343 results match your criteria: "Norton Leatherman Spine Center[Affiliation]"
Immediate Postoperative Change in the Upper Instrumented Screw-Vertebra Angle Is a Predictor for Proximal Junctional Kyphosis and Failure.
Spine (Phila Pa 1976)
May 2024
Norton Leatherman Spine Center, 210 East Gray Street, Suite 900, Louisville, KY 40202.
Article Synopsis
- The study retrospectively reviews patient data to assess whether changes in the position of the upper instrumented vertebral (UIV) screw during surgery predict the development of proximal junctional kyphosis or failure (PJK/PJF).
- It involves a cohort of 143 cases analyzed over an average follow-up of 3.5 years, revealing that significant changes in the screw's angle are correlated with higher rates of PJK/PJF and the need for surgical revision.
- The findings suggest that a change of the screw position greater than 5° notably increases the risk of both developing PJK/PJF and requiring revision surgery, highlighting the importance of careful surgical technique.
The Incremental Clinical Benefit of Adding Layers of Complexity to the Planning and Execution of Adult Spinal Deformity Corrective Surgery.
Oper Neurosurg (Hagerstown)
November 2024
Departments of Orthopaedic and Neurologic Surgery, NYU Langone Orthopedic Hospital, New York Spine Institute, New York , New York , USA.
Background And Objectives: For patients with surgical adult spinal deformity (ASD), our understanding of alignment has evolved, especially in the last 20 years. Determination of optimal restoration of alignment and spinal shape has been increasingly studied, yet the assessment of how these alignment schematics have incrementally added benefit to outcomes remains to be evaluated.
Methods: Patients with ASD with baseline and 2-year were included, classified by 4 alignment measures: Scoliosis Research Society (SRS)-Schwab, Age-Adjusted, Roussouly, and Global Alignment and Proportion (GAP).
Intraoperative Hypotension Is an Important Modifiable Risk Factor for Major Complications in Spinal Fusion Surgery.
Spine (Phila Pa 1976)
January 2025
Norton Leatherman Spine Center, Louisville, KY.
Study Design: Retrospective observational cohort.
Objectives: This study explores the impact of Intraoperative hypotension (IOH) on postoperative complications for major thoracolumbar spine fusion procedures.
Summary Of Background Data: IOH with mean arterial pressure (MAP) <65 mm Hg is associated with postoperative acute kidney injury (AKI) in general surgery.
Comparison of No Tap (two-step) and tapping robotic assisted cortical bone trajectory screw insertion.
J Robot Surg
May 2024
Norton Leatherman Spine Center, 210 East Gray Street, Suite #900, Louisville, KY, 40202, USA.
Article Synopsis
- The study compares two workflows for placing cortical bone trajectory (CBT) screws during robotic-assisted spinal surgery: a traditional "Tap" three-step method and a new "No-Tap" two-step method.
- It analyzed metrics like screw-related complications, surgical time, and blood loss in 91 No-Tap and 88 Tap cases, finding that No-Tap significantly reduced robotic time without increasing the risk of complications.
- The results suggest that the No-Tap technique is a safer, more efficient alternative to the traditional tapping method in this type of surgery.
Factors Associated With the Maintenance of Cost-effectiveness at Five Years in Adult Spinal Deformity Corrective Surgery.
Spine (Phila Pa 1976)
October 2024
Department of Orthopedic Surgery, University of Kansas Medical Center, Kansas City, KS.
Study Design: Retrospective cohort.
Objective: To evaluate factors associated with the long-term durability of cost-effectiveness (CE) in ASD patients.
Background: A substantial increase in costs associated with the surgical treatment for adult spinal deformity (ASD) has given precedence to scrutinize the value and utility it provides.
Machine learning clustering of adult spinal deformity patients identifies four prognostic phenotypes: a multicenter prospective cohort analysis with single surgeon external validation.
Spine J
June 2024
Department of Orthopaedics, Columbia University Medical Center, New York, NY, USA.
Background Context: Among adult spinal deformity (ASD) patients, heterogeneity in patient pathology, surgical expectations, baseline impairments, and frailty complicates comparisons in clinical outcomes and research. This study aims to qualitatively segment ASD patients using machine learning-based clustering on a large, multicenter, prospectively gathered ASD cohort.
