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Adult spinal deformity

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https://www.readbyqxmd.com/read/29778596/anterior-vs-posterior-approach-for-thoracic-corpectomy-an-analysis-of-risk-factors-outcomes-and-complications
#1
Ryan G Chiu, Jonathan Hobbs, Darian R Esfahani, Saavan Patel, David Rosenberg, Clayton L Rosinski, Akash S Patel, Anisse N Chaker, Ankit I Mehta
BACKGROUND: Thoracic corpectomies are performed for various reasons including spinal deformity, trauma, neoplasms, and infection. Regardless of indication, both anterior and posterior approaches are surgical options, selected based on pathology, anatomy, patient characteristics, and surgical experience. Risk profiles and outcomes for these procedures are poorly characterized, however, and the choice between the two approaches remains inconclusive. OBJECTIVE: To compare risk factors and complications for adult patients undergoing anterior and posterior thoracic corpectomies...
May 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29775162/validation-of-prone-intraoperative-measurements-of-global-spinal-alignment
#2
Max Vaynrub, Brandon P Hirsch, Jared Tishelman, Dennis Vasquez-Montes, Aaron J Buckland, Thomas J Errico, Themistocles S Protopsaltis
OBJECTIVE Verifying the adequacy of surgical correction of adult spinal sagittal deformity (SSD) leads to improved postoperative alignment and clinical outcomes. Traditionally, surgeons relied on intraoperative measurements of lumbar lordosis (LL) correction. However, T-1 pelvic angle (TPA) and its component angles more reliably predict postoperative alignment. While TPA is readily measured on standing radiographs, intraoperative radiographs offer poor resolution of the bicoxofemoral axis. A method to recreate this radiographic landmark by extrapolating preoperative measurements has been described...
May 18, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29772370/does-nasal-carriage-of-staphylococcus-aureus-increase-the-risk-of-post-operative-infections-after-elective-spine-surgery-do-most-infections-occur-in-carriers
#3
Owoicho Adogwa, Victoria D Vuong, Aladine A Elsamadicy, Daniel T Lilly, Shyam A Desai, Syed Khalid, Joseph Cheng, Carlos A Bagley
BACKGROUND: Wound infections following adult spinal deformity surgery place a high toll on patients, providers, and the healthcare system. Staphylococcus aureus is a common cause of postoperative wound infections, and nasal colonization by this organism may be an important factor development of surgical site infections (SSI's). The aim is to investigate whether post-operative surgical site infections after elective spine surgery occur at a higher rate in patients with Methicillin-Resistant Staphylococcus Aureus (MRSA) nasal colonization...
May 14, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29766672/ribcage-deformity-and-the-altered-breathing-pattern-in-children-with-osteogenesis-imperfecta
#4
Antonella LoMauro, Paolo Fraschini, Simona Pochintesta, Marianna Romei, Maria G D'Angelo, Andrea Aliverti
AIM: Osteogenesis Imperfecta (OI) is a genetic disease characterized by bones fragility and progressive deformity. Life expectancy is reduced in the non-lethal most severe type III form before the age of 10 years. The main cause of death in OI is respiratory insufficiency resulting from impaired thoracic function worsened by ribcage deformity and scoliosis. METHODS: We used opto-electronic plethysmography to study chest geometry, the ventilatory, and the thoraco-abdominal pattern at rest in supine position in children younger than 10 years...
May 15, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29762340/external-validation-of-the-adult-spinal-deformity-asd-frailty-index-asd-fi-in-the-scoli-risk-1-patient-database
#5
Emily K Miller, Lawrence G Lenke, Brian J Neuman, Daniel M Sciubba, Khaled M Kebaish, Justin S Smith, Yong Qiu, Benny T Dahl, Ferran Pellisé, Yukihiro Matsuyama, Leah Y Carreon, Michael G Fehlings, Kenneth M Cheung, Stephen Lewis, Mark B Dekutoski, Frank J Schwab, Oheneba Boachie-Adjei, Hossein Mehdian, Shay Bess, Christopher I Shaffrey, Christopher P Ames
STUDY DESIGN: Analysis of a prospective multicenter database. OBJECTIVE: To assess the ability of the recently created Adult Spinal Deformity (ASD) Frailty Index (ASD-FI) to predict odds of major complications and length of hospital stay for patients who had more severe preoperative deformity and underwent more invasive ASD surgery compared with patients in the database used to create the index. SUMMARY OF BACKGROUND DATA: Accurate preoperative estimates of risk are necessary given the high complication rates currently associated with ASD surgery...
