Tethered Cord Syndrome in the United States Cluster Analysis of Presenting Anomalies and Associated.

Purpose: Tethered cord syndrome (TCS) is an occult spinal dysraphism that includes low lying conus, tight filum terminale, lipomeningomyelocele, split cord malformations, dermal sinus tracts, and dermoids. This congenital disorder has been associated with musculoskeletal, neurological, and gastrointestinal abnormalities. This study presents a retrospective review of the prospectively collected data of TCS patients and their concurrent diagnoses or associated anomalies.

Factors Associated With Short Length of Stay After Long Fusions for Adult Spinal Deformity: Initial Steps Toward Developing an Enhanced Recovery Pathway.

Study Design: Retrospective cohort study.

Objectives: The identification of case types and institutional factors associated with reduced length of stay (LOS) is a key initial step to inform the creation of clinical care pathways that can assist hospitals to maximize the benefit of value-based payment models. The objective of this study was to identify preoperative, intraoperative, and postoperative factors associated with shorter than expected LOS after adult spinal deformity (ASD) surgery.

Posterior Ligamentous Reinforcement of the Upper Instrumented Vertebrae +1 Does Not Decrease Proximal Junctional Kyphosis in Adult Spinal Deformity.

Study Design: Retrospective cohort study.

Objectives: Violation of the posterior soft tissues is believed to contribute to the development of proximal junctional kyphosis (PJK). Biomechanical and clinical studies suggest that augmentation of the posterior ligamentous structures (PLS) may help prevent PJK.

Complication Risk in Primary and Revision Minimally Invasive Lumbar Interbody Fusion: A Comparable Alternative to Conventional Open Techniques?

Study Design: Retrospective cohort study of prospective patients undergoing minimally invasive lumbar fusion at a single academic institution.

Objective: To assess differences in perioperative outcomes between primary and revision MIS (minimally invasive surgical) lumbar interbody fusion patients and compare with those undergoing corresponding open procedures.

Methods: Patients ≥18 years old undergoing lumbar interbody fusion were grouped by surgical technique: MIS or open.

Pelvic Incidence Affects Age-adjusted Alignment Outcomes in a Population of Adult Spinal Deformity.

Study Design: A single-center retrospective cohort study.

Objective: The objective of this study was to assess the effects of patient height and pelvic incidence (PI) on age-adjusted alignment outcomes of surgical adult spinal deformity (ASD) patients.

Summary Of Background Data: Patient height and PI have yet to be evaluated for their individual effects on achieving age-adjusted alignment targets.

Prospective multicenter assessment of complication rates associated with adult cervical deformity surgery in 133 patients with minimum 1-year follow-up.

Objective: Although surgical treatment can provide significant improvement of symptomatic adult cervical spine deformity (ACSD), few reports have focused on the associated complications. The objective of this study was to assess complication rates at a minimum 1-year follow-up based on a prospective multicenter series of ACSD patients treated surgically.

Methods: A prospective multicenter database of consecutive operative ACSD patients was reviewed for perioperative (< 30 days), early (30-90 days), and delayed (> 90 days) complications with a minimum 1-year follow-up.

Mandibular slope: a reproducible and simple measure of horizontal gaze.

Study Design: This study is a single-center retrospective radiographic review.

Objectives: The objective of this study is to evaluate a novel measurement parameter, mandibular slope (MS), as a measure of horizontal gaze.

Introduction: Assessment of sagittal spinal alignment is essential in the evaluation of spinal deformity patients.

ODI Cannot Account for All Variation in PROMIS Scores in Patients With Thoracolumbar Disorders.

Study Design: Retrospective review of single institution.

Objective: To assess the relationship between Patient-Reported Outcomes Measurement Information System (PROMIS) and Oswestry Disability Index (ODI) scores in thoracolumbar patients.

Methods: Included: Patients ≥18 years with a thoracolumbar spine condition (spinal stenosis, disc herniation, low back pain, disc degeneration, spondylolysis).

Defining an Algorithm of Treatment for Severe Cervical Deformity Using Surgeon Survey and Treatment Patterns.

