Determining the utility of three-column osteotomies in revision surgery compared with primary surgeries in the thoracolumbar spine: a retrospective cohort study in the United States.

Study Design: Retrospective cohort study.

Purpose: To determine the incidence and success of three-column osteotomies (3COs) performed in primary and revision adult spine deformity (ASD) corrective surgeries.

Overview Of Literature: 3COs are often required to correct severe, rigid ASD presentations.

Should pelvic incidence influence realignment strategy? A detailed analysis in adult spinal deformity.

Objective: The purpose of this study was to assess how various realignment strategies affect mechanical failure and clinical outcomes in pelvic incidence (PI)-stratified cohorts following adult spinal deformity (ASD) surgery.

Methods: Median and interquartile range statistics were calculated for demographics and surgical details. Further statistical analysis was used to define subsets within PI generating significantly different rates of mechanical failure.

Developing a risk score to inform the use of rhBMP-2 in adult spinal deformity surgery.

Background: Recombinant human bone morphogenetic protein-2 (rhBMP-2) has not shown superior benefit overall in cost-effectiveness during adult spinal deformity (ASD) surgery.

Study Design/setting: Retrospective PURPOSE: Generate a risk score for pseudarthrosis to inform the utilization of rhBMP-2, balancing costs against quality of life and complications.

Methods: ASD patients with 3-year data were included.

Lower Hounsfield Units at the Planned Lowest Instrumented Vertebra Is an Independent Risk Factor for Complications Following Adult Cervical Deformity Surgery.

Background: The association of Hounsfield units (HU) and junctional pathologies in adult cervical deformity (ACD) surgery has not been elucidated.

Objective: Assess if the bone mineral density of the LIV, as assessed by HUs, is prognostic for the risk of complications after ACD surgery.

Study Design/setting: Retrospective cohort study.

Comparison of multilevel low-grade techniques versus three-column osteotomies in adult spinal deformity surgery: does harmonious correction matter?

Objective: Recent debate has arisen between whether to use a three-column osteotomy (3CO) or multilevel low-grade (MLG) techniques to treat severe sagittal malalignment in adult spinal deformity (ASD) surgery. The goal of this study was to compare the outcomes of 3CO and MLG techniques performed in corrective surgeries for ASD.

Methods: ASD patients who had a baseline PI-LL > 30° and 2-year follow-up data were included.

Predictors of reoperation for spinal disorders in Chiari malformation patients with prior surgical decompression.

Background: Chiari malformation (CM) is a cluster of related developmental anomalies of the posterior fossa ranging from asymptomatic to fatal. Cranial and spinal decompression can help alleviate symptoms of increased cerebrospinal fluid pressure and correct spinal deformity. As surgical intervention for CM increases in frequency, understanding predictors of reoperation may help optimize neurosurgical planning.

Outcomes and survival analysis of adult cervical deformity patients with 10-year follow-up.

Background: Previous studies have demonstrated that adult cervical deformity patients may be at increased risk of death in conjunction with increased frailty or a weakened physiologic state. However, such studies have often been limited by follow-up duration, and longer-term studies are needed to better assess temporal changes in ACD patients and associated mortality risk.

Purpose: To assess if patients with decreased comorbidities and physiologic burden will be at lessened risk of death for a greater length of time after undergoing adult cervical deformity surgery.

Patient-specific Cervical Deformity Corrections With Consideration of Associated Risk: Establishment of Risk Benefit Thresholds for Invasiveness Based on Deformity and Frailty Severity.

Study Design/setting: This was a retrospective cohort study.

Background: Little is known of the intersection between surgical invasiveness, cervical deformity (CD) severity, and frailty.

Objective: The aim of this study was to investigate the outcomes of CD surgery by invasiveness, frailty status, and baseline magnitude of deformity.

The Importance of Incorporating Proportional Alignment in Adult Cervical Deformity Corrections Relative to Regional and Global Alignment: Steps Toward Development of a Cervical-Specific Score.

Study Design/setting: Retrospective single-center study.

Background: The global alignment and proportion score is widely used in adult spinal deformity surgery. However, it is not specific to the parameters used in adult cervical deformity (ACD).

Efficacy of Varying Surgical Approaches on Achieving Optimal Alignment in Adult Spinal Deformity Surgery.

Background: The Roussouly, SRS-Schwab, and Global Alignment and Proportion (GAP) classifications define alignment by spinal shape and deformity severity. The efficacy of different surgical approaches and techniques to successfully achieve these goals is not well understood.

Purpose: Identify the impact of surgical approach and/or technique on meeting complex realignment goals in adult spinal deformity (ASD) corrective surgery.

Surgical costs in adult cervical Deformity: Do higher cost surgeries lead to better Outcomes?

Background: As our focus on delivering cost effective healthcare increases, interventions like cervical deformity surgery, which are associated with high resource utilization, have received greater scrutiny. The purpose of this study was to assess relationship between surgical costs, deformity correction, and patient reported outcomes in ACD surgery.

Methods: ACD Patients ≥ 18 years with baseline (BL) and 2-year (2Y) data were included.

The Impact of Lumbopelvic Realignment Versus Prevention Strategies at the Upper-instrumented Vertebra on the Rates of Junctional Failure Following Adult Spinal Deformity Surgery.

