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Lawrence Lenke

Leo Fradet, Xiaoyu Wang, Lawrence G Lenke, Carl-Eric Aubin
BACKGROUND: Proximal junctional failure is a severe proximal junctional complication following adult spinal instrumentation and involving acute proximal junctional kyphotic deformity, mechanical failure at the upper instrumented vertebra or just above, and/or proximal junctional osseoligamentous disruption. Clinical studies have identified potential risk factors, but knowledge on their biomechanics is still lacking for addressing the proximal junctional failure issues. The objective of this study was to develop comprehensive computational modeling and simulation techniques to investigate proximal junctional failure...
October 11, 2016: Clinical Biomechanics
Yong-Chan Kim, Lawrence G Lenke, Seon-Jong Lee, Jeffrey L Gum, Sirichai Wilartratsami, Kathy M Blanke
PURPOSE: Our study aimed to confirm the correlation between the Cranial Sagittal Vertical Axis (CrSVA) and patient-reported outcomes and to compare clinical correlation between CrSVA and C7 SVA in adult spinal deformity (ASD) patients. METHODS: 108 consecutive ASD patients were evaluated using the EOS(®) 2D/3D radio-imaging device. A vertical plumb line from the cranial center was utilized to measure the distance to the posterior corner of S1 (CrSVA-S), and to the centers of the hip (CrSVA-H), the knee (CrSVA-K), and ankle (CrSVA-A), as well as measuring the standard C7 SVA...
October 14, 2016: European Spine Journal
Jeffrey L Gum, Leah Y Carreon, Jacob M Buchowski, Lawrence G Lenke, Steven D Glassman
BACKGROUND: Increased awareness regarding the importance of the sagittal spinal profile has led to more aggressive correction of sagittal malalignment. The utilization trends of pedicle subtraction osteotomy (PSO) for sagittal plane correction in spinal deformity surgery have not been well characterized. METHODS: A commercially available database (PearlDiver, Inc) was queried for both Private Payor and 5 % Medicare claims from 2008 to 2011. Revision and clarification of the coding guidelines for PSO were introduced in 2008...
2016: Scoliosis and Spinal Disorders
Joshua S Murphy, Vidyadhar V Upasani, Burt Yaszay, Tracey P Bastrom, Carrie E Bartley, Amer Samdani, Lawrence G Lenke, Peter O Newton
STUDY DESIGN: Retrospective review of prospectively collected dataObjective: To determine whether the last substantially touched vertebra (LSTV) is a valid lowest instrumented vertebra (LIV) for both Lenke 1 and 2 curve patterns with AR lumbar modifiers,and to identify pre-operative risk factors of distal adding-on. SUMMARY OF BACKGROUND: Previous studies have recommended selecting the LSTV as the LIV for Lenke 1AR curves (main thoracic curve with 'A' lumbar modifier and L4 tilt to the right (thoracic overhang / King type IV curve)...
July 7, 2016: Spine
Ammar H Hawasli, Jodie Chang, Chester K Yarbrough, Karen Steger-May, Lawrence G Lenke, Ian G Dorward
BACKGROUND CONTEXT: Spine surgeons must correlate clinical presentation with radiographic findings in a patient-tailored approach. Despite the prevalence of adult degenerative scoliosis (ADS), there are few radiographic markers to predict the presence of radiculopathy. Emerging data suggest that spondylolisthesis, obliquity, foraminal stenosis, and curve concavity may be associated with radiculopathy in ADS. PURPOSE: The purpose of this study was to determine if radicular pain in ADS is associated with reduced interpedicular heights (IPHs) as measured on routine radiographs...
September 2016: Spine Journal: Official Journal of the North American Spine Society
Yong-Chan Kim, Lawrence G Lenke, Keith H Bridwell, Seung-Jae Hyun, Ki-Han You, Young-Woo Kim, Ho-Guen Chang, Michael P Kelly, Linda A Koester, Kathy M Blanke, David B Bumpass
STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To evaluate radiographic and patient-reported outcomes at minimum 2 years after revision surgery for proximal junctional kyphosis (PJK), correlating these results with PJK etiology. SUMMARY OF BACKGROUND DATA: There are no studies detailing the results of revision surgery for PJK following posterior segmental instrumentation. METHODS: Thirty-two consecutive patients treated with revision surgery after PJK above posterior fusions (25 women/7 men, average age at surgery 60...
April 26, 2016: Spine
Sravisht Iyer, Lawrence G Lenke, Venu M Nemani, Michael Fu, Grant D Shifflett, Todd J Albert, Brenda A Sides, Lionel N Metz, Matthew E Cunningham, Han Jo Kim
STUDY DESIGN: Cross-Sectional Cohort Study OBJECTIVE.: Describe age-stratified normative values of novel occipitocervical, cervical and cervicothoracic alignment parameters. SUMMARY OF BACKGROUND DATA: Full-body radiographic images obtained without stitching or vertical distortion represent an ideal method to evaluate occipitocervical alignment and horizontal gaze. METHODS: 120 adults with no back or neck symptoms were recruited. Age, Gender, Body Mass Index (BMI), Neck Disability Index (NDI) and Oswestry Disability Index (ODI) scores were recorded...
