An age and sex matched study on the effect of obesity on the functional outcomes and complication rates in patients with adult spinal deformity undergoing primary multi-level thoracolumbar spinal fusion.

Background: The objective of this study was to determine the effect of obesity on the functional outcomes and complication rates of patients with adult spinal deformity (ASD) undergoing multi-level thoracolumbar fusion.

Methods: An age and sex matched comparison of functional outcomes [Numeric Rating Scale (NRS) back and leg scores, Core Outcome Measurement Index (COMI) back scores, Scoliosis Research Society 22 (SRS22) satisfaction and total scores, Short Form 36 (SF36) general health scores, Physical Component Score (PCS), Mental Component Score (MCS), Oswestry Disability Index (ODI) (including all domains)] at 6 months, 1, 2, 3 and 4 years and the complication rates at final follow-up between obese [body mass index (BMI) >30] and normal BMI (18.5-24.

The Effect of Discharging Patients with Low Hemoglobin Levels on Hospital Readmission and Quality of Life after Adult Spinal Deformity Surgery.

Study Design: Retrospective cohort.

Purpose: This study aims to evaluate the impact of anemia on functional outcomes, health-related quality of life (HRQoL), and early hospital readmission (EHR) rates after adult spinal deformity (ASD) surgery at the time of discharge from the hospital.

Overview Of Literature: Concerns with risks of transfusion, insufficient evidence for its benefits, and the possibility of associated adverse outcomes have led to restrictive transfusion practices.

Variation of Minimum Clinically Important Difference by Age, Gender, Baseline Disability, and Change of Direction in Adult Spinal Deformity Population: Is It a Constant Value?

Background: The minimum clinically important difference (MCID), an important concept to evaluate the effectiveness of treatments, might not be a single "magical" constant for any given health-related quality of life (HRQoL) scale. Thus, we analyzed the effects of various factors on MCIDs for several HRQoL measures in an adult spinal deformity population.

Methods: Surgical and nonsurgical patients from a multicenter adult spinal deformity database who had completed pretreatment and 1-year follow-up questionnaires (Core Outcome Measures Index [COMI], Oswestry Disability Index [ODI], Medical Outcomes Study 36-item short-form questionnaire, 22-item Scoliosis Research Society Outcomes questionnaire, and an anchor question of "back health"-related change during the previous year) were evaluated.

Decision Analysis in Quest of the Ideal Treatment in Adult Spinal Deformity Adjusted for Minimum Clinically Important Difference.

Background: Surgery appears to yield better results in adult spinal deformity treatment when fixed minimum clinically important difference values are used to define success. Our objective was to analyze utilities and improvement provided by surgical versus nonsurgical treatment at 2 years using Oswestry Disability Index with treatment-specific minimum clinically important difference values.

Methods: From a multicenter database including 1452 patients, 698 with 2 years of follow-up were analyzed.

Anterior Spinal Artery Syndrome: Rare Precedented Reason of Postoperative Plegia After Spinal Deformity Surgery: Report of 2 Cases.

Background: Complications in spinal deformity surgery vary from insignificant to severe. Apart from direct mechanical insult, ischemia can also cause spinal cord injury. Ischemic injury may be detected during surgery or may manifest itself postoperatively.

The effect of increasing body mass index on the pain and function of patients with adult spinal deformity.

Background: Both adult spinal deformity (ASD) and obesity are growing concerns internationally. This study therefore aims to determine the effect of increasing body mass index (BMI) on the pain and function of patients with ASD.

Methods: A retrospective review of prospectively collected data from a multicentre European database was undertaken.

Does the Application of Topical Intrawound Vancomycin Powder Affect Deep Surgical Site Infection and the Responsible Organisms after Spinal Surgery?: A Retrospective Case Series with a Historical Control Group.

Study Design: Retrospective case series with a historical control group.

Purpose: To compare the deep wound infection rates in patients undergoing spinal surgery with the application of topical intrawound vancomycin powder (TIVP) in the surgical site in addition to standard systemic prophylaxis with those in a matched historical cohort of patients for whom TIVP was not used.

