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Machine Learning-based Cluster Analysis Identifies Three Unique Phenotypes of Patients With Adult Spinal Deformity With Distinct Clinical Profiles and Long-term Recovery Trajectory: A Development Study.
Spine (Phila Pa 1976)
January 2025
Department of Orthopedics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China.
Study Design: A retrospective review of a prospective adult spinal deformity data.
Objective: To identify distinct patient clinical profiles and recovery trajectories in patients with adult spinal deformity (ASD).
Summary Of Background Data: Patients with ASD exhibit a diverse array of symptoms and significant heterogeneity in clinical presentations, posing challenges to precise clinical decision-making.
Lumbopelvic hyperlordosis is linked to higher femoral head coverage, lower femoral anteversion and younger age at periacetabular osteotomy.
Knee Surg Sports Traumatol Arthrosc
January 2025
Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Germany.
Purpose: The dynamic alignment of the lumbar spine, pelvis and femur is increasingly studied in hip preservation surgery. However, the interaction between lumbopelvic alignment, acetabular and femoral morphology and its influence on patients' preoperative symptom burden remains poorly understood. The aim of this study was to evaluate whether lumbopelvic malalignment affects osseous hip morphology and exacerbates preoperative patient-reported joint functionality in patients undergoing periacetabular osteotomy (PAO).
View Article and Find Full Text PDFOffset sublaminar hook is an efficient tool for the prevention of distal junctional failure after kyphotic deformity correction.
Spine Deform
December 2024
Clinique du Dos, Elsan Jean Villar Private Hospital, Bordeaux, France.
Purpose: To assess the radiological outcomes and complications focusing on distal junctional failure (DJF) of adult spinal deformity patients who underwent thoracolumbar fixation with the use of offset sublaminar hooks (OSH) distally.
Methods: Retrospective review of a prospective, multicenter adult spinal deformity database (2 sites). Inclusion criteria were age of at least 18 years, presence of a spinal deformity with thoraco-lumbar instrumentation ending distally with OSH (pelvis excluded), with minimum 2 years of follow-up.
Two-stage spinal osteotomy combined with lateral lumbar interbody fusion for lumbar kyphosis: illustrative case.
J Neurosurg Case Lessons
December 2024
Department of Orthopaedic Surgery, University of Toyama, Toyama City, Toyama, Japan.
Background: Adult spinal reconstructive surgery that requires multilevel spinal fusion is highly invasive and requires two-stage surgery using lateral lumbar interbody fusion (LLIF) and/or percutaneous pedicle screw (PPS) fixation to make it less invasive. However, it is still difficult to make spinal osteotomy less invasive, and the high complication rate is an issue.
Observations: The authors present the surgical techniques of a two-stage Schwab grade 4 spinal osteotomy using LLIF, which could reduce surgical invasiveness and enable good correction and anterior spinal column reconstruction for lumbar kyphosis, and also report a case treated with this procedure.
L4 Pedicle Subtraction Osteotomy in a Patient With Multiple Previous Revisions: A Case Report.
Cureus
November 2024
Orthopedic Surgery, MedStar Georgetown University Hospital, Washington DC, USA.
Pedicle subtraction osteotomy (PSO) is a technically complex procedure that is effective at improving the sagittal profile in spinal deformity surgery. This case report describes a 64-year-old man with a history of ten previous spinal surgeries, including failed T10-pelvis posterior spinal fusion, undergoing revision with L4 PSO. The patient regained approximately 30° of lumbar lordosis.
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