The Variability of the Cervicothoracic Inflection Point: A Cohort Analysis of the Multi-Ethnic Asymptomatic Normative Study (MEANS).

Study Design: Cross-sectional Cohort Study.

Objective: To determine the cervicothoracic inflection point in an asymptomatic, adult population.

Introduction: The cervicothoracic inflection point (CTIP) is an important sagittal marker to understand for patients with cervical deformities.

Hip Osteoarthritis in Patients Undergoing Surgery for Severe Adult Spinal Deformity: Prevalence and Impact on Spine Surgery Outcomes.

Background: Hip osteoarthritis (OA) is common in patients with adult spinal deformity (ASD). Limited data exist on the prevalence of hip OA in patients with ASD, or on its impact on baseline and postoperative alignment and patient-reported outcome measures (PROMs). Therefore, this paper will assess the prevalence and impact of hip OA on alignment and PROMs.

Innovative technologies in thoracolumbar and lumbar spine surgery failing to reach standard of care: state-of-art review.

Purpose: To evaluate previously popular technologies in the field of spine surgery, and to better understand their advantages and limitations to the current standards of care. Spine surgery is an ever-evolving field that serves to resolve various spinal pathologies in patients of all ages. While there are established treatments for various conditions, such as lumbar spinal stenosis, idiopathic scoliosis, and degenerative lumbar disease, there is always further research and development in these areas to produce innovative technologies that can lead to better outcomes.

Impact of Self-Reported Loss of Balance and Gait Disturbance on Outcomes following Adult Spinal Deformity Surgery.

The objective of this study was to evaluate if imbalance influences complication rates, radiological outcomes, and patient-reported outcomes (PROMs) following adult spinal deformity (ASD) surgery. ASD patients with baseline and 2-year radiographic and PROMs were included. Patients were grouped according to whether they answered yes or no to a recent history of pre-operative loss of balance.

Characteristics of Spinal Morphology According to the "Current" and "Theoretical" Roussouly Classification Systems in a Diverse, Asymptomatic Cohort: Multi-Ethnic Alignment Normative Study (MEANS).

Study Design: Cross-sectional cohort study.

Objective: To classify spinal morphology using the "current" and "theoretical" Roussouly systems and assess sagittal alignment in an asymptomatic cohort.

Methods: 467 asymptomatic volunteers were recruited from 5 countries.

Impact of Hip and Knee Osteoarthritis on Full Body Sagittal Alignment and Compensation for Sagittal Spinal Deformity.

Study Design: Retrospective review of prospectively collected data.

Objective: To investigate the effect of lower extremity osteoarthritis on sagittal alignment and compensatory mechanisms in adult spinal deformity (ASD).

Background: Spine, hip, and knee pathologies often overlap in ASD patients.

Practical Methods of Assessing Coronal Alignment and Outcomes in Adult Spinal Deformity Surgery: A Comparative Analysis.

Study Design: Asymptomatic cohort: prospective, cross-sectional, multicenter. Symptomatic: retrospective, multisurgeon, single-center.

Objective: To assess the association between cranial coronal alignment and adult spinal deformity (ASD) surgical risk and outcomes.

The Importance of Pelvic Obliquity in Assessing Spinal Coronal Alignment: Normative Values, Demographic, and Radiographic Correlations.

Study Design: Prospective, cross-sectional study.

Objective: In a geographically diverse population of asymptomatic volunteers, we sought to report the incidence of pelvic obliquity (PO), establish normative values of PO across patient factors, and assess the correlation of PO with radiographic parameters.

Summary Of Background Data: PO is defined as the misalignment of the pelvis and can be assessed through several anatomic landmarks.

The Case for Operative Efficiency in Adult Spinal Deformity Surgery: Impact of Operative Time on Complications, Length of Stay, Alignment, Fusion Rates, and Patient-Reported Outcomes.

Study Design: Retrospective review of prospectively collected data.

Objective: To analyze the impact of operative room (OR) time in adult spinal deformity (ASD) surgery on patient outcomes.

Background: It is currently unknown if OR time in ASD patients matched for deformity severity and surgical invasiveness is associated with patient outcomes.

Comparison of the Odontoid and Orbital-Coronal Vertical Axis Lines in Evaluating Coronal Alignment and Outcomes in Adult Spinal Deformity Surgery.

Study Design: Asymptomatic Multi-Ethnic Alignment Normative Study (MEANS) cohort: cross-sectional, multicenter. Symptomatic cohort: retrospective, multisurgeon, single-center.

