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Adult spinal deformity

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https://www.readbyqxmd.com/read/28622903/cell-saver-for-adult-spinal-deformity-surgery-reduces-cost
#1
Jeffrey L Gum, Leah Yacat Carreon, Michael P Kelly, Richard Hostin, Chessie Robinson, Douglas C Burton, David W Polly, Christopher I Shaffrey, Virginie LaFage, Frank J Schwab, Christopher P Ames, Han Jo Kim, Justin S Smith, R Shay Bess
STUDY DESIGN: Retrospective cohort. OBJECTIVES: To determine if the use of cell saver reduces overall blood costs in adult spinal deformity (ASD) surgery. SUMMARY OF BACKGROUND DATA: Recent studies have questioned the clinical value of cell saver during spine procedures. METHODS: ASD patients enrolled in a prospective, multicenter surgical database who had complete preoperative and surgical data were identified. Patients were stratified into (1) cell saver available during surgery, but no intraoperative autologous infusion (No Infusion group), or (2) cell saver available and received autologous infusion (Infusion group)...
July 2017: Spine Deformity
https://www.readbyqxmd.com/read/28622902/a-critical-analysis-of-sagittal-plane-deformity-correction-with-minimally-invasive-adult-spinal-deformity-surgery-a-2-year-follow-up-study
#2
Gregory M Mundis, Jay D Turner, Vedat Deverin, Juan S Uribe, Pierce Nunley, Praveen Mummaneni, Neel Anand, Paul Park, David O Okonkwo, Michael Y Wang, Shay Bess, Adam S Kanter, Richard Fessler, Stacie Nguyen, Behrooz A Akbarnia
INTRODUCTION: Sagittal plane realignment is important to achieve desirable clinical outcomes after adult spinal deformity (ASD) surgery. This study evaluates the impact of minimally invasive (MIS) techniques on sagittal plane alignment and clinical outcomes in ASD patients. METHODS: A retrospective, multi-center review of ASD patients (age ≥18 years, and with one of the following: coronal Cobb ≥20°, sagittal vertical axis [SVA] >5 cm, and/or pelvic tilt >25°), MIS surgery, and four or more levels instrumented...
July 2017: Spine Deformity
https://www.readbyqxmd.com/read/28622901/tridimensional-analysis-of-rotatory-subluxation-and-sagittal-spinopelvic-alignment-in-the-setting-of-adult-spinal-deformity
#3
Emmanuelle Ferrero, Renaud Lafage, Bassel G Diebo, Vincent Challier, Brice Illharreborde, Frank Schwab, Wafa Skalli, Pierre Guigui, Virginie Lafage
STUDY DESIGN: Retrospective single-center. OBJECTIVE: To investigate rotatory subluxation (RS) in adult spinal deformity (ASD) with three-dimensional (3D) stereoradiographic images and analyze relationships between RS, transverse plane parameters, spinopelvic parameters, and clinical outcomes. BACKGROUND: Recent research has demonstrated that sagittal plane malalignment and listhesis correlate with ASD patient-reported outcomes. However, there is still a lack of knowledge regarding the clinical impact of 3D evaluation and rotatory subluxation...
July 2017: Spine Deformity
https://www.readbyqxmd.com/read/28614284/cervical-spine-deformities-in-children-with-rhizomelic-chondrodysplasia-punctata
#4
Oussama Abousamra, Vinay Kandula, Angela L Duker, Kenneth J Rogers, Michael B Bober, William G Mackenzie
BACKGROUND: Cervical spine deformity in rhizomelic chondrodysplasia punctata (RCDP) has been described with different findings reported in the literature. However, available literature provides limited data from a few cases with magnetic resonance imaging (MRI) of the cervical spine. Our report describes the MRI findings in a group of children with RCDP, aiming to reach a better understanding of this pathology. METHODS: An Institutional Review Board-approved RCDP Registry was created at our institution with the goal of identifying pertinent medical issues over the lifespan of individuals with RCDP...