Purpose: To qualitatively segment adult spinal deformity patients using machine learning-based clustering on a large, multicenter, prospectively gathered cohort.
Risk Factors for Medial Breach During Robotic-Assisted Cortical Bone Trajectory Screw Insertion.
World Neurosurg
April 2024
Department of Orthopaedic Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA; Norton Leatherman Spine Center, Louisville, Kentucky, USA.
Article Synopsis
- - The study examined the frequency and risk factors associated with medial breaches of the pedicle wall during robotic-assisted cortical bone trajectory (RA-CBT) screw placements in 145 adult patients from January 2019 to July 2022.
- - Out of 784 screws analyzed, 30 (3.8%) exhibited a medial breach, with a notable correlation to lower bone quality (measured by Hounsfield units), the placement of screws on the right side, and screws in the upper instrumented vertebra.
- - Despite these breaches, no patients required additional surgery for screw repositioning, and there were no significant differences in clinical outcomes between patients with or without a medial breach.
Lumbar Lordosis Redistribution and Segmental Correction in Adult Spinal Deformity: Does it Matter?
Spine (Phila Pa 1976)
September 2024
Department of Orthopedic Surgery, Warren Alpert Medical School of Brown University, Providence, RI.
Study Design: Retrospective analysis of prospectively collected data.
Objective: Evaluate the impact of correcting normative segmental lordosis values on postoperative outcomes.
Background: Restoring lumbar lordosis magnitude is crucial in adult spinal deformity surgery, but the optimal location and segmental distribution remain unclear.
Persistent Lower Extremity Compensation for Sagittal Imbalance After Surgical Correction of Complex Adult Spinal Deformity: A Radiographic Analysis of Early Impact.
Oper Neurosurg (Hagerstown)
February 2024
Departments of Orthopaedic and Neurological Surgery, NYU Langone Orthopaedic Hospital, New York Spine Institute, New York, New York, USA.
Background And Objectives: Achieving spinopelvic realignment during adult spinal deformity (ASD) surgery does not always produce ideal outcomes. Little is known whether compensation in lower extremities (LEs) plays a role in this disassociation. The objective is to analyze lower extremity compensation after complex ASD surgery, its effect on outcomes, and whether correction can alleviate these mechanisms.
View Article and Find Full Text PDFPublisher Correction: A United States multi-site randomized control trial of Schroth-based therapy in adolescents with mild idiopathic scoliosis.
Spine Deform
March 2024
Scottish Rite for Children, 2222 Welborn Street, Dallas, TX, 75219, USA.
Predictors of pelvic tilt normalization: a multicenter study on the impact of regional and lower-extremity compensation on pelvic alignment after complex adult spinal deformity surgery.
J Neurosurg Spine
April 2024
1Departments of Orthopaedic and Neurosurgery, Division of Spinal Surgery, NYU Langone Medical Center, NY Spine Institute, New York, New York.
Objective: The objective was to determine the degree of regional decompensation to pelvic tilt (PT) normalization after complex adult spinal deformity (ASD) surgery.
Methods: Operative ASD patients with 1 year of PT measurements were included. Patients with normalized PT at baseline were excluded.
Impact of Educational Background on Preoperative Disease Severity and Postoperative Outcomes Among Patients With Cervical Spondylotic Myelopathy.
Clin Spine Surg
April 2024
Department of Neurosurgery, University of California, San Francisco, San Francisco, CA.
Study Design: Retrospective review of a prospectively maintained database.
Objective: Assess differences in preoperative status and postoperative outcomes among patients of different educational backgrounds undergoing surgical management of cervical spondylotic myelopathy (CSM).
Summary Of Background Data: Patient education level (EL) has been suggested to correlate with health literacy, disease perception, socioeconomic status (SES), and access to health care.
Performance of the streamlined quality outcomes database web-based calculator: internal and external validation.
Spine J
April 2024
Norton Leatherman Spine Center, 210 East Gray St, Suite 900, Louisville, KY, USA.