Objective: To assess the association of odontoid-coronal vertical axis (OD-CVA) and orbital-coronal vertical axis (ORB-CVA) with radiographic parameters, patient-reported outcomes, and clinical outcomes.

Do Grip Strength Dynamometer Readings Improve After Cervical Spine Surgery?

Study Design: Retrospective, cohort study.

Objectives: Hand function can be difficult to objectively assess perioperatively. In patients undergoing cervical spine surgery by a single-surgeon, we sought to: (1) use a hand dynamometer to report pre/postoperative grip strength, (2) distinguish grip strength changes in patients with radiculopathy-only vs myelopathy, and (3) assess predictors of grip strength improvement.

Predicting Bone Health Using Machine Learning in Patients undergoing Spinal Reconstruction Surgery.

Study Design: Retrospective study of data collected prospectively.

Objective: The goal of this study is to create a predictive model of preoperative bone health status in adult patients undergoing adult spinal reconstructive (ASR) surgery using machine learning (ML).

Summary Of Background Data: Despite understanding that bone health impacts spine surgery outcomes, spine surgeons lack the tools to risk stratify patients preoperatively to determine who should undergo bone health screening.

Demographic and economic trends in vertebral fracture surgeries throughout the United States.

Background: Vertebral fractures, frequently resulting from high-impact trauma to the spine, are an increasingly relevant public health concern. Little is known about the long-term economic and demographic trends affecting patients undergoing surgery for such fractures. This study examines national economic and demographic trends in vertebral fracture surgery in the United States to improve value-based care and health care utilization.

Patients With Coronal Malalignment Undergoing Adult Spinal Deformity Surgery: Does Coronal Alignment Change From Immediately Postoperative to 2-years?

Study Design: Retrospective cohort study.

Objectives: The objectives were to: (1) characterize the changes in coronal vertical axis (CVA) after adult spinal deformity (ASD) surgery from immediate postoperative to 2-years postoperative, and (2) assess for predictors of CVA change from immediate postoperative to 2-years postoperative.

Summary Of Background Data: It is unknown whether coronal correction obtained immediately postoperative accurately reflects long-term coronal alignment.

Setting for single position surgery: survey from expert spinal surgeons.

Purpose: To describe a comprehensive setting of the different alternatives for performing a single position fusion surgery based on the opinion of leading surgeons in the field.

Methods: Between April and May of 2021, a specifically designed two round survey was distributed by mail to a group of leaders in the field of Single Position Surgery (SPS). The questionnaire included a variety of domains which were focused on highlighting tips and recommendations regarding improving the efficiency of the performance of SPS.

Correlation analysis of the PI-LL mismatch according to the pelvic incidence from a database of 468 asymptomatic volunteers.

Purpose: Previous studies on adults with degenerative scoliosis (ADS) have been fixed the threshold of PI-LL mismatch less than 10° for achieving good clinical outcomes. Recent studies discussed that PI-LL mismatch should consider individual pelvic incidence (PI) and should be set first in a normal population. The purpose of this study is to assess the variability of PI-LL mismatch according to PI in an asymptomatic population.

Pelvic thickness, sex, ethnicity, and age affect pelvic incidence in healthy volunteers of Multi-Ethnic Alignment Normative Study (MEANS) database.

Background: The purpose of this study was to investigate the affecting factors on pelvic incidence (PI) and to test the hypothesis that PI changes even after skeletal maturity probably due to hypermobility of the sacroiliac joint using a large international multi-center database.

Methods: A prospective and cross-sectional healthy adult volunteers, ages 18-80 years, across 5 countries were used. Radiographic measurements included standard whole body alignment parameters.

The Rise and Fall of Bone Morphogenetic Protein 2 Throughout the United States.

Study Design: Retrospective Database Study.

Objective: Investigate utilization of bone morphogenetic protein (BMP-2) between 2004 and 2014.

Summary Of Background Data: The utilization, particularly off-label utilization, of BMP-2 has been controversial and debated in the literature.

SRS-22r question 11 is a valid opioid screen and stratifies opioid consumption.

Purpose: To validate the Scoliosis Research Society-22r (SRS-22r) question 11 (Q11) response as a measure to assess and quantify opioid consumption.

Methods: A post hoc analysis of a prospective study regarding opioid use during ASD surgery was performed. Data were collected at enrollment and 2-year follow-up including the SRS-22r and a standardized data collection form (CRF) for self-reported opioid consumption.