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:

Animal Models of Metastatic Lesions to the Spine: A Focus on Epidural Spinal Cord Compression.

Epidural spinal cord compression (ESCC) secondary to spine metastases is one of the most devastating sequelae of primary cancer as it may lead to muscle weakness, paresthesia, pain, and paralysis. Spine metastases occur through a multistep process that can result in eventual ESCC; however, the lack of a preclinical model to effectively recapitulate each step of this metastatic cascade and the symptom burden of ESCC has limited our understanding of this disease process. In this review, we discuss animal models that best recapitulate ESCC. We start with a broad discussion of commonly used models of bone metastasis and end with a focused discussion of models used to specifically study ESCC. Orthotopic models offer the most authentic recapitulation of metastasis development; however, they rarely result in symptomatic ESCC and are challenging to replicate. Conversely, models that involve injection of tumor cells directly into the bloodstream or bone better mimic the symptoms of ESCC; however, they provide limited insight into the epithelial to mesenchymal transition and natural hematogenous spread of tumor cells. Therefore, until an ideal model is created, it is critical to select an animal model that is specifically designed to answer the scientific question of interest.
Authors
Price, MJ; Baëta, C; Dalton, TE; Nguyen, A; Lavau, C; Pennington, Z; Sciubba, DM; Goodwin, CR
MLA Citation
Price, Meghan J., et al. “Animal Models of Metastatic Lesions to the Spine: A Focus on Epidural Spinal Cord Compression.World Neurosurg, vol. 155, Nov. 2021, pp. 122–34. Pubmed, doi:10.1016/j.wneu.2021.07.121.
URI
https://scholars.duke.edu/individual/pub1493360
PMID
34343682
Source
pubmed
Published In
World Neurosurg
Volume
155
Published Date
Start Page
122
End Page
134
DOI
10.1016/j.wneu.2021.07.121

Characterization and rate of symptomatic adjacent-segment disease after index lateral lumbar interbody fusion: a single-institution, multisurgeon case series with long-term follow-up.

OBJECTIVE: The rate of symptomatic adjacent-segment disease (ASD) after newer minimally invasive techniques, such as lateral lumbar interbody fusion (LLIF), is not known. This study aimed to assess the incidence of surgically significant ASD in adult patients who have undergone index LLIF and to identify any predictive factors. METHODS: Patients who underwent index LLIF with or without additional posterior pedicle screw fixation between 2010 and 2012 and received a minimum of 2 years of postoperative follow-up were retrospectively included. Demographic and perioperative data were recorded, as well as radiographic data and immediate perioperative complications. The primary endpoint was revision surgery at the level above or below the previous construct, from which a survivorship model of patients with surgically significant symptomatic ASD was created. RESULTS: Sixty-seven patients with a total of 163 interbody levels were included in this analysis. In total, 17 (25.4%) patients developed surgically significant ASD and required additional surgery, with a mean ± SD time to revision of 3.59 ± 2.55 years. The mean annual rate of surgically significant ASD was 3.49% over 7.27 years, which was the average follow-up. One-third of patients developed significant disease within 2 years of index surgery, and 1 patient required surgery at the adjacent level within 1 year. Constructs spanning 3 or fewer interbody levels were significantly associated with increased risk of surgically significant ASD; however, instrument termination at the thoracolumbar junction did not increase this risk. Surgically significant ASD was not impacted by preoperative disc height, foraminal area at the adjacent levels, or changes in global or segmental lumbar lordosis. CONCLUSIONS: The risk of surgically significant ASD after LLIF was similar to the previously reported rates of other minimally invasive spine procedures. Patients with shorter constructs had higher rates of subsequent ASD.
Authors
Wang, TY; Mehta, VA; Sankey, EW; Than, KD; Goodwin, CR; Karikari, IO; Isaacs, RE; Abd-El-Barr, MM
MLA Citation
URI
https://scholars.duke.edu/individual/pub1483242
PMID
34020422
Source
pubmed
Published In
J Neurosurg Spine
Published Date
Start Page
1
End Page
8
DOI
10.3171/2020.10.SPINE201635

Non-English Primary Language Is Associated with Short-Term Outcomes After Supratentorial Tumor Resection.

