A Novel Tool for Deformity Surgery Planning: Determining the Magnitude of Lordotic Correction Required to Achieve a Desired Sagittal Vertical Axis.

Objective: We sought to create a model capable of predicting the magnitude of pelvic incidence-lumbar lordosis (PI-LL) correction necessary to achieve a desired change in sagittal vertical axis (SVA).

Methods: A retrospective review was conducted of a prospectively maintained multicenter adult spinal deformity database collected by the International Spine Study Group between 2009 and 2014. The independent variable of interest was the degree of correction achieved in the PI-LL mismatch 6 weeks after surgery.

Retrospective analysis underestimates neurological deficits in complex spinal deformity surgery: a Scoli-RISK-1 Study.

OBJECTIVE The authors conducted a study to compare neurological deficit rates associated with complex adult spinal deformity (ASD) surgery when recorded in retrospective and prospective studies. Retrospective studies may underreport neurological deficits due to selection, detection, and recall biases. Prospective studies are expensive and more difficult to perform, but they likely provide more accurate estimates of new neurological deficit rates.

Orientation of the Upper-most Instrumented Segment Influences Proximal Junctional Disease Following Adult Spinal Deformity Surgery.

Study Design: Retrospective review of a prospective database.

Objective: The aim of this study was to define the role of sagittal orientation of the construct at the upper instrumented levels in the development of proximal junctional kyphosis (PJK) in adult spinal deformity (ASD) patients.

Summary Of Background Data: PJK following ASD surgery remains challenging.

Design and Testing of 2 Novel Scores That Predict Global Sagittal Alignment Utilizing Cervical or Lumbar Plain Radiographs.

Background: Global sagittal deformity is an established cause of disability. However, measurements of sagittal alignment are often ignored when patients present with symptoms localizing to the cervical or lumbar spine.

Objective: To develop scoring scales to predict the risk of sagittal malalignment in patients with only cervical or lumbar spine radiographs.

Importance of patient-reported individualized goals when assessing outcomes for adult spinal deformity (ASD): initial experience with a Patient Generated Index (PGI).

Background Context: Current metrics to assess patients' health-related quality of life (HRQOL) may not reflect a true change in the patients' specific perception of what is most important to them.

Purpose: This study aimed to describe the initial experience of a Patient Generated Index (PGI) in which patients create their own outcome domains.

Study Design: This is a single-center prospective study.

Uptake and Distribution of Silver in the Aquatic Plant Landoltia punctata (Duckweed) Exposed to Silver and Silver Sulfide Nanoparticles.

Aquatic ecosystems are expected to receive Ag and AgS nanoparticles (NPs) through anthropogenic waste streams. The speciation of silver in Ag-NPs affects their fate in ecosystems, but its influence on interactions with aquatic plants is still unclear. Here, the Ag speciation and distribution was measured in an aquatic plant, duckweed (Landoltia punctata), exposed to Ag or AgS NPs, or to AgNO.

[Development of antimicrobial resistance in Germany : What is the current situation?].

Background: The frequency of multidrug-resistant organisms (MDRO) is increasing in Germany and worldwide.

Objectives: Presentation of MDRO resistance rates and prevalence in Germany MATERIALS AND METHODS: Results from the Antibiotic Resistance Surveillance (ARS) and Hospital Infection Surveillance Systems (Krankenhausinfektions-Surveillance-Systems, KISS) and from recent prevalence surveys are presented.

Results: MRSA-resistance rates and the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) have remained at a stable level over the last few years.

The Health Impact of Adult Cervical Deformity in Patients Presenting for Surgical Treatment: Comparison to United States Population Norms and Chronic Disease States Based on the EuroQuol-5 Dimensions Questionnaire.

Background: Although adult cervical spine deformity (ACSD) is associated with pain and disability, its health impact has not been quantified in comparison to other chronic diseases.

Objective: To perform a comparative analysis of the health impact of symptomatic ACSD to US normative and chronic disease values using EQ-5D (EuroQuol-5 Dimensions questionnaire) scores.

