Courtney Goodwin

Positions:

Assistant Professor of Neurosurgery

Neurosurgery
School of Medicine

Assistant Professor in Radiation Oncology

Radiation Oncology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

B.S. 2002

University of Florida

Ph.D. 2008

Johns Hopkins University School of Medicine

M.D. 2010

Johns Hopkins University School of Medicine

Internship, Neurosurgery

Johns Hopkins Medicine

Residency, Neurosurgery

Johns Hopkins Medicine

Grants:

Health Related Quality of Life Outcomes in Spinal Metastases

Administered By
Neurosurgery
Awarded By
Robert Wood Johnson Foundation
Role
Principal Investigator
Start Date
End Date

Pain Outcomes in Single-High Dose vs. Hypofractionated SBRT for Spinal Metastases

Administered By
Neurosurgery
Awarded By
Neurosurgery Research and Education Foundation
Role
Principal Investigator
Start Date
End Date

Extent of Resection and Spinal Stabilization and Reconstruction in Spinal Tumors

Administered By
Neurosurgery
Awarded By
Medtronic, Inc.
Role
Co-Principal Investigator
Start Date
End Date

SUMOylation of PYK2 in breast cancer spinal metastases

Administered By
Neurosurgery
Role
Principal Investigator
Start Date
End Date

The Influence of Spinopelvic parameters on Spinal Tumor Outcomes

Administered By
Neurosurgery
Awarded By
North Carolina Spine Society
Role
Principal Investigator
Start Date
End Date

Publications:

Comparison of three predictive scoring systems for morbidity in oncological spine surgery

Estimating complications in oncological spine surgery is challenging. The objective of this study was to compare the accuracy of three scoring systems for predicting perioperative morbidity after surgery for spinal metastases. One-hundred and five patients who underwent surgery between 2013 and 2019 were included in this study. All patients had scores retrospectively calculated using the New England Spinal Metastasis Score (NESMS), Metastatic Spinal Tumor Frailty Index (MSTFI), and Anzuategui scoring systems. The main outcome measure was development of a medical complication (minor or major) within 30 days of surgery. The predictive ability for each system was assessed using receiver operating characteristic analysis and calculations of the area under the curve (AUC). The average age for all patients was 61 years and 61/105 patients (58.1%) were male. The most common primary tumor origins were hematologic (23.8%), prostate (16.2%), breast (14.3%), and lung (13.3%). The overall 30-day complication rate was 36.2% and the rate of major complications was 21.9%. Among all patients who underwent oncological spine surgery, the NESMS score had the highest AUC for 30-day overall (AUC 0.64; 95% CI, 0.53 – 0.75) and major morbidity (AUC 0.68; 95% CI, 0.54– 0.81) in our population. However, the accuracy did not meet the threshold for clinical utility. Future prospective validation of these systems in other populations is encouraged.
Authors
De la Garza Ramos, R; Naidu, I; Choi, JH; Pennington, Z; Goodwin, CR; Sciubba, DM; Shin, JH; Yanamadala, V; Murthy, S; Gelfand, Y; Yassari, R
MLA Citation
De la Garza Ramos, R., et al. “Comparison of three predictive scoring systems for morbidity in oncological spine surgery (Accepted).” Journal of Clinical Neuroscience, vol. 94, Dec. 2021, pp. 13–17. Scopus, doi:10.1016/j.jocn.2021.09.031.
URI
https://scholars.duke.edu/individual/pub1498753
Source
scopus
Published In
Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
Volume
94
Published Date
Start Page
13
End Page
17
DOI
10.1016/j.jocn.2021.09.031

Radiotherapy and Surgical Advances in the Treatment of Metastatic Spine Tumors: A Narrative Review.

