About

Andrew T. Dailey, MD, is a Professor of Neurosurgery and an Adjunct Professor of Orthopaedics at the University of Utah. He serves as the Chief of the Spine Division in the Department of Neurosurgery. Dr. Dailey received his medical training at Columbia University’s College of Physicians and Surgeons in New York City and completed his neurosurgical training at the University of Washington. His international experience includes being a Senior Registrar at St. George’s Medical School and Atkinson Morley’s Hospital in London, England, and completing a fellowship in orthopedics and neurological surgery at the University of Washington. With over 20 years of experience, he is well-known for his expertise in spinal cord injury, spine trauma, cervical degenerative disease, and spinal deformities. Dr. Dailey has contributed to the establishment of evidence-based spine guidelines on a national level and has published over 140 peer-reviewed publications. He is Board Certified by the American Board of Neurological Surgery and is a member of several professional organizations, including the American Association of Neurological Surgeons, the Congress of Neurological Surgeons, the Lumbar Spine Research Society, and the Cervical Spine Research Society.

Research topics

• Surgery
• Medicine
• Computer Science
• Internal medicine
• Engineering
• Mathematical analysis
• Clinical psychology
• Structural engineering
• Physical therapy
• Orthodontics
• Mathematics
• Anatomy

Selected publications

• Healthcare fraud and abuse in spine surgery: a review of medicolegal actions brought by the United States federal government

  Journal of Neurosurgery Spine · 2026-02-13

  article

  OBJECTIVE: Healthcare fraud and abuse can lead to overutilization, greater care costs, corruption of medical decision-making, and unfair competition. Because of the close relationship between spine surgeons and medical device companies, it is important that spine surgeons understand their legal environment to properly comply with statutory requirements and avoid criminal violations. The aim of this study was to review the major types of healthcare fraud relevant to spine surgery and identify the legal characteristics of cases brought by the US Department of Justice (DOJ). METHODS: A retrospective review of closed cases brought by the DOJ under five major healthcare fraud and abuse laws, as well as settlements involving healthcare fraud, was performed without time constraints in the legal research database Westlaw Edge. All cases were screened by two independent reviewers, and discrepancies were settled by the first author. RESULTS: Of the 54 cases included in the final analysis, most involved settlements (n = 42, 78%) or guilty pleas (n = 10, 19%). Most cases involved multiple defendants (n = 36, 67%), with medical device companies being named in 48 cases (89%), hospitals in 15 cases (28%), and physicians in 13 cases (24%). An ultimate ruling against the defendant occurred in 52 cases (96%), including 7 criminal convictions resulting in a median total incarceration of 60 months. Most federal indictments were based on the False Claims Act (45 of 87, 52%) or the Anti-Kickback Statute (29 of 87 claims, 33%), but cases involving the Physician Self-Referral Law/Stark Law (2 of 87, 2%) and the Exclusion Authorities Law (11 of 87 claims, 13%) were also represented. The median award for settlements was $4,410,000 (range $177,000-$82,900,000). Spinal implants were involved in 22 cases (41%), and the remaining cases were related to spinal stimulators or intrathecal pain pumps. In cases brought under the qui tam provision of the False Claims Act (n = 25, 46%), the median payout of the entire lawsuit was $5,182,139 (range $228,556-$96,277,279). The median payout for the qui tam relators themselves was $2,786,981 (range $338,649-$15,513,351), representing 17% (range 10%-27%) of the total award payout. Most cases originated in the Northeast region of the US (n = 20, 37%). CONCLUSIONS: Most cases of healthcare fraud involving spine surgery resulted in a settlement (78%) or a guilty plea by the defendant (18%). Violations of healthcare fraud and abuse laws in the field of spine surgery can lead to exorbitant fines, exclusion from federal healthcare programs, and even incarceration. These findings can inform spine surgeons and other healthcare providers of the dynamics of healthcare fraud and abuse laws, as well as the consequences of violating such statutes.