April 22, 2016: Spine
Sravisht Iyer, Lawrence G Lenke, Venu M Nemani, Todd J Albert, Brenda A Sides, Lionel Nicholas Metz, Matthew E Cunningham, Han Jo Kim
STUDY DESIGN: Cross-Sectional Cohort Study. OBJECTIVE: Describe age-stratified normative values of traditional and novel sagittal alignment parameters. SUMMARY OF BACKGROUND DATA: Full-body radiographic techniques can capture coronal and sagittal standing images from the occiput to the foot without stitching or vertical distortion. This provides an ideal method to evaluate measures of global alignment. METHODS: Adults with no back or neck symptoms were recruited...
April 20, 2016: Spine
Steven L Bokshan, Jakub Godzik, Jonathan Dalton, Jennifer Jaffe, Lawrence G Lenke, Michael P Kelly
BACKGROUND CONTEXT: The non-response rates are as high as 20% to 50% after 5 years of follow-up in adult spinal deformity (ASD) surgery. Minimizing loss to follow-up is essential to protect the quality of data in long-term studies. Phone and internet administration of outcomes instruments has grown in popularity and has been found to not only provide a convenient way of collecting data, but also show improved response rates. PURPOSE: The study aimed to examine the reliability of the revised Scoliosis Research Society-22 (SRS-22r) and the Oswestry Disability Index (ODI) questionnaires in ASD patients when administered by telephone...
September 2016: Spine Journal: Official Journal of the North American Spine Society
Xiao-Bin Wang, Lawrence G Lenke, Earl Thuet, Kathy Blanke, Linda A Koester, Michael Roth
STUDY DESIGN: Retrospective review of prospectively collected data. OBJECTIVE: To assess the value of the deformity angular ratio (DAR, maximum Cobb measurement divided by number of vertebrae involved) in evaluating the severity of spinal deformity, and predicting the risk of neurologic deficit in posterior vertebral column resection (PVCR). SUMMARY OF BACKGROUND DATA: Although the literature has demonstrated that PVCR in spinal deformity patients has achieved excellent outcomes, it is still high risk neurologically...
September 15, 2016: Spine
Barry L Raynor, Anne M Padberg, Lawrence G Lenke, Keith H Bridwell, K Daniel Riew, Jacob M Buchowski, Scott J Luhmann
STUDY DESIGN: Retrospective. OBJECTIVE: The purpose was to categorize and evaluate intraoperative monitoring (IOM) failure to detect neurologic deficits occurring during spinal surgery. SUMMARY OF BACKGROUND DATA: The efficacy of spinal cord/nerve root monitoring regarding undetected neurologic deficits is examined in a large, single institution series involving all levels of the spinal column and all spinal surgical procedures. METHODS: Multimodality IOM included somatosensory-evoked potentials (SSEPs), descending neurogenic-evoked potentials (DNEPs), transcranial motor-evoked potentials (MEPs), dermatomal somatosensory-evoked potentials (DSEPs), and spontaneous and triggered electromyography (spEMG, trgEMG)...
September 2016: Spine
Melvin C Makhni, Jon-Michael E Caldwell, Comron Saifi, Charla R Fischer, Ronald A Lehman, Lawrence G Lenke, Francis Y Lee
Autograft, while currently the gold standard for bone grafting, has several significant disadvantages including limited supply, donor site pain, hematoma formation, nerve and vascular injury, and fracture. Bone allografts have their own disadvantages including reduced osteoinductive capability, lack of osteoprogenitor cells, immunogenicity and risk of disease transmission. Thus demand exists for tissue-engineered constructs that can produce viable bone while avoiding the complications associated with human tissue grafts...
March 2016: Regenerative Medicine
Lawrence G Lenke, Michael G Fehlings, Christopher I Shaffrey, Kenneth M C Cheung, Leah Carreon, Mark B Dekutoski, Frank J Schwab, Oheneba Boachie-Adjei, Khaled M Kebaish, Christopher P Ames, Yong Qiu, Yukihiro Matsuyama, Benny T Dahl, Hossein Mehdian, Ferran Pellisé-Urquiza, Stephen J Lewis, Sigurd H Berven
STUDY DESIGN: Prospective, multicenter, international observational study. OBJECTIVE: To evaluate motor neurologic outcomes in patients undergoing surgery for complex adult spinal deformity (ASD). SUMMARY OF BACKGROUND DATA: The neurologic outcomes after surgical correction for ASD have been reported with significant variability and have not been measured as a primary endpoint in any prospective, multicenter, observational study. METHODS: The primary outcome measure was the change in American Spinal Injury Association (ASIA) Lower Extremity Motor Scores (LEMS) obtained preoperatively, and at hospital discharge, 6 weeks and 6 months postoperatively...
