Revision Rate After Adult Deformity Surgery.

Study Design: Epidemiological study.

Purpose: To establish the revision rate of adult spinal deformity surgery.

Summary Of Background Data: Historically, surgical treatment of adult spinal deformity was limited by inadequate correction and high complication rates.

Health-related quality-of-life scores, spine-related symptoms, and reoperations in young adults 7 to 17 years after surgical treatment of adolescent idiopathic scoliosis.

The goal of surgical treatment of adolescent idiopathic scoliosis (AIS) is to prevent disability associated with curve progression. Few investigators have considered whether the function of patients with AIS becomes adversely affected by major spine fusion surgery. Tertiary referral center patients (age, 10-17 years) who underwent spinal deformity correction a minimum of 5 years earlier were identified.

Relative benefit of TLIF versus PSF stratified by diagnostic indication.

Study Design: Case-matched retrospective.

Objectives: The purpose of this study is to compare 2-year health-related quality of life (HRQOL) outcomes of patients who underwent 1-level or 2-level posterolateral spine fusion (PSF) versus transforaminal interbody fusion (TLIF) for degenerative spondylolisthesis, disk pathology, and postdecompression instability.

Summary Of Background Data: The optimal surgical technique for patients with spondylolisthesis or other degenerative conditions has not been defined.

Estimating EQ-5D values from the Neck Disability Index and numeric rating scales for neck and arm pain.

Object: The Neck Disability Index (NDI) and numeric rating scales (0 to 10) for neck pain and arm pain are widely used cervical spine disease-specific measures. Recent studies have shown that there is a strong relationship between the SF-6D and the NDI such that using a simple linear regression allows for the estimation of an SF-6D value from the NDI alone. Due to ease of administration and scoring, the EQ-5D is increasingly being used as a measure of utility in the clinical setting.

Evaluation of complications and neurological deficits with three-column spine reconstructions for complex spinal deformity: a retrospective Scoli-RISK-1 study.

Object: The goal in this study was to evaluate the risk factors for complications, including new neurological deficits, in the largest cohort of patients with adult spinal deformity to date.

Methods: The Scoli-RISK-1 inclusion criteria were used to identify eligible patients from 5 centers who were treated between June 1, 2009, and June 1, 2011. Records were reviewed for patient demographic information, surgical data, and reports of perioperative complications.

Delayed spontaneous reduction of traumatic pediatric atlantoaxial rotatory subluxation.

Pediatric atlantoaxial rotatory subluxation (AARS) is a rare finding with various etiologies and treatment recommendations. Etiologies include both traumatic and nontraumatic causes. The diagnosis is suggested by clinical presentation and confirmed with imaging.

Outcomes in patients with minimal back pain undergoing prophylactic lumbar fusion for iatrogenic instability.

For most patients undergoing lumbar fusion, back pain is a substantial part of their preoperative symptomatology. Occasionally, there are patients with minimal back pain in whom the extent of decompression required to treat leg symptoms requires a concomitant fusion to prevent postoperative instability. Although these patients may obtain relief of their leg pain, an additional concern is whether they will develop increased back pain after fusion.

Estimating EQ-5D values from the Oswestry Disability Index and numeric rating scales for back and leg pain.

Study Design: Cross-sectional cohort.

Objective: The purpose of this study is to determine whether the EuroQOL-5D (EQ-5D) can be derived from commonly available low back disease-specific health-related quality of life measures.

Summary Of Background Data: The Oswestry Disability Index (ODI) and numeric rating scales (0-10) for back pain (BP) and leg pain (LP) are widely used disease-specific measures in patients with lumbar degenerative disorders.

Clinically important deterioration in patients undergoing lumbar spine surgery: a choice of evaluation methods using the Oswestry Disability Index, 36-Item Short Form Health Survey, and pain scales: clinical article.

Object: Health-related quality of life (HRQOL) measures have become the mainstay for outcome appraisal in spine surgery. Clinically meaningful interpretation of HRQOL improvement has centered on the minimum clinically important difference (MCID). The purpose of this study was to calculate clinically important deterioration (CIDET) thresholds and determine a CIDET value for each HRQOL measure for patients undergoing lumbar fusion.

Discriminative Properties of the Spinal Appearance Questionnaire Compared With the Scoliosis Research Society-22 Revised.

Study Design: Longitudinal cohort.

Objectives: To determine the responsiveness of the Spinal Appearance Questionnaire (SAQ) in patients with adolescent idiopathic scoliosis (AIS) undergoing surgical correction of the deformity.

Summary Of Background Data: The SAQ has been found to be a valid and reliable measure in patients with AIS.

Adult Lumbar Degenerative Scoliosis 40° or Less: Outcomes of Surgical Treatment With Minimum 2-Year Follow-up.

Study Design: Longitudinal cohort.

Objective: To determine the outcomes of operative treatment of adult lumbar degenerative scoliosis (ALDS) with Cobb angles of 40° or less.