May 14, 2018: Spine
https://www.readbyqxmd.com/read/29762339/the-relationship-between-fear-avoidance-and-neuromuscular-measures-of-function-in-patients-with-adult-degenerative-scoliosis
#6
Ram Haddas, Isador H Lieberman, Andrew Block
STUDY DESIGN: A prospective cohort study. OBJECTIVE: To examine the relationship of fear-avoidance beliefs and neuromuscular activity during gait in adult degenerative scoliosis (ADS) patients. SUMMARY OF BACKGROUND DATA: Among patients with chronic spine pain, fear-avoidance beliefs are predictive of poor surgical outcomes. Fear-avoidance occurs when patients perceive that movement will worsen underlying physical problems. This process leads them to restrict activity, which further heightens emotional distress...
May 14, 2018: Spine
https://www.readbyqxmd.com/read/29751181/adult-spinal-deformity-patients-with-previous-fusions-have-an-equal-chance-of-reaching-substantial-clinical-benefit-thresholds-in-health-related-quality-of-life-measures-but-do-not-reach-the-same-absolute-level-of-improvement
#7
Tamir Ailon
BACKGROUND: Substantial clinical benefit (SCB) represents a threshold above which patients recognize substantial improvement and represents a rational target for defining clinical success. In adult spinal deformity (ASD) surgery, previous fusions may impact outcomes after deformity correction. OBJECTIVE: Investigate the impact of prior spinal fusion on the likelihood of reaching SCB thresholds for 2-year health-related quality of life (HRQOL) after ASD surgery. METHODS: We conducted a retrospective review comparing baseline demographic, HRQOL, and radiographic features for ASD patients undergoing primary versus revision procedures...
May 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29750137/posterior-only-stabilization-for-traumatic-thoracolumbar-burst-fractures
#8
Omid R Hariri, Samir Kashyap, Ariel Takayanagi, Chris Elia, Quang Ma, Dan E Miulli
Background No consensus exists for the management of unstable thoracolumbar (TL) burst fractures. Surgical options include anterior, lateral, or posterior stabilization (or a combination), depending on the fracture. The potential benefits of anterior reconstruction come with increased operative time and associated morbidity. A posterior-only approach can offer stable correction without increased operative risks but may result in loss of kyphotic correction over time. Purpose To determine whether posterior-only stabilization is a viable treatment option for patients with traumatic TL fractures as opposed to anterior and combined approaches...
March 9, 2018: Curēus
https://www.readbyqxmd.com/read/29738410/sagittal-spinal-alignment-in-adult-spinal-deformity-an-overview-of-current-concepts-and-a-critical-analysis-review
#9
Sravisht Iyer, Evan Sheha, Michael C Fu, Jeffrey Varghese, Matthew E Cunningham, Todd J Albert, Frank J Schwab, Virginie C Lafage, Han Jo Kim
No abstract text is available yet for this article.
May 1, 2018: JBJS Reviews
https://www.readbyqxmd.com/read/29735136/assessment-of-coronal-spinal-alignment-for-adult-spine-deformity-cases-after-intraoperative-t-square-shaped-use
#10
Swamy Kurra, Umesh Metkar, Henaku Yirenkyi, Richard A Tallarico, William F Lavelle
STUDY DESIGN: Retrospectively reviewed surgeries between 2011 and 2015 of patients who underwent posterior spinal deformity instrumentation with constructs involving fusions to pelvis and encompassing at least five levels. OBJECTIVE: Measure the radiographic outcomes of coronal malalignment (CM) after use of an intraoperative T square shaped instrument in posterior spinal deformity surgeries with at least five levels of fusion and extension to pelvis. BACKGROUND: Neuromuscular children found to benefit from intraoperative T square technique to help achieve proper coronal spinal balance with extensive fusions...