February 2016: Spine
Brian J Neuman, Christine Baldus, Lukas P Zebala, Michael P Kelly, Christopher Shaffrey, Charles Edwards, Tyler Koski, Frank Schwab, Steven Glassman, Stefan Parent, Stephen Lewis, Lawrence G Lenke, Jacob M Buchowski, Justin S Smith, Charles H Crawford, Han Jo Kim, Virginia Lafage, Jon Lurie, Leah Carreon, Keith H Bridwell
STUDY DESIGN: A prospective study with randomized and observational cohorts. OBJECTIVE: The aim of this study was to determine baseline variables affecting adult symptomatic lumbar scoliosis (ASLS) decision making to participate in randomization (RAND), observational nonsurgical (OBS-NS), or observational surgical (OBS-S) cohorts. SUMMARY OF BACKGROUND DATA: Multiple factors play a key role in a patient's decision to be randomized or to choose an OBS-NS or OBS-S course for ASLS...
March 2016: Spine
Michael P Kelly, Tenner J Guillaume, Lawrence G Lenke
Despite the frequency of Chiari-associated spinal deformities, this disease process remains poorly understood. Syringomyelia is often present; however, this is not necessary and scoliosis has been described in the absence of a syrinx. Decompression of the hindbrain is often recommended. In young patients (<10 years old) and/or those with small coronal Cobb measurements (<40°), decompression of the hindbrain may lead to resolution of the spinal deformity. Spinal fusion is reserved for those curves that progress to deformities greater than 50°...
October 2015: Neurosurgery Clinics of North America
Tamir Ailon, Justin S Smith, Christopher I Shaffrey, Lawrence G Lenke, Darrel Brodke, James S Harrop, Michael Fehlings, Christopher P Ames
Degenerative spinal deformity afflicts a significant portion of the elderly and is increasing in prevalence. Recent evidence has revealed sagittal plane malalignment to be a key driver of pain and disability in this population and has led to a significant shift toward a more evidence-based management paradigm. In this narrative review, we review the recent literature on the epidemiology, evaluation, management, and outcomes of degenerative adult spinal deformity (ASD). ASD is increasing in prevalence in North America due to an aging population and demographic shifts...
October 2015: Neurosurgery
Tamir Ailon, Christopher I Shaffrey, Lawrence G Lenke, James S Harrop, Justin S Smith
Thoracic kyphosis tends to increase with age. Hyperkyphosis is defined as excessive curvature of the thoracic spine and may be associated with adverse health effects. Hyperkyphosis in isolation or as a component of degenerative kyphoscoliosis has important implications for the surgical management of adult spinal deformity. Our objective was to review the literature on the epidemiology, etiology, natural history, management, and outcomes of thoracic hyperkyphosis. We performed a narrative review of literature on thoracic hyperkyphosis and its implications for adult spinal deformity surgery...
October 2015: Neurosurgery
Gabe Haller, David M Alvarado, Marcia C Willing, Alan C Braverman, Keith H Bridwell, Michael Kelly, Lawrence G Lenke, Scott J Luhmann, Christina A Gurnett, Matthew B Dobbs
BACKGROUND: Scoliosis is a feature of several genetic disorders that are also associated with aortic aneurysm, including Marfan syndrome, Loeys-Dietz syndrome, and type-IV Ehlers-Danlos syndrome. Life-threatening complications of aortic aneurysm can be decreased through early diagnosis. Genetic screening for mutations in populations at risk, such as patients with adolescent idiopathic scoliosis, may improve recognition of these disorders. METHODS: The coding regions of five clinically actionable genes associated with scoliosis (COL3A1, FBN1, TGFBR1, TGFBR2, and SMAD3) and aortic aneurysm were sequenced in 343 adolescent idiopathic scoliosis cases...
September 2, 2015: Journal of Bone and Joint Surgery. American Volume
Noah D H Lewis, Sam G N Keshen, Lawrence G Lenke, Michael G Zywiel, David L Skaggs, Taylor E Dear, Samuel Strantzas, Stephen J Lewis
STUDY DESIGN: A retrospective analysis. OBJECTIVE: The purpose of this study was to determine whether the deformity angular ratio (DAR) can reliably assess the neurological risks of patients undergoing deformity correction. SUMMARY OF BACKGROUND DATA: Identifying high-risk patients and procedures can help ensure that appropriate measures are taken to minimize neurological complications during spinal deformity corrections. Subjectively, surgeons look at radiographs and evaluate the riskiness of the procedure...
August 1, 2015: Spine
Kevin R O'Neill, Lawrence G Lenke, Keith H Bridwell, Brian J Neuman, Han Jo Kim, Kristin R Archer
BACKGROUND CONTEXT: Studies have demonstrated sustained improvements in patient-reported outcomes (PROs) after three-column osteotomies (three-COs), but no study has evaluated what factors impact long-term outcomes. PURPOSE: The aim was to investigate factors associated with PROs in patients who underwent three-CO at minimum 5 years postoperatively. STUDY DESIGN/SAMPLE: This was a retrospective review of prospective database. PATIENT SAMPLE: All patients who had a three-CO at a single institution and completed clinical evaluations after at least 5 years postoperative were included...
November 1, 2015: Spine Journal: Official Journal of the North American Spine Society
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