Nitin Agarwal, MD

  • PGY-6 Resident

Nitin Agarwal, MD, joined the University of Pittsburgh Department of Neurological Surgery residency program in July of 2014. Prior to matriculating into the residency program, Dr. Agarwal received his doctorate of medicine from Rutgers New Jersey Medical School.

His funded research activities focus on improving patient education to optimize patient outcomes. To date, he has published over 150 peer-reviewed articles and 10 book chapters and has spoken at several regional and national conferences, with over 100 oral and poster presentations. His health literary related research has been published in several high impact factor journals including JAMA Internal Medicine and featured by prominent healthcare oriented news outlets such as Reuters Health. He is also the co-editor of the book The Evolution of Health Literacy: Empowering Patients through Improved Education. In October of 2018, his multi-contributor guide for aspiring neurosurgeons, Neurosurgery Fundamentals, was released by Thieme Medical Publishers..

Dr. Agarwal also maintains an active role in organized neurosurgery advocating for medical student and patient education. His article entitled “Improving Medical Student Recruitment into Neurological Surgery” was featured online by the American Association of Neurological Surgeons. He was appointed as a member of the Young Neurosurgeons Committee of the American Association of Neurological Surgeons (AANS) and serves as the Medical Student Task Force resource coordinator and Top Gun Competition chair. He was also selected as a Council of State Neurological Societies socioeconomic fellow and continues to serve as a past resident fellow mentor as well as an alternate delegate appointee of the Congress of Neurological Surgeons (CNS). Moreover, Dr. Agarwal serves a member of the Joint AANS/CNS Drugs and Devices committee as well. In addition, he is an advocate for philanthropic support and has been placed on the board of directors of both the Neurosurgery PAC, as a young neurosurgeon member, and served as a resident liaison for the Neurosurgery Research and Education Foundation. In the fall of 2018, he was selected to be a part of the CNS Resident Fellows program for the 2019 to 2020 term.

Dr. Agarwal is pursing an enfolded fellowship in minimally invasive and complex spine surgery at the University of Pittsburgh and plans to complete further training in this subspecialty during post-residency through an approved fellowship with the Committee on Advanced Subspecialty Training (CAST) at the University of California, San Francisco.

Outside of neurological surgery, Dr. Agarwal is deeply dedicated to martial arts, specifically the disciplines of Taekwondo, Krav Maga, and Jiu-Jitsu

Specialized Areas of Interest

Scoliosis and complex spinal deformity; minimally invasive spine surgery; spinal biomechanics; patient education and outcomes research; socioeconomic policy in organized neurosurgery.

Professional Organization Membership

American Association of Neurological Surgeons
American Association of South Asian Neurosurgeons
American Medical Association
Congress of Neurological Surgeons
Council of State Neurological Societies
North American Spine Society

Education & Training

  • BS, Biology, The College of New Jersey, 2010
  • MD, Rutgers, The State University of New Jersey, 2014

Honors & Awards

  • Congress of Neurological Surgeons Resident Fellow, 2019-2020
  • Socioeconomics, Health Policy, & Law Top Paper of the Year, Congress of Neurological Surgeons Annual Meeting, 2018
  • Journalistic and Academic Neurosurgical Excellence (J.A.N.E.) Award, AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves, 2018
  • Socioeconomic E-poster Award, First Place, AANS Annual Scientific Meeting, 2017
  • Socioeconomic E-poster Award, First Place, AANS Annual Scientific Meeting, 2017
  • Charlie Kuntz IV Scholar Award, Spine Summit Outstanding Abstract, 2016
  • Peter W. Carmel, MD, Award in Neurological Surgery, 2014
  • Kenneth G. Swan, MD, Memorial Award, NJMS Student Affairs, 2014
  • NJMS Alumni Association Grant, 2011
  • Richard Pozen and Ann Silver Pozen Community Scholar, 2011
  • Armstrong Engineering Scholarship Award, 2007
  • Oval Society Award, Community Service Distinction, 2007

Selected Publications

Agarwal N, Gupta R, Agarwal P, Matthew P, Wolferz R, Shah A, Adeeb N, Prabhu AV, Kanter AS, Okonkwo DO, Hamilton DK. Descriptive Analysis of State and Federal Spine Surgery Malpractice Litigation in the United States. Spine Journal 43(14):984-990, 2018.

Agarwal N, Heary RF, Agarwal P. Adjacent-Segment Disease after Thoracic Pedicle Screw Fixation. Journal of Neurosurgery: Spine 28(3):280-286, 2018.

Agarwal N, Agarwal P, Querry A, Mazurkiewicz A, Tempel ZJ, Friedlander RM, Gerszten PC, Hamilton D, Okonkwo DO, Kanter AS. Implementation of an Infection Prevention Bundle and Increased Physician Awareness Improves Surgical Outcomes and Reduces Costs Associated with Spine Surgery. Journal of Neurosurgery: Spine [Epub ahead of print], 2018.