Summary Of Background Data: Some ALDS patients have curves less than 40°.

Superior articulating facet violation: percutaneous versus open techniques.

Object: Recent studies have reported the incidence of superior facet joint violation using percutaneous techniques. These techniques have not been compared with the open midline approach. An increased incidence of superior facet violation may lead to adjacent-segment disease.

Predictors of Oswestry Disability Index worsening after lumbar fusion.

The authors identified patients with an increase in their Oswestry Disability Index (ODI) score after lumbar spine fusion to evaluate whether this is a plausible definition of deterioration and to determine whether any common patient characteristics exist.A total of 1054 patients who underwent lumbar spinal fusion and had 2-year follow-up data, including the Short Form 36, the ODI, and numeric rating scales for back and leg pain, were identified. Patients with worsening ODI were compared with the remaining cohort.

Outcomes Following Posterior Fusion for Adolescent Idiopathic Scoliosis With and Without Autogenous Iliac Crest Bone Graft Harvesting.

Study Design: Retrospective.

Summary Of Background Data: There is continued controversy regarding the morbidity associated with harvesting iliac crest bone graft (ICBG). More important, its effect on clinical outcomes is poorly understood.

Clinical outcomes following repair of the pars interarticularis.

Spondylolysis is a source of back pain in adolescents and young adults. The purpose of this study was to report clinical outcomes in 49 patients treated with isolated motion-sparing repair of the pars interarticularis. Patients who underwent direct repair of the pars interarticularis between 2002 and 2009 were identified.

Impact of perioperative complications on clinical outcome scores in lumbar fusion surgery.

Object: Although lumbar fusion is effective in well-selected patients, it is not without complications associated with short-term morbidity. There is a paucity of literature on the effect of these complications on long-term clinical outcomes. The purpose of this study was to determine whether perioperative complications-that is, those occurring within 30 days after surgery-alter the long-term clinical outcomes after lumbar fusion.

Does Thoracic Hypokyphosis Matter in Lenke Type 1 Adolescent Idiopathic Scoliosis?

Study Design: We analyzed a prospective cohort of Lenke 1ABC adolescent idiopathic scoliosis (AIS) patients based on differences in T5-T12 sagittal alignment.

Objective: Our objective was to determine whether patients with hypokyphotic scoliosis demonstrate unique characteristics in terms of baseline health status and response to surgery.

Background Summary: Right thoracic AIS often presents as a hypokyphotic scoliosis, with rotatory deformity resulting in a diminution of the normal thoracic kyphosis.

Predictive factors for the use of autologous cell saver transfusion in lumbar spinal surgery.

Study Design: Retrospective review.

Objective: To identify risk factors for cell saver transfusion in lumbar spinal surgery and determine if cell saver transfusions affected intraoperative or postoperative transfusion rates.

Summary Of Background Data: Cell saver has been used to minimize allogeneic blood transfusion in lumbar spinal surgery.

Differentiating minimum clinically important difference for primary and revision lumbar fusion surgeries.

Object: Previous studies have reported on the minimum clinically important difference (MCID), a threshold of improvement that is clinically relevant for lumbar degenerative disorders. Recent studies have shown that pre- and postoperative health-related quality of life (HRQOL) measures vary among patients with different diagnostic etiologies. There is also concern that a patient's previous care experience may affect his or her perception of clinical improvement.

Comparison of the EuroQOL-5D with the Oswestry Disability Index, back and leg pain scores in patients with degenerative lumbar spine pathology.

Study Design: Cross-sectional study.

Objective: To evaluate the response behavior of EuroQOL-5D (EQ-5D) compared with the Oswestry Disability Index (ODI), and back and leg pain scores.

Summary Of Background Data: Recent changes in policies have highlighted the need for demonstration of both quality and cost effectiveness.

Is type of compensation a predictor of outcome after lumbar fusion?

Study Design: Propensity-matched case-control study.

Objective: To examine the impact of compensation status on clinical outcomes after lumbar spine fusion.

Summary Of Background Data: Workers' compensation has been associated with inferior outcomes after treatment of low back pain.

Clinical and radiographic parameters that distinguish between the best and worst outcomes of scoliosis surgery for adults.

Purpose: Predictors of marked improvement versus failure to improve following surgery for adult scoliosis have not been identified. Our objective was to identify factors that distinguish between patients with the best and worst outcomes following surgery for adult scoliosis.

Methods: This is a secondary analysis of a prospective, multicenter spinal deformity database.

Blood salvage produces higher total blood product costs in single-level lumbar spine surgery.

Study Design: Retrospective review.

Objective: To determine the incremental cost-effectiveness of cell saver for single-level posterior lumbar decompression and fusion (PLDF).

Summary Of Background Data: Intraoperative cell salvage is used during surgery to reduce the need for perioperative allogeneic blood transfusion.