The Shape of the Fused Spine is Associated With Acute Proximal Junctional Kyphosis in Adult Spinal Deformity: An Assessment Based on Vertebral Pelvic Angles.

Study Design: Retrospective review of prospective database.

Objectives: Vertebral pelvic angles (VPAs) account for complexity in spine shape by assessing the relative position of each vertebra with regard to the pelvis. This study uses VPAs to investigate the shape of the fused spine after T10-pelvis fusion, in patients with adult spinal deformity (ASD), and then explores its association with proximal junctional kyphosis (PJK).

The impact of preoperative supine radiographs on surgical strategy in adult spinal deformity.

Objective: Preoperative planning for adult spinal deformity (ASD) surgery is essential to prepare the surgical team and consistently obtain postoperative alignment goals. Positional imaging may allow the surgeon to evaluate spinal flexibility and anticipate the need for more invasive techniques. The purpose of this study was to determine whether spine flexibility, defined by the change in alignment between supine and standing imaging, is associated with the need for an osteotomy in ASD surgery.

Use of rhBMP-2 for adult spinal deformity surgery: patterns of usage and changes over the past decade.

Objective: Recombinant human bone morphogenetic protein-2 (rhBMP-2) has been shown to increase fusion rates; however, cost, limited FDA approval, and possible complications impact its use. Decisions regarding rhBMP-2 use and changes over time have not been well defined. In this study, the authors aimed to assess changes in rhBMP-2 use for adult spinal deformity (ASD) surgery over the past decade.

Cervicothoracic Versus Proximal Thoracic Lower Instrumented Vertebra Have Comparable Radiographic and Clinical Outcomes in Adult Cervical Deformity.

Study Design: Comparative cohort study.

Objective: Factors that influence the lower instrumented vertebra (LIV) selection in adult cervical deformity (ACD) are less reported, and outcomes in the cervicothoracic junction (CTJ) and proximal thoracic (PT) spine are unclear.

Methods: A prospective ACD database was analyzed using the following inclusion criteria: LIV between C7 and T5, upper instrumented vertebra at C2, and at least a 1-year follow-up.

The utility of supine radiographs in the assessment of thoracic flexibility and risk of proximal junctional kyphosis.

Objective: Supine radiographs have successfully been used for preoperative planning of lumbar deformity corrections. However, they have not been used to assess thoracic flexibility, which has recently garnered attention as a potential contributor to proximal junctional kyphosis (PJK). The purpose of this study was to compare supine to standing radiographs to assess thoracic flexibility and to determine whether thoracic flexibility is associated with PJK.

Lowest Instrumented Vertebra Selection to S1 or Ilium Versus L4 or L5 in Adult Spinal Deformity: Factors for Consideration in 349 Patients With a Mean 46-Month Follow-Up.

Study Design: Retrospective cohort study.

Objective: To compare the outcomes of patients with adult spinal deformity (ASD) following spinal fusion with the lowest instrumented vertebra (LIV) at L4/L5 versus S1/ilium.

Methods: A multicenter ASD database was evaluated.

The relationship of global sagittal malalignment to fatty infiltration in the aging spine.

Purpose: To investigate associations between muscle size, fat infiltration (FI), and global sagittal alignment in patients with adult spinal deformity (ASD).

Methods: Retrospective cohort study was conducted on a single-institution database of ASD patients with preoperative radiographs and CTs. Following multiplanar reconstructions of CTs, images in the plane of each vertebra were generated.

Supine Imaging Is a Superior Predictor of Long-Term Alignment Following Adult Spinal Deformity Surgery.

Study Design: Retrospective cohort study.

Objective: To investigate correlations between preoperative supine imaging and postoperative alignment.

Methods: A retrospective review was conducted of a single-institution database of patients with adult spinal deformity (ASD).

In the Relationship Between Change in Kyphosis and Change in Lordosis: Which Drives Which?

Study Design: Retrospective single-center study.

Objective: Investigate the effect of posterior instrumentation on the relationship between lordosis and kyphosis.

Methods: Surgically treated patients with a minimum of 6 months of follow-up were analyzed.