Spine tumors encompass a wide range of diseases with a commensurately broad spectrum of available treatments, ranging from radiation for spinal metastases to highly invasive en bloc resection for primary vertebral column malignancies. This high variability in treatment approaches stems both from variability in the goals of surgery (e.g., oncologic cure vs. symptom palliation) and from the significant advancements in surgical technologies that have been made over the past 2 decades. Among these advancements are improvements in surgical technique, namely minimally invasive approaches, increased availability of focused radiation modalities (e.g., proton therapy and linear accelerator devices), and new surgical technologies, such as carbon fiber-reinforced polyether ether ketone rods. In addition, several groups have described nonsurgical interventions, such as vertebroplasty and kyphoplasty for spinal instability secondary to pathologic fracture, and lesion ablation with spinal laser interstitial thermoablation, radiofrequency ablation, or cryoablation. We provide an overview of the latest technological advancements in spinal oncology and their potential usefulness for modern spinal oncologists.
Authors
Porras, JL; Pennington, Z; Hung, B; Hersh, A; Schilling, A; Goodwin, CR; Sciubba, DM
MLA Citation
Porras, Jose L., et al. “Radiotherapy and Surgical Advances in the Treatment of Metastatic Spine Tumors: A Narrative Review.World Neurosurg, vol. 151, July 2021, pp. 147–54. Pubmed, doi:10.1016/j.wneu.2021.05.032.
URI
https://scholars.duke.edu/individual/pub1488203
PMID
34023467
Source
pubmed
Published In
World Neurosurg
Volume
151
Published Date
Start Page
147
End Page
154
DOI
10.1016/j.wneu.2021.05.032

Core imaging in adult hydrocephalus

Advances in neuroimaging have greatly improved the management of hydrocephalus. The various imaging modalities are useful in confirming the diagnosis, determining the etiology of hydrocephalus, providing intraoperative guidance, and improving the follow-up of patients who have undergone treatment including cerebrospinal fluid (CSF) shunting or endoscopic third ventriculostomy (ETV). The various imaging modalities that are utilized include: conventional X-rays; ultrasonography; computerized axial tomography (CT); magnetic resonance imaging (MRI); radionuclide shunt patency imaging. As systematically as possible, we will list for each modality their use in the preoperative, perioperative, and postoperative period. Conventional X-rays Conventional X-rays often are used to evaluate shunted patients as the entire shunt hardware can be visualized to assess the continuity of the shunt. However, as the majority of shunt malfunctions are unrelated to mechanical discontinuity, the majority of images obtained will demonstrate intact tubing; Lehnert et al. [1] found only 4% of shunt surveys to be abnormal in a series of 296 patients in the emergency room. Similarly, Griffey et al. [2] assessed the utility of shunt surveys in diagnosing shunt malfunctions in the emergency room in adult hydrocephalus patients and found a sensitivity of only 0.11 but a specificity of 0.98. A similar study in the pediatric population demonstrated a slightly higher sensitivity of 0.31 [3]. Conventional X-rays are also utilized to verify the shunt setting, because programmable shunt valves generally have radiopaque markers.
Authors
Elder, BD; Bankah, P; Blitz, AM; Rory Goodwin, C; Kosztowski, TA; Jusué–Torres, I; Rigamonti, D
MLA Citation
Elder, B. D., et al. “Core imaging in adult hydrocephalus.” Adult Hydrocephalus, 2012, pp. 110–20. Scopus, doi:10.1017/CBO9781139382816.012.
URI
https://scholars.duke.edu/individual/pub1430916
Source
scopus
Published Date
Start Page
110
End Page
120
DOI
10.1017/CBO9781139382816.012

The role of patient primary language in access to brain tumor resection: Evaluating emergent admission and hospital volume