  PublisherDOI

• C1-C2 Stabilization

  Clinical Spine Surgery A Spine Publication · 2026-04-23

  articleSenior author

  STUDY DESIGN: Cadaver study. OBJECTIVE: To examine whether C1-C2 intrafacet spacers (IFSs) contribute meaningful stability when added to traditional posterior instrumentation constructs. SUMMARY OF BACKGROUND DATA: The atlantoaxial (C1-C2) junction plays a pivotal role in cervical mobility, making surgical stabilization challenging. Traditional posterior instrumentation achieves significant stability but carries several notable risks. C1-C2 IFSs have been proposed as an adjunct approach to decompression and stabilization. METHODS: Seven adult cadaveric specimens were subjected repeatedly to 7-axis biomechanical testing to quantify range-of motion (ROM) at the O-C3 complex after 6 sequential interventions: (1) intact baseline; (2) posterior C1 lateral mass and C2 pedicle screw construct; (3) addition of wired bone graft; (4) addition of IFS; (5) IFS with screw construct alone; and (6) IFS alone. Movements were normalized to baseline and compared using ANOVA with post hoc Tukey analysis. RESULTS: Posterior instrumentation (interventions 2-5) significantly reduced C1-C2 axial rotation (≤2% of baseline), flexion-extension, and lateral bending (all P<0.01). IFS alone (intervention 6) did not limit ROM and, in some cases, increased it. The stiffest construct involved traditional screw and rod instrumentation with both a wired bone graft and IFS. CONCLUSIONS: The traditional C1-C2 screw-rod construct provides substantial biomechanical rigidity. The addition of IFS may augment construct stability, but it is insufficient as a standalone stabilizer. Compared with the wired bone graft, IFSs provide equivalent rigidity when added to the C1-C2 screw and rod construct. LEVEL OF EVIDENCE: Level V.

  PublisherDOI

• Complications of spine surgery

  Neurosurgical FOCUS · 2026-03-01

  articleOpen access

  Complications from spine surgery are not just devastating because they happen, or because we believe that complications can be avoided, but are magnified because many of the complications occur in elective cases. Catastrophic outcomes in surgeries that are intended to improve lifestyle and comfort do not fit our sensibility. In the first Neurosurgical Focus issue on complications published in October 2024, most of the complications shared involved cranial neurosurgery. Many of these complications occurred in cases in which there was no acceptable option except to operate, such as cases involving extensive arteriovenous malformations, tumors, and aneurysms. In life-threatening diseases, the existence of challenged outcomes is often considered the trade-off. In spine surgery, however, we face risks of worse functional outcomes in patients who often have other options. We roll stochastic dice with each surgery. A 2% risk of a certain complication occurs with random precision and strikes with 100% completeness. This makes complications in spine surgery hard to express to patients in their full reality, hard to process for the surgeon when they do occur, and sometimes hard to bring to light, because the presence of a serious complication in an elective case horrifies. This issue of Neurosurgical Focus, like the laudable issue before, attempts to grapple with these challenges by presenting spinal complications in all of their attendant difficulties. These case illustrations were all written by esteemed and senior neurosurgeons who share hundreds of years of experience among them. The authors have a track record of sound judgment and technical excellence but are laying bare the challenges they have faced, primarily because they recognize the benefits of awareness and of the personal lessons they learned. A layer of anonymity is created by disassociating individual work from the authors. Videos were narrated by an individual who was not involved in video or case preparation.

  PublisherDOI

• Increasing levels of craniocervical junction fusion increase cervical annulus stress and facet joint forces while decreasing cervical motion

  The Spine Journal · 2026-04-01

  article
  PublisherDOI

• 2118 European Versus North American Results in Secondary Surgery After Cervical Arthroplasty Versus ACDF: Meta-analysis of RCTs

  Neurosurgery · 2025-03-14

  articleSenior author

  INTRODUCTION: Cervical disc arthroplasty (CDA) and anterior cervical discectomy and fusion (ACDF) are both treatment options for patients with cervical degenerative disc disease. Prior studies have demonstrated lower rates of adjacent segment degeneration (ASD) and secondary surgery after CDA compared to ACDF, yet the geographic differences in prior randomized controlled trial (RCT) data are unclear. METHODS: Two independent reviewers searched PubMed, Embase, and the Cochrane Library for RCTs comparing CDA and ACDF for cervical degenerative disc disease with at least 60 months of clinical follow-up. We then grouped study results based on European or North American study population. The risk ratio or standardized mean difference (and 95% CIs) were calculated for secondary surgery, NDI, VAS neck and VAS arm scores. RESULTS: A total of 5 RCTs were included for analysis published between 2014-2023. Two studies were performed in Europe and 3 were performed in North America. The North American RCTs were more likely to be industry-sponsored. The pooled North American RCT analysis showed a significant benefit of CDA over ACDF for ASD requiring secondary surgery (combined OR 0.47, 95% CI 0.32-0.70, p=0.0002), whereas no difference was seen in the analysis of European RCTs (OR 0.46, 95% CI 0.07-2.89, p=0.40). No differences in NDI or VAS neck or arm scores were observed between regions. When the RCTs with at least 60 month follow-up were combined, European RCTs had statistically higher rates of postoperative follow-up in ACDF patients vs. North American RCTs (p=0.03). CONCLUSIONS: The results of this meta analysis of RCT data from North America and Europe comparing CDA vs. ACDF suggest that North American RCTs were more likely to demonstrate a positive benefit of CDA over ACDF for ASD requiring secondary surgery, were more likely to be industry-sponsored, and more likely to have lower postoperative follow-up rates.