Methods: ACSD patients presenting for surgical treatment were identified from a prospectively collected multicenter database.

Three-column osteotomy for correction of cervical and cervicothoracic deformities: alignment changes and early complications in a multicenter prospective series of 23 patients.

Purpose: Three-column osteotomy (3CO), including pedicle subtraction osteotomy (PSO) and vertebral column resection (VCR), can provide powerful alignment correction for adult cervical deformity (ACD). Our objective was to assess alignment changes and early complications associated with 3CO for ACD.

Methods: ACD patients treated with 3CO with minimum 90-day follow-up were identified from a prospectively collected multicenter ACD database.

Recent and Emerging Advances in Spinal Deformity.

Background: Over the last several decades, significant advances have occurred in the assessment and management of spinal deformity.

Objective: The primary focus of this narrative review is on recent advances in adult thoracic, thoracolumbar, and lumbar deformities, with additional discussions of advances in cervical deformity and pediatric deformity.

Methods: A review of recent literature was conducted.

Outcomes of open staged corrective surgery in the setting of adult spinal deformity.

Background Context: Adult spinal deformity (ASD) represents a constellation of complex malalignments affecting the spinal column. Corrective surgical procedures aimed at improving ASD can be equally challenging, and commonly require multiple index procedures and potential revisions before definitive management. There is a paucity of data comparing the outcomes of same-day(simultaneous [SIM]) and 2-day (staged [STA]) procedures for long spinal fusions for ASD.

Development of a preoperative predictive model for major complications following adult spinal deformity surgery.

OBJECTIVE The operative management of patients with adult spinal deformity (ASD) has a high complication rate and it remains unknown whether baseline patient characteristics and surgical variables can predict early complications (intraoperative and perioperative [within 6 weeks]). The development of an accurate preoperative predictive model can aid in patient counseling, shared decision making, and improved surgical planning. The purpose of this study was to develop a model based on baseline demographic, radiographic, and surgical factors that can predict if patients will sustain an intraoperative or perioperative major complication.

Complication rates associated with 3-column osteotomy in 82 adult spinal deformity patients: retrospective review of a prospectively collected multicenter consecutive series with 2-year follow-up.

OBJECTIVE Although 3-column osteotomy (3CO) can provide powerful alignment correction in adult spinal deformity (ASD), these procedures are complex and associated with high complication rates. The authors' objective was to assess complications associated with ASD surgery that included 3CO based on a prospectively collected multicenter database. METHODS This study is a retrospective review of a prospectively collected multicenter consecutive case registry.

Principal Radiographic Characteristics for Cervical Spinal Deformity: A Health-related Quality-of-life Analysis.

Study Design: Retrospective study.

Objective: The aim of this study was to propose radiographic characteristics of patients with cervical disability and to investigate the relevant parameters when assessing cervical alignment.

Summary Of Background Data: Although cervical kyphosis is traditionally recognized as presentation of cervical deformity, an increasing number of studies demonstrated that cervical kyphosis may not equal cervical deformity.

Age-Adjusted Alignment Goals Have the Potential to Reduce PJK.

Study Design: Retrospective cohort.

Objective: To explore proximal junctional kyphosis (PJK) as a function of age-adjusted surgical correction goals.

Summary Of Background Data: Recent adult spinal deformity (ASD) studies show that alignment targets are age-specific.

Timing of Complications Occurring Within 30 Days After Adult Spinal Deformity Surgery.

Study Design: Cross-sectional study of a national surgical database.

Objective: To investigate the timing of complications after adult spinal deformity (ASD) surgery.

Summary Of Background Data: There is limited data on the range of days when complications after ASD surgery occur.

Predictors of Health-Related Quality-of-Life After Complex Adult Spinal Deformity Surgery: A Scoli-RISK-1 Secondary Analysis.

Study Design: Longitudinal cohort.