Overview Of Literature: Surgical site infection (SSI) after spine surgery is debilitating and is responsible for a significant increase in the health care costs, hospital stay, and morbidities.

Adult Spinal Deformity Over 70 Years of Age: A 2-Year Follow-Up Study.

Background: Treatment of adult spinal deformity (ASD) in elderly patients remains controversial. The aim of this study was to identify the factors leading to the surgical treatment by comparing the baseline characteristics of operative versus nonoperative patients, to evaluate the safety and efficacy of surgery, and to compare operative and nonoperative management of elderly ASD patients at the end of the 2-year follow-up period.

Methods: Retrospective review of a multicenter, prospective ASD database was performed.

Development of predictive models for all individual questions of SRS-22R after adult spinal deformity surgery: a step toward individualized medicine.

Purpose: Health-related quality of life (HRQL) instruments are essential in value-driven health care, but patients often have more specific, personal priorities when seeking surgical care. The Scoliosis Research Society-22R (SRS-22R), an HRQL instrument for spinal deformity, provides summary scores spanning several health domains, but these may be difficult for patients to utilize in planning their specific care goals. Our objective was to create preoperative predictive models for responses to individual SRS-22R questions at 1 and 2 years after adult spinal deformity (ASD) surgery to facilitate precision surgical care.

Development and validation of risk stratification models for adult spinal deformity surgery.

Objective: Adult spinal deformity (ASD) surgery has a high rate of major complications (MCs). Public information about adverse outcomes is currently limited to registry average estimates. The object of this study was to assess the incidence of adverse events after ASD surgery, and to develop and validate a prognostic tool for the time-to-event risk of MC, hospital readmission (RA), and unplanned reoperation (RO).

Impact of resolved early major complications on 2-year follow-up outcome following adult spinal deformity surgery.

Purpose: Major complications are a concern following ASD surgery. Even when properly managed and resolved, they may still have a relevant impact on HRQL. We aimed to investigate the impact of resolved early major complications on 2-year outcome after ASD surgery.

Validation of a Simplified SRS-Schwab Classification Using a Sagittal Modifier.

Study Design: Multicenter, prospective study of consecutive adult spinal deformity (ASD) patients.

Objective: To Validate Schwab's classification accuracy for surgical indication, and to evaluate a simplified sagittal modifier.

Summary Of Background Data: The SRS-Schwab Radiologic Classification based on clinical impact parameters, offers 27 different sagittal classification possibilities regarding sagittal vertical alignment (SVA), pelvic tilt (PT), and pelvic incidence-lumbar lordosis (PI-LL).

Development of Deployable Predictive Models for Minimal Clinically Important Difference Achievement Across the Commonly Used Health-related Quality of Life Instruments in Adult Spinal Deformity Surgery.

Study Design: Retrospective analysis of prospectively-collected, multicenter adult spinal deformity (ASD) databases.

Objective: To predict the likelihood of reaching minimum clinically important differences in patient-reported outcomes after ASD surgery.

Summary Of Background Data: ASD surgeries are costly procedures that do not always provide the desired benefit.

The Influence of Diagnosis, Age, and Gender on Surgical Outcomes in Patients With Adult Spinal Deformity.

Study Design: Retrospective review of prospectively collected data from a multicentric database.

Objectives: To determine the clinical impact of diagnosis, age, and gender on treatment outcomes in surgically treated adult spinal deformity (ASD) patients.

Methods: A total of 199 surgical patients with a minimum follow-up of 1 year were included and analyzed for baseline characteristics.

Cryo-Compression Therapy After Elective Spinal Surgery for Pain Management: A Cross-Sectional Study With Historical Control.

Objective: Postoperative dynamic cryo-compression (DC) therapy has been proposed as a method of reducing pain and the inflammatory response in the early postoperative period after orthopedic joint reconstruction surgery. Our aim was to analyze the analgesic efficacy of DC therapy after adult lumbar spinal surgery.

Methods: DC was applied for 30 minutes every 6 hours after surgery.

The Global Spine Care Initiative: care pathway for people with spine-related concerns.