  PublisherDOI

• Impact of Cage Material (PEEK vs. Titanium) on Subsidence, Fusion, and Patient-reported Outcomes After Transforaminal Lumbar Interbody Fusion

  Clinical Spine Surgery A Spine Publication · 2025-06-09 · 1 citations

  article

  STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To assess potential risk factors for cage subsidence after transforaminal lumbar interbody fusion (TLIF), specifically comparing polyetheretherketone (PEEK) versus titanium cages. SUMMARY OF BACKGROUND DATA: PEEK and titanium cages are commonly used for arthrodesis in TLIF. Titanium may demonstrate osseointegration superior to PEEK, but there is little evidence comparing the risk-stratified subsidence rate between the 2 cage types. METHODS: We identified adult patients who underwent 1-level TLIF over a 5-year period at our institution. We recorded patient demographics, cage subsidence, fusion status, and average Hounsfield unit (HU) measurements of the target endplates. Univariate analysis evaluated cage subsidence and clinical and patient-reported outcomes. Risk stratification was based on subsidence grades. Potential risk factors for subsidence were identified by multivariate analysis. RESULTS: The 130 TLIF patients received 74 PEEK and 56 titanium cages. Demographics, clinical characteristics, and average HU did not differ between the cage types, and no statistically significant correlation was observed between these measures and subsidence grade. PEEK (86.5%) and titanium (89.3%) groups demonstrated similar fusion rates (P=0.630). The titanium group had a higher subsidence rate than the PEEK group (55.4% vs. 39.2%, P=0.067) and overall more higher-grade (25%-100%) subsidence (51.5% vs. 45.5%, P=0.186). Patients who demonstrated evidence of subsidence within 1 month of surgery were more likely to experience high-grade subsidence at 1-year follow-up (odds ratio=30.178, P<0.001). Although high-grade subsidence was associated with pseudarthrosis, early subsidence did not necessarily lead to pseudarthrosis. CONCLUSIONS: The rate and severity of cage subsidence may be multifactorial and warrant further high-powered, risk-adjusted studies. LEVEL OF EVIDENCE: Level III.

  PublisherDOI

• Patent Rights and Infringement Claims in Spine Surgery in the United States: A Primer for Neurosurgeons

  Neurosurgery · 2025-05-09

  article

  BACKGROUND AND OBJECTIVES: Despite the importance of patent rights and the prevalence of patent infringement claims in spine surgery, no study to date has comprehensively assessed this topic. Therefore we investigated patent infringement claims in the United States within the field of spine surgery. We also provide neurosurgeons with a basic knowledge of patent law. METHODS: A retrospective review of legal cases published on the legal databases Westlaw and LexisNexis was conducted without time constraints. Patent infringement cases in spine surgery involving medical device companies were included. Criminal cases, other intellectual property cases (eg, copyrights, trademarks), and patent-related litigation not explicitly involving infringement claims (eg, royalties disputes) were excluded. Case characteristics included verdict outcomes, party demographics, case location, case year, type of spinal device involved (eg, surgical implant), type of patent infringement, and legal outcome. Comparisons between plaintiff and defendant verdicts were performed using independent samples t -test or χ 2 test. RESULTS: Of the initial 468 screened cases, 35 met the final inclusion criteria. Cases ranged from 1996 to 2021. Verdict outcomes were split evenly between plaintiffs (49%) and defendants (51%), with most cases involving disputes about surgical implants (n = 25, 71%) between medical device companies (n=29, 83%). Among the 35 cases, there were a total of 55 patent infringement claims, with 35 direct, 8 indirect, and 12 willful infringement claims. Among the 6 (out of 17) plaintiff verdicts reporting monetary damages, the median, inflation-adjusted award payout was $28 899 596 ($2 833 870-$202 626 170). There were no significant differences in case characteristics, infringement subtypes, or award outcomes between plaintiffs and defendants' verdict decisions. CONCLUSION: In addition to serving as a primer in patent law for neurosurgeons, our empirical analysis provides valuable insights into the complex legal environment surrounding technological innovation and intellectual property rights in spine surgery in the United States.