Objectives: To identify variables that predict 2-year Short Form-36 Physical Composite Summary Score (SF-36PCS) and the Scoliosis Research Society-22R (SRS22-R) Total score after surgery for complex adult spinal deformity.

Summary Of Background Data: Increasingly, treatment effectiveness is assessed by the extent to which the procedure improves a patient's health-related quality of life (HRQOL).

Initial Experience With Real-Time Continuous Physical Activity Monitoring in Patients Undergoing Spine Surgery.

Study Design: Multicenter prospective pilot study.

Objective: To evaluate if continuous physical activity monitoring by a personal electronic 3-dimensional accelerometer device is feasible and can provide objective data that correlates with patient-reported outcomes following spine surgery.

Summary Of Background Data: Self-reported health-related quality-of-life (HRQOL) metrics are inherently limited by being very subjective, having a low frequency of data collection, and inconsistent follow-up.

Magnitude, Location, and Factors Related to Regional and Global Sagittal Alignment Change in Long Adult Deformity Constructs: Report of 183 Patients With 2-Year Follow-up.

Study Design: This is a retrospective review of a prospective multicenter adult spinal deformity (ASD) database.

Objective: To quantify the location and magnitude of sagittal alignment changes within instrumented and noninstrumented spinal segments and to investigate the factors associated with these changes after surgery for ASD.

Summary Of Background Data: Spinal realignment is one of the major goals in ASD surgery and changes in the alignment are common following surgical correction.

Role of Ethnicity in Alignment Compensation: Propensity Matched Analysis of Differential Compensatory Mechanism Recruitment Patterns for Sagittal Malalignment in 288 ASD Patients From Japan, Korea, and United States.

Study Design: Retrospective review of adult spinal deformity patients in a multiethnic database.

Objective: To investigate the role of ethnicity on recruitment of compensatory mechanisms for sagittal spinal deformity.

Summary Of Background Data: While the impacts of age, sex, and pelvic morphology on the ability to compensate for sagittal malalignment have been investigated, the role of ethnicity in compensatory mechanism recruitment is poorly understood.

Virtual Modeling of Postoperative Alignment After Adult Spinal Deformity Surgery Helps Predict Associations Between Compensatory Spinopelvic Alignment Changes, Overcorrection, and Proximal Junctional Kyphosis.

Study Design: Retrospective review of a prospective multicenter database.

Objective: To develop a method to analyze sagittal alignment, free of the influence of proximal junctional kyphosis (PJK), and then compare PJK to non-PJK patients using this method.

Summary Of Background Data: PJK after adult spinal deformity (ASD) surgery remains problematic as it alters sagittal alignment.

Preoperative functional status as a predictor of short-term outcome in adult spinal deformity surgery.

Adult spinal deformity (ASD) may cause severe disability and difficulty with daily activities. The purpose of this study was to investigate the impact of preoperative functional status on 30-day major complication occurrence in ASD surgery. A review of the prospectively-collected American College of Surgeons National Surgical Quality Improvement database was performed for the years 2007-2013.

Adult Scoliosis Deformity Surgery: Comparison of Outcomes Between One Versus Two Attending Surgeons.

Study Design: Retrospective review of prospectively collected data.

Objective: Assess outcomes of adult spinal deformity (ASD) surgery performed by one versus two attending surgeons.

Summary Of Background Data: ASD centers have developed two attending teams to improve efficiency; their effects on complications and outcomes have not been reported.

Comparing Quality of Life in Cervical Spondylotic Myelopathy with Other Chronic Debilitating Diseases Using the Short Form Survey 36-Health Survey.

Background: Although cervical spondylotic myelopathy (CSM) can be devastating, its relative impact on general health remains unclear. Patient responses to the Short Form Survey 36-Health Survey (SF-36) Physical Component Summary (PCS)/Mental Component Summary (MCS) were compared between CSM and other diseases to evaluate their respective impacts on quality of life. The objective of this study was to compare SF-36 PCS/MCS scores in CSM with population and disease-specific norms.