Objective: Our aim was to define a treatment strategy for patients with severe cervical deformity (sCD).

Methods: Surgical patients with sCD were isolated based on preoperative radiographic parameters. We sent 10 sCD cases to 7 surgeons to find consensus on approach, upper instrumented vertebrae (UIVs), lower instrumented vertebrae (LIVs), and osteotomy.

Hospital-acquired conditions occur more frequently in elective spine surgery than for other common elective surgical procedures.

Hospital-acquired conditions (HACs) have been the focus of recent initiatives by the Centers for Medicare and Medicaid Services in an effort to improve patient safety and outcomes. Spine surgery can be complex and may carry significant comorbidity burden, including so called "never events." The objective was to determine the rates of common HACs that occur within 30-days post-operatively for elective spine surgeries and compare them to other common surgical procedures.

Probability of severe frailty development among operative and nonoperative adult spinal deformity patients: an actuarial survivorship analysis over a 3-year period.

Background: Little is known of how frailty, a dynamic measure of physiological age, progresses relative to age or disability status. Operative treatment of adult spinal deformity (ASD) may play a role in frailty remediation and maintenance.

Purpose: Compare frailty status, severe frailty development, and factors influencing severe frailty development among ASD patients undergoing operative or nonoperative treatment.

Intraoperative alignment goals for distinctive sagittal morphotypes of severe cervical deformity to achieve optimal improvements in health-related quality of life measures.

Background Context: Patients with severe cervical deformity (CD) often have profound deficits in numerous activities of daily living. The association between health status and postoperative radiographic goals is difficult to quantify.

Purpose: We aimed to investigate the radiographic characteristics of patients who achieved optimal health related quality of life scores following surgery for CD.

Bariatric Surgery Population at Significantly Increased Risk of Spinal Disorders and Surgical Intervention Compared With Morbidly Obese Patients.

Introduction: Obesity is associated with acceleration of musculoskeletal degenerative diseases and functional impairment secondary to spinal disorders. Bariatric surgery (BS) is an increasingly common treatment for severe obesity but can affect bone and mineral metabolism. The effect of BS on degenerative spinal disorders is yet to be fully described.

Deformity correction in thoracic adolescent idiopathic scoliosis.

Aims: To compare the rates of sagittal and coronal correction for all-pedicle screw instrumentation and hybrid instrumentation using sublaminar bands in the treatment of thoracic adolescent idiopathic scoliosis (AIS).

Methods: We retrospectively reviewed the medical records of 124 patients who had undergone surgery in two centres for the correction of Lenke 1 or 2 AIS. Radiological evaluation was carried out preoperatively, in the early postoperative phase, and at two-year follow-up.

Group-based Trajectory Modeling: A Novel Approach to Classifying Discriminative Functional Status Following Adult Spinal Deformity Surgery: Study of a 3-year Follow-up Group.

Study Design: Retrospective review of prospectively collected database.

Objective: To delineate and visualize trajectories of the functional status in surgically-treated adult spinal deformity (ASD) patients.

Summary Of Background Data: Classifying long-term recovery following ASD surgery is not well defined.

Cervical, Thoracic, and Spinopelvic Compensation After Proximal Junctional Kyphosis (PJK): Does Location of PJK Matter?

Study Design: Retrospective case series.

Objective: Compensatory changes above a proximal junctional kyphosis (PJK) have not been defined. Understanding these mechanisms may help determine optimal level selection when performing revision for PJK.

Erratum to Tridimensional Analysis of Rotatory Subluxation and Sagittal Spinopelvic Alignment in the Setting of Adult Spinal Deformity [Spine Deformity 5/4 (2017) 255-264].

The authors regret that one of the co-author's name was misspelt as "Brice Illharreborde, MD, PhD'" in the proof. However, the name should be spelled as "Brice Ilharreborde, MD, PhD'".

The clinical impact of global coronal malalignment is underestimated in adult patients with thoracolumbar scoliosis.

Study Design: Retrospective review of multicenter adult spine deformity (ASD) database.