June 13, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28609324/results-of-the-2015-scoliosis-research-society-survey-on-single-versus-dual-attending-surgeon-approach-for-adult-spinal-deformity-surgery
#5
Justin K Scheer, Rajiv K Sethi, Lloyd A Hey, Michael O LaGrone, Malla Keefe, Henry E Aryan, Thomas J Errico, Vedat Deviren, Robert A Hart, Virginie Lafage, Frank Schwab, Michael D Daubs, Christopher P Ames
STUDY DESIGN: An electronic survey administered to Scoliosis Research Society (SRS) membership. OBJECTIVE: To characterize surgeon practices and views regarding the use of two attending surgeons for adult spinal deformity (ASD) surgery. SUMMARY OF BACKGROUND DATA: The use of two experienced attending surgeons can decrease the operative time, estimated blood loss, and perioperative complication rates. However, the current practice patterns for the use of two attending surgeons remains unknown...
June 15, 2017: Spine
https://www.readbyqxmd.com/read/28604992/a-new-bioinspired-collagen-hydroxyapatite-bone-graft-substitute-in-adult-scoliosis-surgery-results-at-3-year-follow-up
#6
Pietro Giorgi, Dario Capitani, Simone Sprio, Monica Sandri, Anna Tampieri, Valentina Canella, Angelo Nataloni, Giuseppe R Schirò
BACKGROUND: Spinal fusion is a common procedure used for surgical treatment of spinal deformity. In recent years, many bone graft substitutes (BGS) have been developed to provide good arthrodesis when the available autologous bone harvested from the patient is not enough. The aim of this study was to analyze the use of a new-generation composite material (RegenOss) made of Mg-hydroxyapatite nanoparticles nucleated on type I collagen to obtain long posterolateral fusion in adult scoliosis surgery...
June 7, 2017: Journal of Applied Biomaterials & Functional Materials
https://www.readbyqxmd.com/read/28603565/current-concepts-congenital-scoliosis
#7
Agnivesh Tikoo, Manish K Kothari, Kunal Shah, Abhay Nene
BACKGROUND: Congenital scoliosis is one of the 'difficult to treat' scenarios which a spine surgeon has to face. Multiple factors including the age of child at presentation, no definite pattern of deformity and associated anomalies hinder the execution of the ideal treatment plan. All patients of congenital scoliosis need to be investigated in detail. X rays and MRI of spine is usually ordered first. Screening investigations to rule out VACTERL (Visceral, Anorectal, Cardiac, Tracheo-esophageal fistula, Renal and Lung) abnormalities are required...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28600009/the-case-for-deformity-correction-in-the-management-of-radiculopathy-with-concurrent-spinal-deformity
#8
REVIEW
Sigurd Berven, Anthony DiGiorgio
The management of adult deformity varies significantly. Options range from nonoperative care to limited decompression to decompression with limited or extensive fusion. The appropriate surgical management is the approach that optimizes the likelihood of improvement in health-related quality of life, while limiting risks of complications and costs. Decompression alone is unreliable in the setting of significant deformity contributing to radiculopathy. Decompression with limited fusion is most appropriate for patients with age-appropriate global alignment of the spine, and decompression with more extensive fusion is most appropriate for patients with progressive deformity or with global sagittal or coronal malalignment...
July 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28600008/lumbar-radiculopathy-in-the-setting-of-degenerative-scoliosis-mis-decompression-and-limited-correction-are-better-options
#9
REVIEW
Ricardo B Fontes, Richard G Fessler
Surgery for adult spinal deformity (ASD) has emerged as an efficient treatment alternative, but it is fraught with potential perioperative morbidity, incompletely mitigated by emerging minimally invasive surgical techniques. In mild-to-moderate ASD balanced in the sagittal plane, there are situations in which the counterintuitive simple decompression through a foraminotomy or laminectomy, or even a short-segment fusion may be an attractive treatment. This article presents a case example and the authors' treatment rationale and reviews the limited available literature supporting it...
July 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28598493/adult-degenerative-lumbar-scoliosis
#10
Eugene Wong, Farhaan Altaf, Lawrence J Oh, Randolph J Gray
Adult degenerative lumbar scoliosis is a 3-dimensional deformity defined as a coronal deviation of greater than 10°. It causes significant pain and disability in the elderly. With the aging of the population, the incidence of adult degenerative lumbar scoliosis will continue to increase. During the past decade, advancements in surgical techniques and instrumentation have changed the management of adult spinal deformity and led to improved long-term outcomes. In this article, the authors provide a comprehensive review of the pathophysiology, diagnosis, and management of adult degenerative lumbar scoliosis...