  PublisherDOI

• Robotic Cervical Traction

  Clinical Spine Surgery A Spine Publication · 2025-07-10

  articleCorresponding

  STUDY DESIGN: Basic science. OBJECTIVE: To characterize robotically controlled cervical traction applied to intact and C4-C5 facet injury cadaveric models and compare the radiographic results with those of weight-pulley traction. SUMMARY OF BACKGROUND DATA: Manual application of weight-pulley cervical traction for dislocated facet reduction or cervical deformity correction has many limitations. Robotic cervical traction has demonstrated mechanical proof of concept but has not yet demonstrated reduction of dislocated facets in multiple cadaveric specimens. METHODS: Nine cephalus to T4 adult human cadaveric specimens were obtained. Intact specimens (n=4) were placed first into weight-pulley traction with Gardner-Wells tongs and then into robotic traction, and radiographs were obtained at each weight interval. Intervertebral disc heights were measured at all visualized levels. Posterior cervical dissection was performed in 5 cadaveric specimens for the iatrogenic creation of bilateral C4-C5 facet dislocation injury. These specimens were placed into weight-pulley traction, and force was applied in 5-lb increments until reduction was achieved. The injuries were then re-created, and the injured specimens were then placed into robotic traction, and force was applied in 5 lb increments until reduction was obtained. Radiographs were obtained at each force increment in the injured specimens in both traction systems. RESULTS: In the intact cadaveric specimens, there was no radiographic difference in intervertebral disc space height at 90 lbs of force between weight-pulley and robotic traction. In the 3 successful C4-C5 facet dislocation injury specimens, radiographic reduction was achieved at similar traction forces between robotic (mean force 31.7±11.9 lbs) and weight-pulley (mean force: 30.0±15.0 lbs) traction. Robotic traction slip-detection functions prevented unnecessary overdistraction in one injured cadaver. CONCLUSIONS: Radiographic outcomes for robotic cervical traction and weight-pulley traction were similar at identical traction forces in intact cadaveric specimens. C4-C5 facet dislocation injuries were reduced at a similar traction force when compared with weight-pulley traction and may prevent overdistraction.

  PublisherDOI

• Segmental and overall lumbar lordosis after single-level minimally invasive transforaminal lumbar interbody fusion: a systematic review and meta-analysis

  Journal of Neurosurgery Spine · 2025-05-01 · 2 citations

  review

  OBJECTIVE: Because of heterogeneity in previous studies, the effect of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) on postoperative segmental lordosis (SL) and lumbar lordosis (LL) remains unclear. Given this evidence gap, the authors performed a systematic review and meta-analysis of studies reporting lordotic outcomes after single-level MI-TLIF. The authors also performed a meta-regression to identify preoperative factors associated with lordosis after surgery and assessed correlations between lordotic changes and patient-reported outcomes. METHODS: In this systematic review, PubMed, Medline, CENTRAL, EMBASE, and Scopus were searched for studies describing single-level MI-TLIF for degenerative lumbar etiologies with at least 10 patients. Random-effects meta-analysis was used for data synthesis and I2 was used to assess heterogeneity. Primary outcomes were changes in SL and/or changes in overall LL. RESULTS: Thirty-five studies comprising 1935 patients were included: 23 (66%) retrospective case series, 9 (26%) retrospective, and 3 (9%) prospective cohort studies. Twenty-five (71%) studies evaluated static interbody devices, 5 (14%) expandable devices, and 5 (14%) both device types. Thirty (86%) studies used bilateral pedicle screw fixation, 2 (6%) used unilateral screw fixation, and 3 (9%) included both techniques. The mean (range) sample size was 55 (13-171) patients, mean ± SD age was 59.5 ± 10.6 years, mean ± SD BMI was 26.9 ± 4.6 kg/m2, and mean ± SD (range) length of follow-up was 21.4 ± 4.3 (6.0-63.7) months. On random-effects modeling, patients experienced a significant increase in SL (standardized mean difference [SMD] +2.2°, 95% CI 1.3°-3.1°, p < 0.001) and overall LL (SMD +2.8°, 95% CI 0.8°-4.8°, p < 0.001) at the latest follow-up. On meta-regression, preoperative SL (β = -0.24°, 95% CI -0.42° to -0.05°, p = 0.01) was predictive of a change in SL, whereas preoperative LL (β = -0.53°, 95% CI -0.81° to -0.25°, p = 0.009) and use of an expandable cage (β = 6.56°, 95% CI 1.0°-12.2°, p = 0.02) were predictive of a change in LL. Univariable meta-regression found that greater increases in SL were associated with larger reductions in postoperative leg pain (β = -1.03, 95% CI -1.6 to -0.45, p = 0.003); however, no significant associations were detected between changes in SL or LL and other clinical outcomes in either univariable or multivariable analyses. CONCLUSIONS: Despite the significant heterogeneity among the included studies, these results suggest that single-level MI-TLIF is generally lordosis preserving, with preoperative alignment and interbody device type as possible predictors of postoperative lordosis.