Objectives: A recent publication demonstrated that the laterality of the coronal offset is a key parameter that directly impacts postoperative outcomes. The objective of this study is to analyze the relationship between global coronal malalignment (GCM) and functional outcomes in a North American population of ASD patients with no history of previous surgery.

Fatty infiltration of the cervical extensor musculature, cervical sagittal balance, and clinical outcomes: An analysis of operative adult cervical deformity patients.

Purpose: To assess preliminary associations between fatty-infiltration (FI) of cervical spine extensor musculature, cervical sagittal balance, and clinical outcomes in cervical deformity (CD) patients.

Methods: Operative CD patients (C2-C7 Cobb > 10°, CL > 10°, cSVA > 4 cm, or CBVA > 25°) with pre-operative (BL) MRIs and 1-year (1Y) post-operative MRIs or CTs were assessed for fatty-infiltration of cervical extensor musculature, using dedicated imaging software at each C2-C7 intervertebral level and the apex of deformity (apex). FI was gauged as a ratio of fat-free-muscle-cross-sectional-area (FCSA) over total-muscle-CSA (TCSA), with lower ratio values indicating greater FI.

Obesity negatively affects cost efficiency and outcomes following adult spinal deformity surgery.

Background Context: Obesity has risen to epidemic proportions within the United States. As the rates of obesity have increased, so has its prevalence among patients undergoing adult spinal deformity (ASD) surgery. The effect of obesity on the cost efficiency of corrective procedures for ASD has not been effectively evaluated.

Comparing Predictors of Complications After Anterior Cervical Diskectomy and Fusion, Total Disk Arthroplasty, and Combined Anterior Cervical Diskectomy and Fusion-Total Disk Arthroplasty With a Minimum 2-Year Follow-Up.

Introduction: Outcomes after anterior cervical diskectomy and fusion (ACDF) and cervical total disk arthroplasty (TDA) are satisfactory, but related morbidity and revision surgery rates are notable. This study sought to determine complication variations among ACDF, TDA, and combined ACDF-TDA as well as predictors of postoperative complications.

Methods: Patients undergoing 1- to 2-level ACDF and/or TDA with at least a 2-year follow-up from 2009 to 2011 were identified from the Statewide Planning and Research Cooperative System database.

Predicting the Occurrence of Postoperative Distal Junctional Kyphosis in Cervical Deformity Patients.

Background: Distal junctional kyphosis (DJK) development after cervical deformity (CD)-corrective surgery is a growing concern for surgeons and patients. Few studies have investigated risk factors that predict the occurrence of DJK.

Objective: To predict DJK development after CD surgery using predictive modeling.

PROMIS physical health domain scores are related to cervical deformity severity.

Introduction: The aim of this study was to evaluate the association of available cervical alignment components through the Ames cervical deformity (CD) classification parameters with the Patient-Reported Outcomes Measurement Information System (PROMIS) physical health domain metrics.

Methods: Surgical CD patients (C2-C7 Cobb >10° or C2-C7 sagittal vertical axis [cSVA] >4 cm or T1 slope minus cervical lordosis (TS-CL) >15°) ≥18 years with available baseline (BL) radiographic and PROMIS were isolated in a single-center spine database. Patients were classified according to the Ames CD modifiers for cSVA and TS-CL (low deformity [Low], moderate deformity [Mod], and severe deformity [Sev]).

The impact of osteotomy grade and location on regional and global alignment following cervical deformity surgery.

Introduction: Correction of cervical deformity (CD) often involves different types of osteotomies to address sagittal malalignment. This study assessed the relationship between osteotomy grade and vertebral level on alignment and clinical outcomes.

Methods: Retrospective review of a multi-center prospectively collected CD database.

Global spinal deformity from the upper cervical perspective. What is "Abnormal" in the upper cervical spine?

Hypothesis: Reciprocal changes in the upper cervical spine correlate with adult TL deformity modifiers.

Design: This was a retrospective review.

Introduction: The upper cervical spine has remarkable adaptability to wide ranges of thoracolumbar (TL) deformity.