Agarwal N, Kommana SS, Hansberry DR, Kashkoush AI, Friedlander RM, Lunsford, LD. The Accessibility, Reliability, and Usability of Neurological Surgery Resources. Neurosurgery 126(4):1263-1268, 2017.
Agarwal N, Choi PA, Okonkwo DO, Barrow DL, Friedlander RM. Financial Burden Associated with the Residency Match in Neurological Surgery. Journal of Neurosurgery 126(1):184-190, 2017.
Heary RF, Parvathreddy NK, Qayumi ZS, Ali NS, Agarwal N. Suitability of Carbon Fiber-Reinforced PEEK Cages for Use as Anterior Struts Following Corpectomy. Journal of Neurosurgery: Spine 25(2):248-255, 2016.
Heary RF, Goldstein IM, Getto KM, Agarwal N. Solid Radiographic Fusion with a Non-Constrained Device Five Years after Cervical Arthroplasty. Journal of Neurosurgery: Spine 21(6):951-955, 2014.
Agarwal N, Feghhi DP, Gupta R, Hansberry DR, Quinn JC, Heary RF, Goldstein IM. A Comparative Analysis of Minimally Invasive and Open Spine Surgery Patient Education Resources. Journal of Neurosurgery: Spine 21(3):468-74, 2014.
Agarwal N, Clark P, Svider PF, Eloy JA, Liu JK. Impact of Fellowship Training on Research Productivity in Academic Neurological Surgery. World Neurosurgery 80(6):738-744, 2013.
Agarwal N, Norrmén-Smith IO, Tomei KL, Prestigiacomo CJ, Gandhi CD. Improving Medical Student Recruitment into Neurological Surgery: A Single Institution’s Experience. World Neurosurgery 80(6):745-750, 2013.
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, 2013.
Heary RF, Choudhry OJ, Jalan D, Agarwal N. Analysis of Cervical Sagittal Alignment after Screw-Rod Fixation. Neurosurgery 72(6):983-992, 2013.
Dr. Agarwal’s publications can be reviewed through the National Library of Medicine's publication database.

Research Activities

1) Video Integration for Surgical Improvement of Outcomes after Neurosurgery (VISION) 

Neurosurgical residents develop their skills through active, experiential learning that is followed by reflection and analysis. Although trainees are involved in the operating room, there are limited opportunities for self-assessment of their technical skills. Inspired by instant replay systems used in sports, a video feedback system will serve as a debriefing tool for residents following hands-on surgical training in the operating room. 

Through this innovative project, digital video editing, analysis, and playback software will be developed with such features as motion instant replay, coaching highlight tools, and event data logging. The goal is to increase the surgical skills and decrease any technical errors of trainees, which may ultimately improve patient outcomes. 

Outcomes also will be measured to evaluate usefulness, number of staff takeovers during the procedure, time commitment of participants, patient comprehension, and patient satisfaction. 

2) Defining the Severity of Perioperative Spinal Cord Injury: A Pilot Study to Establish Serum and Cerebrospinal Fluid Biomarkers 

This pilot study seeks to establish serum and cerebrospinal fluid biomarkers that may be reliably associated and utilized to track perioperative spinal cord injury. 

3) Efficacy of Intraoperative Trans-cranial Motor Evoked Potential (MEP) Recordings for Reducing Lumbar Plexopathy in L4-5 Extreme Lateral Lumbar Interbody Fusion (XLIF) 

This research project was designed with the intention to evaluate the efficacy of intraoperative trans-cranial motor evoked potential (MEP) recordings for reducing lumbar plexopathy in L4/5 eXtreme Lateral lumbar Interbody Fusion (XLIF). 

4) Treatment of Alzheimer’s Disease Utilizing Lumbar-Peritoneal Shunts: A Pilot Study to Assess Cerebrospinal Fluid Biomarkers along the Rostral-Caudal Concentration Gradient 

This research endeavor seeks to establish a rostral-caudal concentration gradient for cerebrospinal fluid biomarkers. Identification of this gradient with markers associated with Alzheimer’s disease will be utilized to establish a precedent to justify to the utilization of lumbar-peritoneal shunts as a therapeutic intervention for Alzheimer’s Disease. 

5) Assessment of Patient Comprehension to Improve Health Outcomes 

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 to get information from professional medical websites, but 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 UPMC patient education materials so patients can participate in shared decision making with a better understanding of disease processes and necessary treatments, and ability to follow physician instructions. It also aspired to identify the best way to educate patients about specific diseases and then create a teaching protocol for physicians to follow. 

Through this project, UPMC patient education materials were analyzed and patients assessed to determine their level of understanding of literature regarding their diagnosis, treatment, and prognosis. Patient ratings for accessibility, reliability, and usability of selected patient resources were obtained as a benchmark using several website quality assessment tools. During the next phase of the project, patients will be followed at scheduled clinical visits and reassessed to determine their level of understanding of their disease and how it impacts their health. Patient outcomes will be evaluated and followed over a period of three years. 

Information gathered from the analysis and evaluation were published in the Journal of Neurosurgery and in Dr. Agarwal’s 2016 book—co-authored with David R. Hansberry, MD, PhD, and Arpan Vaikunth—The Evolution of Health Literacy: Empowering Patients through Improved Education

Given the immediate impact revision of patient education materials may have on outcomes, the investigators hope to rapidly share and implement the project’s findings throughout the UPMC network. Ultimately, the investigators strive to create a national database for all disease conditions, providing patients access to accurate information pertaining to their health care needs.

Media Appearances

Managing Early Success
February 9, 2020
Neurosurgery Podcast

NeurosurgeryPAC: Nonpartisan Support of Candidates Advocating for Neurosurgeons
February 2019
AANS Young Neurosurgeons News

Increased physician awareness may decrease infection incidence, implant cost
September 13, 2018
Healio Orthopedics Today

Chapter Profile: Pitt Neurosurgery Interest Group
Winter 2016
Young Neurosurgeons News