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adult spinal deformities

Samrat Yeramaneni, Jeffrey L Gum, Leah Y Carreon, Eric O Klineberg, Justin S Smith, Amit Jain, Richard A Hostin
BACKGROUND: Readmissions following adult spinal deformity surgical procedures frequently occur, placing a substantial burden on patients and providers. Existing literature on readmission costs, including reason-specific readmission costs, is limited. The purposes of this study were to determine the most expensive reasons for readmission, to assess the impact of reasons and timing on readmission costs, and to estimate the drivers of total costs associated with adult spinal deformity surgical procedures...
March 21, 2018: Journal of Bone and Joint Surgery. American Volume
Bassel G Diebo, Denis Cherkalin, Cyrus M Jalai, Neil V Shah, Greg W Poorman, George A Beyer, Frank A Segreto, Virginie Lafage, Qais Naziri, Jared M Newman, William P Urban, Thomas J Errico, Frank J Schwab, Carl B Paulino, Peter G Passias
Retrospective review of National Inpatient Sample (2000-2012) revealed that 31.28% of musculoskeletal (MSK) patients were found to have in-hospital psychological burdens (PBs). Adult spinal deformity (ASD), degenerative disc disease (DDD) and lung cancer patients had highest PB-prevalence. MSK patients with PB were more often young, white females with increased Deyo index compared to no-PB patients. Patients who underwent spinal revision procedures had higher PB rates than with primary procedures; a converse trend was observed for total hip/knee arthroplasty...
June 2018: Journal of Orthopaedics
Peter G Passias, Samantha R Horn, Nicholas J Frangella, Gregory W Poorman, Dennis Vasquez-Montes, Bassel G Diebo, Cole A Bortz, Frank A Segreto, John Y Moon, Peter L Zhou, Shaleen Vira, Akhila Sure, Bryan Beaubrun, Jared C Tishelman, Subaraman Ramchandran, Cyrus M Jalai, Wesley Bronson, Charles Wang, Virginie Lafage, Aaron J Buckland, Thomas J Errico
BACKGROUND: Prior studies have built a foundation for understanding compensation in adult spinal deformity (ASD) patients using full-body stereographic assessments. These mechanisms, in relation to age-adjusted alignment targets, have yet to be fully studied. The aim of this study is to assess lower limb compensatory mechanisms of patients failing to meet age-adjusted alignment goals. METHODS: ASD patients >40 y/o with full body baseline and follow-up radiographs were included...
March 16, 2018: World Neurosurgery
Christian B Theodotou, George M Ghobrial, Andrew L Middleton, Michael Y Wang, Allan D Levi
BACKGROUND: Cervical facet dislocations are among the most common traumatic spinal injuries. Posterior, anterior, and combined surgical approaches have been described and are widely debated. OBJECTIVE: To demonstrate efficacy in anterior-only surgical management for subaxial cervical facet dislocations. METHODS: A consistent surgical algorithm for cervical facet dislocation was applied over a 19-yr period and analyzed retrospectively in adults with acute unilateral or bilateral facet dislocation of the subaxial cervical spine...
March 14, 2018: Neurosurgery
S Hemmer, H Almansour, W Pepke, M M Innmann, M Akbar
BACKGROUND: In the light of the increasingly aging population and the widespread understanding of the sagittal profile of symptomatic patients with adult spinal deformity (ASD), pervasive utilization of osteotomies on the vertebral column should be expected. These surgeries are accompanied with relatively high complication rates. However, there is no uniform definition or classification in terms of grading the severity or chronological incidence of complications after ASD surgery. OBJECTIVES: The aim of this work is to give an overview of the different classifications described in the literature hitherto and to propose a standardized, clinically utile classification of complications after ASD surgery...
March 15, 2018: Der Orthopäde
Micheal Raad, Amit Jain, Brian J Neuman, Hamid Hassanzadeh, Munish C Gupta, Douglas C Burton, Gregory M Mundis, Virginie Lafage, Eric O Klineberg, Richard A Hostin, Christopher P Ames, Shay Bess, Daniel M Sciubba, Khaled M Kebaish
STUDY DESIGN: Retrospective analysis of prospective registry OBJECTIVE.: To investigate associations of preoperative narcotic use with outcomes after adult spinal deformity (ASD) surgery. SUMMARY OF BACKGROUND DATA: We hypothesized that preoperative narcotic use would predict longer hospital stays, greater postoperative narcotic use, and greater disability 2 years after ASD surgery. METHODS: A multicenter database of surgical ASD patients was analyzed retrospectively for patients with self-reported data on preoperative narcotic use...
