Selective thoracolumbar fusion in adult spinal deformity double curves with circumferential minimally invasive surgery: 2-year minimum follow-up.

Objective: Selection of the upper instrumented vertebra (UIV) level for adult spinal deformity (ASD) remains controversial. Although selective fusion attempts have been described for fractional curves or adolescent curves, no authors have described selective thoracolumbar fusion performance for ASD with double curves. This study evaluated the clinical impact of selective fusion constructs within the lower thoracic and/or lumbar spine on ASD with double curves.

Do peri-operative parathyroid hormone (PTH) analogues improve bone density and decrease mechanical complications in spinal deformity correction?-a minimum 2-year radiological study measuring Hounsfield units.

Objective: To delineate whether use of a PTH analogue in the 1-year peri-operative period improves lumbar bone density.

Methods: A prospectively collected data registry of 254 patients who underwent CMIS correction of ASD (Cobb angle > 20 or SVA > 50 mm or (PI-LL) > 10) from Jan 2011 to Jan 2020 was analysed. Patients who were placed on PTH analogues for one year in conjunction with surgery were included in the study.

Spinal Deformity Complexity Checklist for Minimally Invasive Surgery: Expert Consensus from the Minimally Invasive International Spine Study Group.

Background: We developed a spinal deformity complexity checklist (SDCC) to assess the difficulty in performing a circumferential minimally invasive surgery (MIS) for adult spinal deformity.

Methods: A modified Delphi method of panel experts was used to construct an SDCC checklist of radiographic and patient-related characteristics that could affect the complexity of surgery via MIS approaches. Ten surgeons with expertise in MIS deformity surgery were queried to develop and refine the SDCC with 3 radiographic categories (x-ray, magnetic resonance imaging, computed tomography) and 1 patient-related category.

Does the Global Alignment and Proportion score predict mechanical complications in circumferential minimally invasive surgery for adult spinal deformity?

Objective: The Global Alignment and Proportion (GAP) score was developed to serve as a tool to predict mechanical complication probability in patients undergoing surgery for adult spinal deformity (ASD), serving as an aid for setting surgical goals to decrease the prevalence of mechanical complications in ASD surgery. However, it was developed using ASD patients for whom open surgical techniques were used for correction. Therefore, the purpose of this study was to assess the applicability of the score for patients undergoing circumferential minimally invasive surgery (cMIS) for correction of ASD.

Prevalence and Modes of Posterior Hardware Failure With a Staged Protocol for Circumferential Minimally Invasive Surgical Correction of Adult Spinal Deformity: A 13-Year Experience.

Background: One of the common complications of adult spinal deformity (ASD) correction is the failure to relieve pain. This may result from the failure of implanted hardware to provide adequate stabilization. While numerous studies exist, characterizing complications that can occur with minimally invasive correction of ASD and data regarding hardware failure in this setting are limited.

Management of severe adult spinal deformity with circumferential minimally invasive surgical strategies without posterior column osteotomies: a 13-year experience.

Objective: To evaluate the mid- to long-term clinical outcomes of circumferential minimally invasive surgery (CMIS) without posterior column osteotomies for severe adult spine deformity (ASD) correction.

Methods: All patients with a minimum of 2-year follow-up undergoing staged CMIS correction of ASD from January 2007 to July 2018 were identified. All included patients had fusion of 3 or more interbody levels that spanned the L5-S1 junction.

The prevalence of proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) in patients undergoing circumferential minimally invasive surgical (cMIS) correction for adult spinal deformity: long-term 2- to 13-year follow-up.

Objectives: This aim of this study is to evaluate the prevalence of PJK and PJF in patients who underwent circumferential minimally invasive surgery (cMIS) for ASD.

Methods: A prospective database of patients who underwent cMIS correction of ASD from November 2006 to July 2018 was queried. PJK was defined as angle > 10° and at least 10° greater than the baseline when measuring UIV to UIV + 2.

Analysis of Spino-Pelvic Parameters and Segmental Lordosis with L5-S1 Oblique Lateral Interbody Fusion at the Bottom of a Long Construct in Circumferential Minimally Invasive Surgical Correction of Adult Spinal Deformity.

Background: Lateral interbody fusion (LIF) is an effective adjuvant for circumferential minimally invasive surgery (CMIS) treatment of adult spinal deformity (ASD). Accessing L5-S1 via an oblique LIF (OLIF) approach (OLIF 5-1) allows for anterior LIF (ALIF) at the lumbosacral junction without repositioning the patient. We review the early outcomes and complications of OLIF 5-1 at the bottom of a long construct for an MIS approach to treat ASD.

The Influence of Lordotic cages on creating Sagittal Balance in the CMIS treatment of Adult Spinal Deformity.

Background: CMIS techniques are heavily dependent on placement of lateral interbody cages. Cages with an increased lordotic angle are being advocated to improve segmental lordosis and SVA. We assessed the segmental lordosis achieved with the individual cages.

Comparison of a Newer Versus Older Protocol for Circumferential Minimally Invasive Surgical (CMIS) Correction of Adult Spinal Deformity (ASD)-Evolution Over a 10-Year Experience.

Study Design: Retrospective.

Objectives: Compare circumferential minimally invasive surgical (CMIS) correction outcomes of patients treated for adult spinal deformity (ASD) with a newer versus older protocol SUMMARY OF BACKGROUND DATA: CMIS techniques have become increasingly popular. Increasing experience and learning curve may help improve outcomes.

Thirty-Day Reoperation and Readmission Rates After Correction of Adult Spinal Deformity via Circumferential Minimally Invasive Surgery-Analysis of a 7-Year Experience.

Study Design: Single-center retrospective analysis of consecutive patients who have undergone circumferential minimally invasive surgery (cMIS) for correction of adult spinal deformity (ASD).

Objectives: To study the rates of reoperations and readmissions within the first 30 days following cMIS for correction of ASD.

Background: Hospital readmission and reoperation rates have been emphasized as an important measure of quality and cost-effectiveness of care.

Evidence basis/outcomes in minimally invasive spinal scoliosis surgery.

Traditional adult scoliosis surgery is associated with long-term patient improvement in clinical and radiographic outcome measures, significant blood loss, and high likelihood of medical complications. Because the patient population undergoing adult scoliosis surgery is often elderly with medical comorbidities, minimally invasive spinal surgery (MISS) for adult scoliosis is theoretically appealing, because it is associated with less tissue trauma and reduced blood loss. Nevertheless, limitations exist with current techniques as far as the achievable degree of coronal and sagittal plane deformity correction.

Long-term 2- to 5-year clinical and functional outcomes of minimally invasive surgery for adult scoliosis.

Study Design: A retrospective study.

Objective: We assess MIS technique's clinical and functional outcomes during a 2- to 5-year period.

Summary Of Background Data: Traditional surgical approaches for adult scoliosis are associated with significant blood loss and morbidity, in a population that is often elderly with multiple medical comorbidities.