Article Synopsis
- A study was conducted to validate the accuracy of the QOD-Calc web-based calculator, which estimates the likelihood of improvement after lumbar spine surgery based on patient data from two cohorts: the Quality Outcomes Database (QOD) and DaneSpine.
- Results showed that QOD-Calc demonstrated good predictive ability, particularly in the QOD cohort, with AUC scores indicating varying levels of accuracy for predicting patient improvement in pain and disability measures.
- It was concluded that while QOD-Calc generally works well in predicting postoperative outcomes, its performance was better with the QOD data compared to the DaneSpine cohort.
Cost Benefit of Implementation of Risk Stratification Models for Adult Spinal Deformity Surgery.
Global Spine J
December 2023
Rocky Mountain Scoliosis and Spine, Denver, CO, USA.
Study Design/setting: Retrospective cohort study.
Objective: Assess the extent to which defined risk factors of adverse events are drivers of cost-utility in spinal deformity (ASD) surgery.
Methods: ASD patients with 2-year (2Y) data were included.
Clinical and Radiographic Outcomes of Repair of Spondylolitic Spondylolisthesis Through Direct Pars Repair.
Spine (Phila Pa 1976)
September 2024
Norton Leatherman Spine Center, Louisville, KY.
Article Synopsis
- - The study is a retrospective chart review that aims to evaluate the effectiveness of direct pars repair in achieving bone healing and alleviating symptoms in patients with spondylolitic spondylolisthesis.
- - 68 patients underwent open surgical pars repair, revealing a solid union rate of 52%, with 50% reporting no postoperative pain and 15% experiencing persistent pain.
- - The study found a significant association between younger age and lower pain levels post-surgery, contributing to a complete or partial union rate of 82%.
Comparison of Bone Mineral Density in Children and Adolescents on CT Versus DEXA Scan.
Spine (Phila Pa 1976)
October 2024
Norton Leatherman Spine Center, Louisville, KY.
Article Synopsis
- - The study aimed to explore the relationship between Hounsfield units (HU) from CT scans and bone mineral density (BMD) assessed through DEXA scans in children and adolescents, as previous research primarily focused on adults.
- - Researchers analyzed patients under 18 years who had both a lumbar spine CT scan and a DEXA scan within six months, finding a moderate correlation between DEXA Z-scores and HU values.
- - Results showed that children with a DEXA Z-score of ≤-2.0 had significantly lower HU values compared to healthy peers, indicating that HU measurements on CT scans might effectively estimate BMD in the pediatric population.
Patient-specific Cervical Deformity Corrections With Consideration of Associated Risk: Establishment of Risk Benefit Thresholds for Invasiveness Based on Deformity and Frailty Severity.
Clin Spine Surg
February 2024
Department of Neurosurgery, University of California, San Francisco, San Francisco, CA.
Study Design/setting: This was a retrospective cohort study.
Background: Little is known of the intersection between surgical invasiveness, cervical deformity (CD) severity, and frailty.
Objective: The aim of this study was to investigate the outcomes of CD surgery by invasiveness, frailty status, and baseline magnitude of deformity.
Clinical and Economic Impact of Proximal Junctional Kyphosis on Pediatric and Adult Spinal Deformity Patients.
Int J Spine Surg
October 2023
Department of Neurosurgery, University of Virginia, VA, USA.
The common goal of pediatric and adult spinal reconstructive procedures is to minimize long-term risk of disability, pain, and mortality. A common complication that has proved particularly problematic in the adult spinal deformity population and that has been an area of increased research and clinical focus is proximal junctional kyphosis (PJK). The incidence of PJK ranges from 10%-40% based on criteria used to define the condition.
View Article and Find Full Text PDFPatient expectations impact patient-reported outcomes and satisfaction after lumbar fusion.
Spine J
February 2024
Norton Leatherman Spine Center, 210 East Gray St, Louisville, KY, 40202 USA. Electronic address:
Background Context: Prior studies suggest that patient expectations impact postoperative patient-reported outcomes (PROMs). However, no consensus exists on an appropriate expectations tool.