March 13, 2018: Spine
Justin Paul, Shaleen Vira, Martin Quirno, Themistocles Protopsaltis
The sagittal plane is known to be important in correction of adult spinal deformity. When surgery is indicated, the surgeon is provided with several tools and techniques to restore balance. But proper use of these tools is essential to avoid harmful complications. This article examines these tools with a focus on lumbar lordosis and the lumbopelvic junction. Positioning, releases, osteotomies, and instrumentation are considered with special attention to the alignment measurements they affect.
March 2018: Bulletin of the Hospital for Joint Diseases
Mian Ma, Zhi-Liang Ding, Zhi-Qi Cheng, Gang Wu, Xiao-Yu Tang, Peng Deng, Jian-Dong Wu
OBJECTIVE: To explore the clinical characteristics of neurocutaneous melanosis (NCM) in adult patients in order to help improve diagnosis and treatment of this disease. METHODS: We present a rare case of an adult patient suffering from neurocutaneous melanosis with malignant melanoma as well as a review Chinese and English literature, and analyze their clinical features. RESULTS: There were thirty adult NCM patients, aged 19 to 65 years old, average 27...
March 9, 2018: World Neurosurgery
Derek T Cawley, Daniel Larrieu, Takashi Fujishiro, David Kieser, Louis Bossiere, Emre Acaroglu, Ahmet Alanay, Frank Kleinsteück, Ferran Pellisé, Francisco Sánchez Pérez-Grueso, Jean-Marc Vital, Olivier Gille, Ibrahim Obeid
STUDY DESIGN: Multicenter, prospective study of consecutive adult spinal deformity (ASD) patients. OBJECTIVE: To evaluate back and leg pain as a combined score in ASD and compare their relative and cumulative correlations with HRQOL and sagittal parameters. SUMMARY OF BACKGROUND DATA: Pain and disability are commonly reported in patients with ASD. This can affect their back, their legs or both. ASD-associated pain has been correlated with numerous health-related quality of life (HRQOL) scores and radiological parameters...
March 9, 2018: Spine
Derek T Cawley
No abstract text is available yet for this article.
March 9, 2018: Spine
Caglar Yilgor, Yasemin Yavuz, Nuray Sogunmez, Sleiman Haddad, Anne F Mannion, Kadir Abul, Louis Boissiere, Ibrahim Obeid, Frank Kleinstück, Francisco Javier Sánchez Pérez-Grueso, Emre Acaroglu, Ferran Pellise, Ahmet Alanay
BACKGROUND CONTEXT: Pelvic Tilt (PT) is used as an indicator of pelvic version with increased values indicating retroversion and disability. The concept of using PT solely as an absolute numerical value can be misleading, especially for the patients with Pelvic Incidence (PI) values near the upper and lower normal limits. Relative Pelvic Version (RPV) is a PI-based individualized measure of the pelvic version. RPV indicates the individualized spatial orientation of the pelvis relative to the ideal sacral slope as defined by the magnitude of PI...
March 8, 2018: Spine Journal: Official Journal of the North American Spine Society
Melvin C Makhni, Jamal N Shillingford, Joseph L Laratta, Seung-Jae Hyun, Yongjung J Kim
The prevalence of patients with adult spinal deformity (ASD) has been reported as high as 68%. ASD often leads to significant pain and disability. Recent emphasis has been placed on sagittal plane balance and restoring normal sagittal alignment with regards to the three dimensional deformity of ASD. Optimal sagittal alignment has been known to increase spinal biomechanical efficiency, reduce energy expenditure by maintaining a stable posture with improved load absorption, influence better bony union, and help to decelerate adjacent segment deterioration...
March 2018: Journal of Korean Neurosurgical Society
Shunan Liu, Yuancheng Zhang, Hongda Bao, Peng Yan, Zezhang Zhu, Zhen Liu, Bangping Qian, Yong Qiu
BACKGROUND: A proper restoration of sagittal alignment is essential in AIS patients, but few studies provided a formula to predict an optimal surgical thoracic kyphosis (TK) gain in adolescent idiopathic scoliosis (AIS) patients. A formula was recently proposed (LL = (PI+TK)/2 + 10) to predict the optimal lumbar lordosis (LL) in adult spinal deformity patients, which has not been validated in adolescents. The aim of this study is to establish a formula with TK and pelvic parameters in normal adolescents and predict an optimal TK with this formula pre- and post-operatively in Lenke 1 AIS patients...
