsin Hospital and Clinics, Resident, Cleveland Clinic Spine Institute, Fellow
	Robert C. Sterner, MD-PhD Candidate, Yale University, B.S. B.A., Cell Biology
	Megan Nedden, MD Program, University of Wisconsin-Madison, B.S., Nutritional Sciences, certificates in Gender & Women’s Studies and Global Health
	Daniel L. Traverzo, MD Program, University of Wisconsin-La Crosse, B.S., Biology
	Delaney Kramar, Researcher, University of Wisconsin-Madison, B.S., Neurobiology and Spanish
	James Y Liu, Research Intern, University of Pittsburgh, B. Eng., Electrical Engineering

Past Members

• Kaitlyn Mayer (6/2013 – 6/2014)
• Stephen Monette (5/2015 – 12/2015)
• Alexander Nguyen (5/2015 – 5/2016)
• Andrew Gold (2/2016 – Summer 2016)
• Keith Dodd (Summer 2016)
• Andrew Hajek (Summer 2016)
• Paul Page (2019-2021)

Publications

Sterner, Robert C. BS, BA^a,b,c; Brooks, Nathaniel P. MD^c. Early Decompression and Short Transport Time After Traumatic Spinal Cord Injury are Associated with Higher American Spinal Injury Association Impairment Scale Conversion. SPINE: January 1, 2022 – Volume 47 – Issue 1 – p 59-66 doi: 10.1097/BRS.0000000000004121

Liu J K, Page P S, Brooks N P (July 21, 2021) Development and Validation of a Low-Cost Endoscopic Spine Surgery Simulator. Cureus 13(7): e16541. doi:10.7759/cureus.16541