Studies

Selected peer-reviewed publications, journal covers, presentations, and press across neurotrauma outcomes, spine surgery outcomes, socioeconomic research, and patient health literacy.

Research concentrations as the principal investigator or primary author have been dedicated to four main areas: neurotrauma outcomes after severe traumatic brain injury and acute spinal cord injury, spine surgery outcomes, socioeconomic research, and patient education. The investigations below have supported the unmet need to identify biomarkers that better predict prognosis after neurotrauma and tailor interventions to augment neurological recovery.

Complete Publications List on Google Scholar →

Selected Publications

Neurotrauma Outcomes

Concentrations as principal investigator or primary author have been dedicated to neurotrauma outcomes after severe traumatic brain injury and acute spinal cord injury. Prior support has been directed at studies improving outcomes and at the development of neurotrauma biomarkers.

  1. Agarwal N, Anand SK, Nwachuku EL, et al. Neuroimaging with the Rotterdam Scoring System and Long-Term Outcomes in Severe Traumatic Brain Injury Patients. British Journal of Neurosurgery 39(6):781–786, 2025.
  2. Lavadi RS, Utt KL, Housley SN, et al. Diffusion Basis Spectrum Imaging Detects Axonal Injury in the Optic Nerve Following Traumatic Brain Injury. Magnetic Resonance Imaging 122:110451, October 2025.
  3. Lavadi RS, Kumar RP, Kann MR, et al. Video Analysis of Concussion Among Slap Fighting Athletes. JAMA Surgery 159(12):1435–1436, December 2024.
  4. Pugazenthi S, Hernandez-Rovira MA, Mitha R, et al. Evaluating the State of Non-invasive Imaging Biomarkers for Traumatic Brain Injury. Neurosurgical Review 46(1):232, September 2023.

Spine Surgery Outcomes

Improving outcomes following spine surgery is a parallel focus, blending clinical practice with research. As principal investigator on these studies, the work has critically analyzed perioperative surgical and patient risk factors with recognition by national academic specialty organizations.

  1. Agarwal P, Kumar RP, Oleksiuk LM, et al. Non–β-Lactam Antibiotic Use, β-Lactam Allergy, and Surgical Site Infections. JAMA Surgery 160(11):1260–1267, November 2025.
  2. Agarwal N, Letchuman V, Lavadi RS, et al. What Is the Effect of Preoperative Depression on Outcomes After Minimally Invasive Surgery for Adult Spinal Deformity? A Prospective Cohort Analysis. Journal of Neurosurgery: Spine 40(5):602–610, May 2024.
  3. Agarwal N, White MD, Zhang X, et al. Impact of Endplate-Implant Area Mismatch on Rates and Grades of Subsidence Following Stand-alone Lateral Lumbar Interbody Fusion: An Analysis of 623 Levels. Journal of Neurosurgery: Spine 33(1):12–16, March 2020.
  4. Agarwal N, Angriman F, Goldschmidt E, et al. Relationship between Body Mass Index and Sagittal Vertical Axis Change as well as Health-Related Quality of Life in 564 Patients following Deformity Surgery. Journal of Neurosurgery: Spine, August 2019.

Socioeconomic & Policy Research

A subset of research interests examines socioeconomic policies that impact neurosurgical practice and the delivery of quality care, stemming from involvement in organized neurosurgery societies whose mission statements center on these issues.

  1. Agarwal N, Agarwal P, Taylor TM, et al. Contributions to the United States Neurosurgery Political Action Committee (NeurosurgeryPAC): A Historical Perspective. World Neurosurgery 135:273–279, March 2020.
  2. Agarwal N, White MD, Pannullo SC, Chambless LB. Analysis of National Trends in Neurosurgical Resident Attrition. Journal of Neurosurgery 131(5):1668–1673, November 2019.
  3. Agarwal N, Kashkoush A, Baucom ET, Ratliff JK, Stroink AR. Quality Reporting in Neurological Surgery: Practice Adherence to Quality Payment Program Guidelines. Neurosurgery 84(2):537–543, February 2019.
  4. Agarwal N, Gupta R, Agarwal P, et al. Descriptive Analysis of State and Federal Spine Surgery Malpractice Litigation in the United States. Spine 43(14):984–990, July 2018.

Patient Education & Health Literacy

Early investigations addressed deficiencies of patient education materials for neurosurgical patients. As principal investigator or senior author, this work culminated in a foundation award to further improve patient education and engagement through multimedia.

  1. Agarwal N, Funahashi R, Taylor T, et al. Patient Education and Engagement Through Multimedia: Prospective Pilot Study on Health Literacy in Patients with Cerebral Aneurysms. World Neurosurgery 138:e819–e826, June 2020.
  2. White MD, Latour K, Giordano M, Taylor T, Agarwal N. The Reliability and Quality of Online Patient Education Videos for Lateral Lumbar Interbody Fusion. Journal of Neurosurgery: Spine, June 2020.
  3. Agarwal N, Feghhi DP, Gupta R, et al. A Comparative Analysis of Minimally Invasive and Open Spine Surgery Patient Education Resources. Journal of Neurosurgery: Spine 21(3):468–474, September 2014.
  4. Agarwal N, Hansberry DR, Sabourin V, Tomei KL, Prestigiacomo CJ. A Comparative Analysis of the Quality of Patient Education Materials from Medical Specialties. JAMA: Internal Medicine 173(13):1257–1259, July 2013.

Journal Covers

Cover articles in The Journal of Neurosurgery Publishing Group titles.

Assessment of Patient Comprehension to Improve Health Outcomes

The Evolution of Health Literacy — book cover

Informed consent is a critical part of patient care, but patients often do not understand the health care information presented to them. Patients frequently turn to the internet for professional medical websites, yet the readability of patient education resources often exceeds the reading ability of the average American adult. This disconnect can negatively impact patient understanding, leading to poor health outcomes and unnecessary hospital readmission.

This project was designed to improve the readability and accessibility of patient education materials so patients can participate in shared decision making with a better understanding of disease processes and necessary treatments. Patient education materials were analyzed and patients were assessed for their level of understanding of literature regarding their diagnosis, treatment, and prognosis. Patients are followed at scheduled clinical visits over a three-year period and reassessed for understanding and outcomes. The work has been published in high-impact journals including JAMA Internal Medicine and the Journal of Neurosurgery: Spine, and featured by Reuters Health.

Findings were also published in Dr. Agarwal's book which was co-edited with David R. Hansberry, MD, PhD, and Arpan V. Prabhu, MD — The Evolution of Health Literacy: Empowering Patients through Improved Education.