March 7, 2018: BMC Musculoskeletal Disorders
Max S Riley, Lawrence G Lenke, Todd M Chapman, Brenda A Sides, Kathy M Blanke, Michael P Kelly
BACKGROUND: Short-term studies have shown improved outcomes and alignment after posterior vertebral column resection for severe spinal deformity. Our goal was to report long-term changes in radiographic and health-related quality-of-life measures in a consecutive series of pediatric and adult patients undergoing posterior vertebral column resection with a minimum follow-up of 5 years. METHODS: We reviewed all patients undergoing posterior vertebral column resection by a single surgeon prior to January 1, 2010, at a single institution...
March 7, 2018: Journal of Bone and Joint Surgery. American Volume
Jian Zhao, Mingyuan Yang, Yilin Yang, Xin Yin, Changwei Yang, Li Li, Ming Li
PURPOSE: Proximal junctional kyphosis (PJK) is a devastating complication for adult spinal deformity (ASD) after correction surgery. However, there is no consensus on the risk factors of PJK, and whether it can be predicted remains unknown. The aim of this study is to detect the primary risk factors for PJK in ASD, and introduce a novel index for prediction of PJK. METHODS: Medical records of 62 ASD patients receiving correction surgery from January 2010 to January 2015 were analyzed...
March 5, 2018: European Spine Journal
A Tateen, J Bogert, H Koller, A Hempfing
BACKGROUND: Surgical correction of ASD can be challenging. The indication for surgery is individual and after specification of the therapeutic goals, detailed planning of the surgery is essential to achieve a good postoperative result. COMPLICATIONS AND INDICATION: The reasons for the comparatively high complication rate are well investigated and are often located at the lumbosacral junction. In addition to negative general factors like osteoporosis, especially undercorrection of the sagittal profile and insufficient lumbo-pelvic stabilization are causative...
March 5, 2018: Der Orthopäde
Tiro Mmopelwa, Selim Ayhan, Selcen Yuksel, Vugar Nabiyev, Asli Niyazi, Ferran Pellise, Ahmet Alanay, Francisco Javier Sanchez Perez Grueso, Frank Kleinstuck, Ibrahim Obeid, Emre Acaroglu
OBJECTIVES: To identify the factors that affect SF-36 mental component summary (MCS) in patients with adult spinal deformity (ASD) at the time of presentation, and to analyse the effect of SF-36 MCS on clinical outcomes in surgically treated patients. METHODS: Prospectively collected data from a multicentric ASD database was analysed for baseline parameters. Then, the same database for surgically treated patients with a minimum of 1-year follow-up was analysed to see the effect of baseline SF-36 MCS on treatment results...
March 1, 2018: Acta Orthopaedica et Traumatologica Turcica
Thamrong Lertudomphonwanit, Michael P Kelly, Keith H Bridwell, Lawrence G Lenke, Steven J McAnany, Prachya Punyarat, Timothy P Bryan, Jacob M Buchowski, Lukas P Zebala, Brenda A Sides, Karen Steger-May, Munish C Gupta
BACKGROUND CONTEXT: Risk factors associated with rod fracture (RF) following adult spinal deformity (ASD) surgery fused to the sacrum remain debatable and the impact of RF on patient-reported outcomes (PROs) after ASD surgery has not been investigated. PURPOSE: To evaluate the prevalence of and risk factors for RF and determine PROs change associated with RF after ASD surgery fused to the sacrum. STUDY DESIGN/SETTING: Retrospective single-center cohort...
February 28, 2018: Spine Journal: Official Journal of the North American Spine Society
Andrea Zanirato, Marco Damilano, Matteo Formica, Andrea Piazzolla, Alessio Lovi, Jorge Hugo Villafañe, Pedro Berjano
PURPOSE: To review the incidence of perioperative and late complications of surgery for spinal deformity (ASD). METHODS: Review of the literature. We reviewed recent literature in English to investigate the incidence of complications in ASD surgery in the perioperative (≤ 3 months post-operative) and late (> 3 months post-operative) periods. Randomized-controlled trials, non-randomized trials, cohort studies, case-control studies, and case series published in 2005 or later were included...
March 1, 2018: European Spine Journal
Michael Akbar
No abstract text is available yet for this article.
February 27, 2018: Der Orthopäde
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