Purpose: To examine the impact of patient expectations using a modified version of the Oswestry Disability Index (ODI) on clinical outcomes and patient satisfaction 1 year after lumbar fusion for degenerative pathologies.
Article Synopsis
- - The study examined intraoperative screw malposition during robot-assisted cortical bone trajectory (RA-CBT) surgeries, focusing on two types of malposition: skive and shift, which occur due to instrument deflection or registration changes, respectively.
- - A total of 1344 screws were placed in 256 patients, with a malposition rate of 2.4%, linked to higher body mass index (BMI) and specific vertebral characteristics at the insertion points.
- - No screw revisions were necessary post-surgery, highlighting that while malpositions occurred, they did not require further intervention, with factors such as obesity and specific bone properties influencing the likelihood of these errors.
The ISSG-AO Complication Intervention Score, but Not Major/Minor Designation, is Correlated With Length of Stay Following Adult Spinal Deformity Surgery.
Global Spine J
September 2023
Department of Orthopedic Surgery, University of Texas, Houston, TX, USA.
Study Design: Retrospective review.
Objectives: The International Spine Study Group-AO (ISSG-AO) Adult Spinal Deformity (ASD) Complication Classification System was developed to improve classification, reporting, and study of complications among patients undergoing ASD surgery. The ISSG-AO system classifies interventions to address complications by level of invasiveness: grade zero (none); grade 1, mild (e.
The Role of Anterior Spine Surgery in Deformity Correction.
Neurosurg Clin N Am
October 2023
Norton Leatherman Spine Center, 210 East Gray Street, Suite 900, Louisville, KY 40202, USA; Department of Orthopaedic Surgery, University of Louisville School of Medicine, 550 S. Jackson St., 1st Floor ACB, Louisville, KY 40202, USA.
Article Synopsis
- * These techniques provide access to different vertebral levels, such as transperitoneal, paramedian anterior retroperitoneal, oblique retroperitoneal, thoracolumbar transdiaphragmatic, and thoracotomy approaches.
- * The lumbar and lumbosacral regions are ideal for these approaches due to the movement of peritoneal organs and the arrangement of blood vessels in that area.
Preoperative Optimization: Risk Factors for Perioperative Complications and Preoperative Modification.
Neurosurg Clin N Am
October 2023
Norton Leatherman Spine Center, 210 East Gray Street, Suite 900, Louisville, KY 40202, USA.
Article Synopsis
- Adult spinal deformity (ASD) surgery has a high complication rate due to its invasive nature and several risk factors, including age and health history.
- The article categorizes these risk factors into modifiable (like frailty and osteoporosis) and non-modifiable.
- It aims to review evidence on these risk factors and highlight recent advancements in assessing surgical risks and planning tailored approaches for patients.
Staged circumferential lumbar fusions have less intraoperative complications and shorter operative time with no difference in 30-, 90-, and 1-year complications: a propensity-matched cohort analysis of 190 patients.
Spine J
January 2024
Norton Leatherman Spine Center, 210 East Gray St, Suite 900, Louisville, KY 40202, USA. Electronic address:
Article Synopsis
- Circumferential lumbar fusions (cLFs) are becoming more popular due to new minimally invasive techniques, leading to a study comparing staged versus single-anesthetic approaches.
- The study used a matched sample of patients who had cLFs for lumbar degenerative disease to evaluate various complications within different time frames post-surgery.
- Results indicated that while the single-anesthetic surgeries took longer overall, they had more intraoperative complications, but there were no significant differences in hospital stays or long-term outcomes between the two methods.
Are We Focused on the Wrong Early Postoperative Quality Metrics? Optimal Realignment Outweighs Perioperative Risk in Adult Spinal Deformity Surgery.
J Clin Med
August 2023
Rocky Mountain Scoliosis and Spine, Denver, CO 80124, USA.
Background: While reimbursement is centered on 90-day outcomes, many patients may still achieve optimal, long-term outcomes following adult spinal deformity (ASD) surgery despite transient short-term complications.
Objective: Compare long-term clinical success and cost-utility between patients achieving optimal realignment and suboptimally aligned peers.
Study Design/setting: Retrospective cohort study of a prospectively collected multicenter database.