Study Design/setting: Retrospective.

Objective: Evaluate the surgical technique that has the greatest influence on the rate of junctional failure following ASD surgery.

Summary Of Background Data: Differing presentations of adult spinal deformity(ASD) may influence the extent of surgical intervention and the use of prophylaxis at the base or the summit of a fusion construct to influence junctional failure rates.

Factors Influencing Maintenance of Alignment and Functional Improvement Following Adult Spinal Deformity Surgery: A 3-Year Outcome Analysis.

Study Design: This was a retrospective review.

Objective: To assess the factors contributing to durability of surgical results following adult spinal deformity (ASD) surgery.

Summary Of Background: Factors contributing to the long-term sustainability of ASD correction are currently undefined.

Impact of Frailty on the Development of Proximal Junctional Failure: Does Frailty Supersede Achieving Optimal Realignment?

Background: Patients undergoing surgery for adult spinal deformity (ASD) are often elderly, frail, and at elevated risk of adverse events perioperatively, with proximal junctional failure (PJF) occurring relatively frequently. Currently, the specific role of frailty in potentiating this outcome is poorly defined.

Purpose: To determine if the benefits of optimal realignment in ASD, with respect to the development of PJF, can be offset by increasing frailty.

Costs of Surgery in Adult Spinal Deformity: Do Higher Cost Surgeries Lead to Better Outcomes?

Study Design: This was a retrospective study.

Objective: To assess the impact of surgical costs on patient-reported outcomes in adult spinal deformity (ASD).

Summary Of Background Data: With increased focus on delivering cost-effective health care, interventions with high-resource utilization, such as ASD surgery, have received greater scrutiny.

Natural history of adult spinal deformity: how do patients with suboptimal surgical outcomes fare relative to nonoperative counterparts?

Objective: Management of adult spinal deformity (ASD) has increasingly favored operative intervention; however, the incidence of complications and reoperations is high, and patients may fail to achieve idealized postsurgical results. This study compared health-related quality of life (HRQOL) metrics between patients with suboptimal surgical outcomes and those who underwent nonoperative management as a proxy for the natural history (NH) of ASD.

Methods: ASD patients with 2-year data were included.

Patient-Centered Outcomes Following Prone Lateral Single-Position Approach to Same-Day Circumferential Spine Surgery.

Study Design: Retrospective study.

Objective: Evaluate surgical characteristics and postoperative 2-year results of the PL approach to spinal fusion.

Summary Of Background Data: Prone-lateral(PL) single positioning has recently gained popularity in spine surgery due to lower blood loss and operative time but has yet to be examined for other notable outcomes, including realignment and patient-reported measures.

A Hierarchical Approach to Realignment Strategies in Adult Cervical Deformity Surgery.

Study Design: Retrospective cohort study.

Objective: Construct an individualized cervical realignment strategy based on patient parameters at the presentation that results in superior 2-year health-related quality of life metrics and decreased rates of junctional failure and reoperation following adult cervical deformity surgery.

Summary Of Background Data: Research has previously focused on adult cervical deformity realignment thresholds for maximizing clinical outcomes while minimizing complications.

Enabling Technologies and the Development of Single Position Lateral Spine Surgery.

Technological advances have paved the way for surgical innovation in spine surgery. These advances have allowed for the creation of more accurate and less invasive surgical techniques. Spine surgeons play a critical role in the integration of new technology into the surgical workflow with the goal of improving safety, efficiency, and clinical outcomes.

Systematic review of electronic health records to manage chronic conditions among displaced populations.

Objectives: The objective of this study was to assess the impact of electronic health records (EHRs) on health outcomes and care of displaced people with chronic health conditions and determine barriers and facilitators to EHR implementation in displaced populations.

Design: A systematic review protocol was developed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Systematic Reviews.

Data Sources: MEDLINE, Embase, PsycINFO, CINAHL, Health Technology Assessment, Epub Ahead of Print, In-Process and Other Non-Indexed Citations, Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews was searched from inception to 12 April 2021.

Should Global Realignment Be Tailored to Frailty Status for Patients Undergoing Surgical Intervention for Adult Spinal Deformity?

Study Design: Retrospective cohort study.

Objective: Assess whether modifying spinal alignment goals to accommodate frailty considerations will decrease mechanical complications and maximize clinical outcomes.

Summary Of Background Data: The Global Alignment and Proportion (GAP) score was developed to assist in reducing mechanical complications, but has had less success predicting such events in external validation.

An Economic Analysis of Early and Late Complications After Adult Spinal Deformity Correction.

Study Design/setting: Retrospective cohort.

Objective: Adult spinal deformity (ASD) corrective surgery is often a highly invasive procedure portending patients to both immediate and long-term complications. Therefore, we sought to compare the economic impact of certain complications before and after 2 years.

Crossing the Bridge From Degeneration to Deformity: When Does Sagittal Correction Impact Outcomes in Adult Spinal Deformity Surgery?

Background: Patients with less severe adult spinal deformity (ASD) undergo surgical correction and often achieve good clinical outcomes. However, it is not well understood how much clinical improvement is due to sagittal correction rather than treatment of the spondylotic process.

Purpose: Determine baseline thresholds in radiographic parameters that, when exceeded, may result in substantive clinical improvement from surgical correction.