Purpose: The purpose of this report is to describe the development of an evidence-based care pathway that can be implemented globally.

Methods: The Global Spine Care Initiative (GSCI) care pathway development team extracted interventions recommended for the management of spinal disorders from six GSCI articles that synthesized the available evidence from guidelines and relevant literature. Sixty-eight international and interprofessional clinicians and scientists with expertise in spine-related conditions were invited to participate.

The Global Spine Care Initiative: World Spine Care executive summary on reducing spine-related disability in low- and middle-income communities.

Purpose: Spinal disorders, including back and neck pain, are major causes of disability, economic hardship, and morbidity, especially in underserved communities and low- and middle-income countries. Currently, there is no model of care to address this issue. This paper provides an overview of the papers from the Global Spine Care Initiative (GSCI), which was convened to develop an evidence-based, practical, and sustainable, spinal healthcare model for communities around the world with various levels of resources.

The Global Spine Care Initiative: methodology, contributors, and disclosures.

Purpose: The purpose of this report is to describe the Global Spine Care Initiative (GSCI) contributors, disclosures, and methods for reporting transparency on the development of the recommendations.

Methods: World Spine Care convened the GSCI to develop an evidence-based, practical, and sustainable healthcare model for spinal care. The initiative aims to improve the management, prevention, and public health for spine-related disorders worldwide; thus, global representation was essential.

The Global Spine Care Initiative: classification system for spine-related concerns.

Purpose: The purpose of this report is to describe the development of a classification system that would apply to anyone with a spine-related concern and that can be used in an evidence-based spine care pathway.

Methods: Existing classification systems for spinal disorders were assembled. A seed document was developed through round-table discussions followed by a modified Delphi process.

The Global Spine Care Initiative: resources to implement a spine care program.

Purpose: The purpose of this report is to describe the development of a list of resources necessary to implement a model of care for the management of spine-related concerns anywhere in the world, but especially in underserved communities and low- and middle-income countries.

Methods: Contents from the Global Spine Care Initiative (GSCI) Classification System and GSCI care pathway papers provided a foundation for the resources list. A seed document was developed that included resources for spine care that could be delivered in primary, secondary and tertiary settings, as well as resources needed for self-care and community-based settings for a wide variety of spine concerns (e.

Minimum clinically important difference of the health-related quality of life scales in adult spinal deformity calculated by latent class analysis: is it appropriate to use the same values for surgical and nonsurgical patients?

Background Context: Health-related quality of life (HRQOL) parameters have been shown to be reliable and valid in patients with adult spinal deformity (ASD). Minimum clinically important difference (MCID) has become increasingly important to clinicians in evaluating patients with a threshold of improvement that is clinically relevant.

Purpose: To calculate MCID and minimum detectable change (MDC) values of total scores of the Core Outcome Measures Index (COMI), Oswestry Disability Index (ODI), Physical Component Summary (PCS), Mental Component Summary (MCS) of the Short Form 36 (SF-36), and Scoliosis Research Society 22R (SRS-22R) in surgically and nonsurgically treated ASD patients who have completed an anchor question at pretreatment and 1-year follow-up.

The impact of deep surgical site infection on surgical outcomes after posterior adult spinal deformity surgery: a matched control study.

Purpose: The impact of deep surgical site infection (SSI) on surgical outcomes after adult spinal deformity (ASD) surgery is still unclear. We aimed to study the morbidity of SSI in ASD and its impact on deformity correction and functional outcome.

Methods: Prospective multicenter matched-cohort study including consecutively enrolled ASD patients.

External validation of the adult spinal deformity (ASD) frailty index (ASD-FI).

Purpose: To assess the ability of the recently developed adult spinal deformity frailty index (ASD-FI) to predict odds of perioperative complications, odds of reoperation, and length of hospital stay after adult spinal deformity (ASD) surgery using a database other than the one used to create the index.

Methods: We used the ASD-FI to calculate frailty scores for 266 ASD patients who had minimum postoperative follow-up of 2 years in the European Spine Study Group (ESSG) database. Patients were enrolled from 2012 through 2013.