June 9, 2017: Orthopedics
https://www.readbyqxmd.com/read/28594512/realignment-planning-in-adult-spinal-deformity-formulas-and-planning-tools
#11
Themistocles Protopsaltis, Dana L Cruz
Adult spinal deformity is a complex pathologic process that has many etiologies and several mechanisms of compensation. A complete understanding of spinopelvic alignment is required to differentiate the origin of spinal deformity from its compensation and, ultimately, optimize surgical correction. Surgeons should understand the spinopelvic parameters involved in the evaluation of a patient who has an adult spinal deformity and their implications for treatment.
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28594511/adult-lumbar-scoliosis-nonsurgical-versus-surgical-management
#12
Jonathan Falakassa, Serena S Hu
Adult spinal deformity has become an increasingly recognized condition, with a 32% incidence in the adult population and a 68% incidence in the elderly population. Often, patients with adult spinal deformity are initially offered nonsurgical treatment for their symptoms despite the lack of data to support its efficacy because of the high complication rate associated with surgical treatment in this age group. Determining which patients would benefit the most from nonsurgical versus surgical treatment remains a challenge...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28591781/global-spinal-alignment-in-cervical-kyphotic-deformity-the-importance-of-head-position-and-thoracolumbar-alignment-in-the-compensatory-mechanism
#13
Jun Mizutani, Kushagra Verma, Kenji Endo, Ken Ishii, Kuniyoshi Abumi, Mitsuru Yagi, Naobumi Hosogane, Jeffrey Yang, Bobby Tay, Vedat Deviren, Christopher Ames
BACKGROUND: Previous studies have evaluated cervical kyphosis (C-kypho) using cervical curvature or chin-brow vertical angle, but the relationship between C-kypho and global spinal alignment is currently unknown. OBJECTIVE: To elucidate global spinal alignment and compensatory mechanisms in primary symptomatic C-kypho using full-spine radiography. METHODS: In this retrospective multicenter study, symptomatic primary C-kypho patients (Cerv group; n = 103) and adult thoracolumbar deformity patients (TL group; n = 119) were compared...
June 7, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28591078/proximal-junctional-kyphosis-inter-and-intra-observer-reliability-of-radiographic-measurements-in-adult-spinal-deformity
#14
Farbod Rastegar, Alec Contag, Alan Daniels, Jayme Hiratzka, Clifford Lin, Jason Chang, Khoi Than, Ahmed Raslan, Christopher Kong, Ngoc-Lam Nguyen, Richard Hostin, Marie Kane, Robert Hart
STUDY DESIGN: Reliability study of radiographic measures of proximal junctional kyphosis in adult spinal deformity patients. OBJECTIVE: Assess impacts of level of proximal endpoint and vertebral fracture on reliability of measurement of junctional kyphosis. SUMMARY OF BACKGROUND DATA: Radiographic assessment is important in determining management of patients with Proximal Junctional Kyphosis (PJK) or Proximal Junctional Failure (PJF). No study to date has evaluated the reliability of radiographic measurement of the junctional kyphotic angle after surgery for Adult Spinal Deformity (ASD)...
June 6, 2017: Spine
https://www.readbyqxmd.com/read/28589303/three-types-of-sagittal-alignment-regarding-compensation-in-asymptomatic-adults-the-contribution-of-the-spine-and-lower-limbs
#15
Hongda Bao, Renaud Lafage, Barthelemy Liabaud, Jonathan Elysée, Bassel G Diebo, Gregory Poorman, Cyrus Jalai, Peter Passias, Aaron Buckland, Shay Bess, Thomas Errico, Lawrence G Lenke, Munish Gupta, Han Jo Kim, Frank Schwab, Virginie Lafage
PURPOSE: A comprehensive understanding of normative sagittal profile is necessary for adult spinal deformity. Roussouly described four sagittal alignment types based on sacral slope, lumbar lordosis, and location of lumbar apex. However, the lower limb, a newly described component of spinal malalignment compensation, is missing from this classification. This study aims to propose a full-body sagittal profile classification in an asymptomatic population based on full-body imaging. METHODS: This is a retrospective analysis of a prospective single-center study of 116 asymptomatic volunteers...