May 2018: Spine Deformity
https://www.readbyqxmd.com/read/29732423/predicting-critical-care-unit-level-complications-after-long-segment-fusion-procedures-for-adult-spinal-deformity
#11
Rafael De la Garza-Ramos, Jonathan Nakhla, Yaroslav Gelfand, Murray Echt, Aleka N Scoco, Merritt D Kinon, Reza Yassari
Background: To identify predictive factors for critical care unit-level complications (CCU complication) after long-segment fusion procedures for adult spinal deformity (ASD). Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database [2010-2014] was reviewed. Only adult patients who underwent fusion of 7 or more spinal levels for ASD were included. CCU complications included intraoperative arrest/infarction, ventilation >48 hours, pulmonary embolism, renal failure requiring dialysis, cardiac arrest, myocardial infarction, unplanned intubation, septic shock, stroke, coma, or new neurological deficit...
March 2018: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29729417/compressive-mechanical-characterization-of-non-human-primate-spinal-cord-white-matter
#12
Shervin Jannesar, Mark Allen, Sarah Mills, Anne Gibbons, Jacqueline C Bresnahan, Ernesto A Salegio, Carolyn J Sparrey
The goal of developing computational models of spinal cord injury (SCI) is to better understand the human injury condition. However, finite element models of human SCI have used rodent spinal cord tissue properties due to a lack of experimental data. Central nervous system tissues in non human primates (NHP) closely resemble that of humans and therefore, it is expected that material constitutive models obtained from NHPs will increase the fidelity and the accuracy of human SCI models. Human SCI most often results from compressive loading and spinal cord white matter properties affect FE predicted patterns of injury; therefore, the objectives of this study were to characterize the unconfined compressive response of NHP spinal cord white matter and present an experimentally derived, finite element tractable constitutive model for the tissue...
May 2, 2018: Acta Biomaterialia
https://www.readbyqxmd.com/read/29728924/the-impact-of-deep-surgical-site-infection-on-surgical-outcomes-after-posterior-adult-spinal-deformity-surgery-a-matched-control-study
#13
Sleiman Haddad, Susana Núñez-Pereira, Carlos Pigrau, Dolors Rodríguez-Pardo, Alba Vila-Casademunt, Ahmet Alanay, Emre R Acaroglu, Frank S Kleinstueck, Ibrahim Obeid, Francisco Javier Sanchez Perez-Grueso, Ferran Pellisé
PURPOSE: The impact of deep surgical site infection (SSI) on surgical outcomes after adult spinal deformity (ASD) surgery is still unclear. We aimed to study the morbidity of SSI in ASD and its impact on deformity correction and functional outcome. METHODS: Prospective multicenter matched-cohort study including consecutively enrolled ASD patients. Patients developing SSI were matched to similar controls in terms of age, gender, ASA, primary or revision, extent of fusion, and use of tri-columnar osteotomies...
May 4, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29715572/risk-factors-for-perioperative-blood-transfusions-in-adult-spinal-deformity-surgery
#14
Samuel White, Zoe B Cheung, Ivan Ye, Kevin Phan, Joshua Xu, James Dowdell, Jun S Kim, Samuel K Cho
OBJECTIVE: Adult spinal deformity (ASD) surgery is associated with a high rate of perioperative blood transfusions and it is important to understand the risk factors for perioperative blood transfusions in order to implement strategies to reduce transfusions. The aim of this study was to identify independent risk factors of perioperative blood transfusions in patients undergoing surgery for ASD. METHODS: A retrospective cohort study was performed using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2010 to 2014...
April 28, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29715236/intraoperative-coagulopathy-101-are-antifibrinolytics-the-answer-and-how-do-they-work-commentary-on-an-article-by-ryan-p-pong-md-et-al-effect-of-tranexamic-acid-on-blood-loss-d-dimer-and-fibrinogen-kinetics-in-adult-spinal-deformity-surgery
#15
https://www.readbyqxmd.com/read/29715224/effect-of-tranexamic-acid-on-blood-loss-d-dimer-and-fibrinogen-kinetics-in-adult-spinal-deformity-surgery
#16
Ryan P Pong, Jean-Christophe A Leveque, Alicia Edwards, Vijay Yanamadala, Anna K Wright, Megan Herodes, Rajiv K Sethi
BACKGROUND: Antifibrinolytics such as tranexamic acid reduce operative blood loss and blood product transfusion requirements in patients undergoing surgical correction of scoliosis. The factors involved in the unrelenting coagulopathy seen in scoliosis surgery are not well understood. One potential contributor is activation of the fibrinolytic system during a surgical procedure, likely related to clot dissolution and consumption of fibrinogen. The addition of tranexamic acid during a surgical procedure may mitigate the coagulopathy by impeding the derangement in D-dimer and fibrinogen kinetics...