BACKGROUND: Despite research indicating that patients with non-English primary language (NEPL) have increased hospital length of stay (LOS) for craniotomies, there is a paucity of neurosurgical research examining the impact of language on short-term outcomes. This study sought to evaluate short-term outcomes for patients with English primary language (EPL) and NEPL admitted for resection of a supratentorial tumor. METHODS: Using the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project New Jersey State Inpatient Database, this study included patients 18-90 years old who underwent resection of a supratentorial primary brain tumor, meningioma, or brain metastasis from 2009 to 2017. The primary outcomes were total, preoperative, and postoperative LOS. Secondary outcomes were complications, mortality, and discharge disposition. Univariable and multivariable analyses compared Spanish primary language (SPL), non-English non-Spanish (NENS) primary language, and EPL groups. RESULTS: A total of 7324 patients were included: 2962 with primary brain tumor, 2091 with meningioma, and 2271 with brain metastasis. Patients with SPL (n = 297) were younger and more likely to have noncommercial insurance, lower income, and fewer comorbidities. Patients with NENS (n = 257) had similar age and comorbidities to the EPL group but had a greater proportion of noncommercially insured and low-income patients (P < 0.001). Multivariable analysis showed that patients with NENS had increased postoperative LOS (adjusted incidence rate ratio, 1.10; P = 0.008) and higher odds of a complication (adjusted odds ratio, 1.36; P = 0.015), and patients with SPL had higher odds of being discharged home (adjusted odds ratio, 1.55; P = 0.017). CONCLUSIONS: Patients with NEPL have different short-term outcomes after supratentorial tumor resection that varies based on primary language. More research is needed to understand the mechanisms driving these findings and to clarify unique experiences for different populations with NEPL.
Authors
Witt, EE; Eruchalu, CN; Dey, T; Bates, DW; Goodwin, CR; Ortega, G
MLA Citation
Witt, Emily E., et al. “Non-English Primary Language Is Associated with Short-Term Outcomes After Supratentorial Tumor Resection.World Neurosurg, vol. 155, Nov. 2021, pp. e484–502. Pubmed, doi:10.1016/j.wneu.2021.08.087.
URI
https://scholars.duke.edu/individual/pub1495011
PMID
34461280
Source
pubmed
Published In
World Neurosurg
Volume
155
Published Date
Start Page
e484
End Page
e502
DOI
10.1016/j.wneu.2021.08.087

Minority Tax Reform - Avoiding Overtaxing Minorities When We Need Them Most.

Authors
Williamson, T; Goodwin, CR; Ubel, PA
MLA Citation
Williamson, Theresa, et al. “Minority Tax Reform - Avoiding Overtaxing Minorities When We Need Them Most.N Engl J Med, vol. 384, no. 20, May 2021, pp. 1877–79. Pubmed, doi:10.1056/NEJMp2100179.
URI
https://scholars.duke.edu/individual/pub1483043
PMID
34014047
Source
pubmed
Published In
The New England Journal of Medicine
Volume
384
Published Date
Start Page
1877
End Page
1879
DOI
10.1056/NEJMp2100179

A Web-Based Calculator for Predicting the Occurrence of Wound Complications, Wound Infection, and Unplanned Reoperation for Wound Complications in Patients Undergoing Surgery for Spinal Metastases.

BACKGROUND: In the present study, we identified the risk factors for wound complications, wound infection, and reoperation for wound complications after spine metastasis surgery and deployed the resultant model as a web-based calculator. METHODS: Patients treated at a single comprehensive cancer center during a 7-year period were included. The demographics, pathology, comorbidities, laboratory values, and operative details were collected. Factors with P < 0.15 on univariable regression were entered into multivariable logistic regression to generate predictive models internally validated using 1000 bootstrapped samples. RESULTS: Of the 330 patients included, 29 (7.6%) had experienced a surgical site infection. The independent predictive factors for wound-related complications were a higher Charlson comorbidity index (CCI; odds ratio [OR], 1.41 per point; P < 0.01), Karnofsky performance scale score ≤70 (OR, 2.14; P = 0.04), lower platelet count (OR, 0.49 per 105/μL; P < 0.01), revision versus index surgery (OR, 3.10; P = 0.02), and increased incision length (OR, 1.21 per level; P = 0.02). Wound infection was associated with a higher CCI (OR, 1.60 per point; P < 0.01), a lower platelet count (OR, 0.35 per 105/μL; P < 0.01), revision surgery (OR, 4.63; P = 0.01), and a longer incision length (OR, 1.25 per level; P = 0.03). Unplanned reoperation for wound complications was predicted by a higher CCI (OR, 1.39 per point; P = 0.003), prior irradiation (OR, 2.52; P = 0.04), a lower platelet count (OR, 0.57 per 105/μL; P = 0.02), and revision surgery (OR, 3.34; P = 0.03), The optimism-corrected areas under the curve were 0.75, 0.81, and 0.72 for the wound complication, infection, and reoperation models, respectively. CONCLUSIONS: Low platelet counts, poorer health status, more invasive surgery, and revision surgery all independently predicted the risk of wound complications, including infection and unplanned reoperation for infection. Validation of the calculators in a prospective study is merited.
Authors
Hersh, AM; Feghali, J; Hung, B; Pennington, Z; Schilling, A; Antar, A; Patel, J; Ehresman, J; Cottrill, E; Lubelski, D; Elsamadicy, AA; Goodwin, CR; Lo, S-FL; Sciubba, DM
MLA Citation
URI
https://scholars.duke.edu/individual/pub1501051
PMID
34403800
Source
pubmed
Published In
World Neurosurg
Volume
155
Published Date
Start Page
e218
End Page
e228
DOI
10.1016/j.wneu.2021.08.041

Research Areas:

Bone metastasis
Ependymoma
Tumor Microenvironment
Tumor markers