June 6, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28586476/development-and-validation-of-a-novel-adult-spinal-deformity-surgical-invasiveness-score-analysis-of-464-patients
#16
Brian J Neuman, Tamir Ailon, Justin K Scheer, Eric Klineberg, Daniel M Sciubba, Amit Jain, Lukas P Zebala, Peter G Passias, Alan H Daniels, Douglas C Burton, Themi S Protopsaltis, D Kojo Hamilton, Christopher P Ames
BACKGROUND: A surgical invasiveness index (SII) has been validated in general spine procedures but not adult spinal deformity (ASD). OBJECTIVE: To assess the ability of the SII to determine the invasiveness of ASD surgery and to create and validate a novel ASD index incorporating deformity-specific factors, which could serve as a standardized metric to compare outcomes and risk stratification of different ASD procedures for a given deformity. METHODS: Four hundred sixty-four patients who underwent ASD surgery between 2009 and 2012 were identified in 2 multicenter prospective registries...
June 6, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28575457/characterizing-adult-cervical-deformity-and-disability-based-on-existing-cervical-and-adult-deformity-classification-schemes-at-presentation-and-following-correction
#17
Peter G Passias, Cyrus M Jalai, Justin S Smith, Virginie Lafage, Bassel G Diebo, Themistocles Protopsaltis, Gregory Poorman, Ubaraman Ramchandran, Hay Bess, Christopher I Shaffrey, Christopher P Ames, Frank Schwab
BACKGROUND: Adult cervical deformity (ACD) classifications have not been implemented in a prospective ACD population and in conjunction with adult spinal deformity (ASD) classifications. OBJECTIVE: To characterize cervical deformity type and malalignment with 2 classifications (Ames-ACD and Schwab-ASD). METHODS: Retrospective review of a prospective multicenter ACD database. Inclusion: patients ≥18 yr with pre- and postoperative radiographs...
May 30, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28574333/depression-as-an-independent-predictor-of-postoperative-delirium-in-spine-deformity-patients-undergoing-elective-spine-surgery
#18
Aladine A Elsamadicy, Owoicho Adogwa, Emily Lydon, Amanda Sergesketter, Rayan Kaakati, Ankit I Mehta, Raul A Vasquez, Joseph Cheng, Carlos A Bagley, Isaac O Karikari
OBJECTIVE Depression is the most prevalent affective disorder in the US, and patients with spinal deformity are at increased risk. Postoperative delirium has been associated with inferior surgical outcomes, including morbidity and mortality. The relationship between depression and postoperative delirium in patients undergoing spine surgery is relatively unknown. The aim of this study was to determine if depression is an independent risk factor for the development of postoperative delirium in patients undergoing decompression and fusion for deformity...
June 2, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28552696/a-novel-tool-for-deformity-surgery-planning-determining-the-magnitude-of-lordotic-correction-required-to-achieve-a-desired-sagittal-vertical-axis
#19
Ezequiel Goldschmidt, Federico Angriman, Nitin Agarwal, James Zhou, Katherine Chen, Zachary J Tempel, Peter C Gerszten, Adam S Kanter, David O Okonkwo, Peter Passias, Justin Scheer, Themistocles Protopsaltis, Virginie Lafage, Renaud Lafage, Frank Schwab, Shay Bess, Christopher Ames, Justin S Smith, Christopher I Shaffrey, Emily Miller, Amit Jain, Brian Neuman, Daniel M Sciubba, Douglas Burton, D Kojo Hamilton
OBJECT: We sought to create a model capable of predicting the magnitude of pelvic incidence-lumbar lordosis (PI-LL) correction necessary to achieve a desired change in sagittal vertical axis (SVA). METHODS: Retrospective review of a prospectively maintained multicenter adult spinal deformity database collected by the International Spine Study Group between 2009 and 2014. The independent variable of interest was the degree of correction achieved in the PI-LL mismatch at 6-weeks post-surgery...
May 24, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28551313/factors-associated-with-prolonged-ventilation-and-reintubation-in-adult-spinal-deformity-surgery
#20
Rafael De la Garza Ramos, Jonathan Nakhla, Rani Nasser, Ajit Jada, Taylor E Purvis, Daniel M Sciubba, Merrit Kinon, Reza Yassari
Prolonged ventilation or reintubation are severe complications after scoliosis surgery, but there is limited data regarding their incidence and risk factors. The purpose of this study is to investigate the incidence and risk factors for prolonged ventilation and reintubation in adult spinal deformity (ASD) surgery. The American College of Surgeons National Surgical Quality Improvement Program database (2007-2013) was reviewed. Inclusion criteria were adult patients over 21years of age who underwent spinal fusion for ASD...
May 24, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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