May 2, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29713416/relationship-between-displacement-of-the-psoas-major-muscle-and-spinal-alignment-in-patients-with-adult-spinal-deformity
#17
Yoshiaki Oda, Tomoyuki Takigawa, Ryo Ugawa, Yasuyuki Shiozaki, Haruo Misawa, Yoshihisa Sugimoto, Masato Tanaka, Toshifumi Ozaki
Study Design: Cross sectional study. Purpose: To clarify the difference in position of the psoas muscle between adult spinal deformity (ASD) and lumbar spinal stenosis (LSS). Overview of Literature: Although it is known that the psoas major muscle deviates in ASD patients, no report is available regarding the difference in comparison with LSS patients. Methods: This study investigates 39 patients. For evaluating spinal alignment, pelvic tilt (PT), pelvic incidence (PI), sacral slope, lumbar lordosis (LL), PI-LL, Cobb angle, and the convex side, the lumbar curves were measured...
April 2018: Asian Spine Journal
https://www.readbyqxmd.com/read/29712521/the-unreimbursed-costs-of-preventing-revision-surgery-in-adult-spinal-deformity-analysis-of-cost-effectiveness-of-proximal-junctional-failure-prevention-with-ligament-augmentation
#18
Michael M Safaee, Cecilia L Dalle Ore, Corinna C Zygourakis, Vedat Deviren, Christopher P Ames
OBJECTIVE Proximal junctional kyphosis (PJK) is a well-recognized complication of surgery for adult spinal deformity and is characterized by increased kyphosis at the upper instrumented vertebra (UIV). PJK prevention strategies have the potential to decrease morbidity and cost by reducing rates of proximal junctional failure (PJF), which the authors define as radiographic PJK plus clinical sequelae requiring revision surgery. METHODS The authors performed an analysis of 195 consecutive patients with adult spinal deformity...
May 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29709744/radiographic-fusion-grade-does-not-impact-health-related-quality-of-life-in-the-absence-of-instrumentation-failure-for-patients-undergoing-posterior-instrumented-fusion-for-adult-spinal-deformity
#19
Tamir Ailon, D Koho Hamilton, Erik Klineberg, Alan H Daniels, Virginie Lafage, Shay Bess, Douglas C Burton, Munish Gupta, Frank Schwab, Christopher P Ames, Justin S Smith, Christopher I Shaffrey, Robert A Hart
BACKGROUND: Pseudarthrosis and rod fracture (RF) remain significant concerns following fusions for adult spinal deformity (ASD). While a radiographic system of fusion grade has been proposed, the correlation between fusion grade and Health Related Quality of Life measures (HRQoL) is not known. METHODS: In a retrospective review of a prospectively collected clinical database, patients that underwent ≥ 5 level posterior instrumented arthrodesis for ASD were evaluated...
April 27, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29707558/limitations-and-complications-of-minimally-invasive-spinal-surgery-in-adult-deformity
#20
Jacob Januszewski, Andrew C Vivas, Juan S Uribe
Minimally invasive spine (MIS) surgery has rapidly progressed from simple short segment fusions to large adult deformity corrections, with radiographic and clinical outcomes as good as those of open surgery. Anterior longitudinal ligament release (ALLR) and anterior column realignment (ACR) have been key advancements in the ability to correct deformity using MIS techniques. However, patient selection and appropriate preoperative workup is critical to obtain good outcomes and for complication avoidance. Despite favorable outcomes in spinal deformity surgery, MIS techniques are limited in (I) pronounced cervical or thoracic deformity; (II) patients with prior fusion mass; and (III) severe sagittal imbalance necessitating Schwab 5 osteotomy or higher...
March 2018: Annals of Translational Medicine
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