  PublisherDOI

• The anterior cervical approach in pediatric patients: indications and outcomes

  Journal of Neurosurgery Pediatrics · 2025-12-19

  article

  OBJECTIVE: Although the anterior approach to cervical spine surgery is an important tool for managing pediatric spine conditions, there is limited literature on the topic. The aim of this single-institution study was to analyze the indications, surgical techniques, complication rates, and outcomes of anterior cervical spine surgery in pediatric patients. METHODS: A single-center retrospective review of pediatric patients (age < 18 years) who underwent anterior cervical spine surgery from 2010 to 2022 was performed. Data collected included demographics, surgical indications, presenting symptoms, operative techniques and outcomes, fusion rate as defined in the postoperative note, complications, returns to the operating room, and rates of proximal/distal junctional issues. RESULTS: A total of 64 patients (mean age 13.3 ± 3.9 years, 73.4% male) with a mean follow-up period of 16 months were evaluated. The most common indication for surgery was trauma (73.4%), followed by deformity/nontraumatic instability (21.9%) and neoplasia (4.7%). Syndromic etiologies necessitating surgery were present in 9.4% of patients (Klippel-Feil syndrome [6.2%], achondroplasia [1.6%], and diastrophic dysplasia [1.6%]). Some patients (35.9%) had neurological deficits at presentation (6.2% motor only, 4.7% sensory only, 25.0% with motor and sensory deficits). Most patients (85.9%) underwent anterior surgery alone, whereas 14.1% underwent staged anterior surgery followed by posterior fixation. Two-level fusions were most common (45.3%), followed by single-level fusions (26.5%) and fusions of 3 or more levels (28.1%). An anterior plate was used in most cases (98.4%), 10.9% of which were small static cervical plate constructs. A synthetic cage was used in 14.1% of cases, most of which were polyetheretherketone (88.9%). A structural allograft was used in 85.9% of cases. Perioperative complications affected 9.4% of patients (hoarseness [4.7%], dysphagia [1.6%], hematoma [1.6%], and vascular injury [1.6%]). Arthrodesis across the anterior instrumented levels was successful in 98.4% of patients. Pseudarthrosis requiring revision surgery occurred in 1 patient within 1 year of the index surgery. Proximal junctional kyphosis was observed in 10.9% of patients, and 6.4% of patients required an unplanned return to the operating room (C3 pseudarthrosis [1.6%], hematoma evacuation [1.6%], and posterior implant failure [3.1%]). CONCLUSIONS: The authors report their single-institution experience with pediatric anterior cervical spine surgery. Most patients underwent anterior instrumented fusion alone with high rates of success. Larger, multicenter studies are needed to better elucidate factors that might contribute to unfavorable outcomes.

  PublisherDOI

Frequent coauthors

• P B Raksin

  John H. Stroger, Jr. Hospital of Cook County

  1448 shared

• Sanjay S. Dhall

  UCLA Medical Center

  1377 shared

• Michael G. Kaiser

  Iowa State University

  1357 shared

• James S. Harrop

  Neurological Surgery

  1357 shared

• Paul M. Arnold

  Carle Foundation Hospital

  1350 shared

• Paul A. Anderson

  University of Wisconsin–Madison

  1341 shared

• Daniel J. Hoh

  1341 shared

• John E. O’Toole

  Rush University Medical Center

  1340 shared

Education

• M.D.

  Columbia University’s College of Physicians and Surgeons

• Other, Orthopedics and Neurological Surgery

  University of Washington

• Other

  St. George’s Medical School and Atkinson Morley’s Hospital