Background: This study investigated the effect of limited English proficiency on access to neuro-oncologic surgery. We compared rates of emergent/urgent admission and admission to high-volume hospitals for English and non-English primary language patients with brain neoplasms. Methods: Using the AHRQ-HCUP New Jersey State Inpatient Database, we included patients 18–90 years old who underwent resection of a supratentorial primary brain tumor (PBT), meningioma (MA) or brain metastasis (BM) from 2009–2017. Outcomes were emergent/urgent admission and annual hospital procedure volume. Univariable and multivariable analyses compared Spanish (SPL), Non-English Non-Spanish (NENS), and English (EPL) primary language groups. Results: 7,402 patients were included: 2,996 PBT, 2,115 MA, and 2,291 BM. SPL patients (n = 300) were younger and had a greater proportion of non-commercially insured, low-income patients with lower comorbidity scores. NENS patients (n = 260) had similar age and comorbidity scores as EPL patients, but a greater proportion had non-commercial insurance and low income (p < 0.001). Multivariable analysis revealed NENS, but not SPL, patients had increased odds of emergent/urgent admission (2.10(1.50−2.93), p < 0.001), but demonstrated no association between admission to higher volume centers and primary language. Conclusion: Patient primary language may influence access to timely neurosurgical care, but access to high-volume centers appears to be mediated by other factors. Policy summary statement: In addition to efforts to improve health care access for patients with limited English proficiency, multilingual health literacy and patient education interventions may help to promote timely presentation for brain tumor resection among this vulnerable patient population.
Authors
Witt, EE; Eruchalu, CN; Dey, T; Bates, DW; Goodwin, CR; Ortega, G
MLA Citation
Witt, E. E., et al. “The role of patient primary language in access to brain tumor resection: Evaluating emergent admission and hospital volume (Accepted).” Journal of Cancer Policy, vol. 30, Dec. 2021. Scopus, doi:10.1016/j.jcpo.2021.100306.
URI
https://scholars.duke.edu/individual/pub1498781
Source
scopus
Published In
Journal of Cancer Policy
Volume
30
Published Date
DOI
10.1016/j.jcpo.2021.100306

Racial Disparities in Perioperative Morbidity Following Oncological Spine Surgery.

STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To assess the impact of race on complications following spinal tumor surgery. METHODS: Adults with cancer who underwent spine tumor surgery were identified in the American College of Surgeons National Surgical Quality Improvement Program datasets from 2012 to 2016. Clavien-Dindo Grade I-II (minor complications) and Clavien-Dindo Grade III-V (major complications including 30-day mortality) complications were compared between non-Hispanic Whites (NHW) and Black patients. A multivariable analysis was also conducted. RESULTS: Of 1,226 identified patients, 85.9% were NHW (n = 1,053) and 14.1% were Black (n = 173). The overall rate of Grade I-II complications was 16.2%; 15.1% for NHW patients and 23.1% for Black patients (P = .008). On multivariable analysis, Black patients had significantly higher odds of having a minor complication (OR 1.87; 95% CI, 1.16-3.01; P = .010). On the other hand, the overall rate of Grade III-V complications was 13.3%; 12.5% for NHW patients and 16.2% for Black patients (P = .187). On multivariable analysis, Black race was not independently associated with major complications (OR 1.26; 95% CI, 0.71-2.23; P = .430). Median length of stay was 8 days (IQR 5-13) for NHW patients and 10 days (IQR 6-15) for Black patients (P = .011). CONCLUSION: Black patients who underwent metastatic spinal tumor surgery were at a significantly increased risk of perioperative morbidity compared to NHW patients independent of baseline and operative characteristics. Major complications did not differ between groups. Race should be further studied in the context of metastatic spine disease to improve our understanding of these disparities.
Authors
De la Garza Ramos, R; Choi, JH; Naidu, I; Benton, JA; Echt, M; Yanamadala, V; Passias, PG; Shin, JH; Altschul, DJ; Goodwin, CR; Sciubba, DM; Yassari, R
MLA Citation
De la Garza Ramos, Rafael, et al. “Racial Disparities in Perioperative Morbidity Following Oncological Spine Surgery.Global Spine J, June 2021, p. 21925682211022290. Pubmed, doi:10.1177/21925682211022290.
URI
https://scholars.duke.edu/individual/pub1485695
PMID
34124959
Source
pubmed
Published In
Global Spine Journal
Published Date
Start Page
21925682211022290
DOI
10.1177/21925682211022290

Research Areas:

Bone metastasis
Ependymoma
Tumor Microenvironment
Tumor markers