Article
Clinical Neurology
Basel Sheikh Alshabab, Munish C. Gupta, Renaud Lafage, Shay Bess, Christopher Shaffrey, Han Jo Kim, Christopher P. Ames, Douglas C. Burton, Justin S. Smith, Robert K. Eastlack, Eric O. Klineberg, Gregory M. Mundis, Frank J. Schwab, Virginie Lafage
Summary: This study investigates the potential associations between postoperative alignment and patient satisfaction in adult spinal deformity (ASD) surgery. The findings suggest that achieving global coronal and sagittal alignment is an independent predictor of satisfaction and disability at 2 years post-op. Preoperative deformity severity and correction of the main aspect of the deformity also play a role in restoring global alignment and influencing patient satisfaction.
Article
Clinical Neurology
Basel Sheikh Alshabab, Munish Gupta, Renaud Lafage, Shay Bess, Christopher Shaffrey, Han Jo Kim, Christopher Ames, Douglas Burton, Justin Smith, Robert Eastlack, Eric Klineberg, Gregory Mundis, Frank Schwab, Virginie Lafage, International Spine Study Group ISSG
Summary: This study retrospectively reviewed the postoperative alignment and satisfaction of adult spinal deformity patients, finding that achieving global coronal and sagittal alignment is an independent predictor of satisfaction and disability. Preoperative disability was also found to be associated with satisfaction.
Article
Clinical Neurology
Chan Woong Byun, Jae Hwan Cho, Choon Sung Lee, Dong-Ho Lee, Chang Ju Hwang
Summary: This study aimed to investigate the effect of age-adjusted sagittal correction on the incidence of proximal junctional kyphosis (PJK) in adult spinal deformity (ASD) patients. The results showed that overcorrection of lumbar lordosis (LL) relative to age-adjusted ideal sagittal alignment tends to increase the occurrence of PJK. Patients with low pelvic incidence (PI) are more likely to undergo overcorrection and have a higher incidence of PJK.
Article
Orthopedics
Yoshinori Okamoto, Hitoshi Wakama, Tomohiro Okayoshi, Shuhei Otsuki, Masashi Neo
Summary: A T1PA/PI > 0.2 and height < 148 cm were associated with greater disability after THA. Post-operative satisfaction, HOOS-JR, and EuroQol 5-Dimension differed between the two groups.
BMC MUSCULOSKELETAL DISORDERS
(2021)
Article
Multidisciplinary Sciences
Akihiko Hiyama, Hiroyuki Katoh, Daisuke Sakai, Masato Sato, Masahiko Watanabe
Summary: This study found that preoperative sagittal misalignment does not significantly affect the correction of alignment after lateral lumbar interbody fusion (LLIF) surgery in patients with lumbar degenerative diseases. However, postoperative low back pain, leg pain, and leg numbness may be improved regardless of the preoperative sagittal alignment.
SCIENTIFIC REPORTS
(2022)
Article
Clinical Neurology
Takayoshi Shimizu, Meghan Cerpa, Lawrence G. Lenke
Summary: This study evaluated the possibility of estimating preoperative lower-extremity compensation in adult spinal deformity (ASD) patients without whole-body radiographs. By analyzing pelvic tilt and lower extremity parameters, it was found that increased cranio-hip anterior imbalance in ASD patients led to a higher prevalence of lower extremity compensation, especially in knee flexion. Surgeons can preoperatively estimate the extent of lower extremity compensation without obtaining a full-body radiograph using the determined cutoff values of pelvic tilt.
JOURNAL OF NEUROSURGERY-SPINE
(2021)
Article
Clinical Neurology
Jichao Ye, Sean M. Rider, Renaud Lafage, Sachin Gupta, Ali S. Farooqi, Themistocles S. Protopsaltis, Peter G. Passias, Justin S. Smith, Virginie Lafage, Han -Jo Kim, Eric O. Klineberg, Khaled M. Kebaish, Justin K. Scheer, Gregory M. Mundis Jr, Alex Soroceanu, Shay Bess, Christopher P. Ames, Christopher I. Shaffrey, Munish C. Gupta, ISSG
Summary: The study aimed to evaluate spinopelvic sagittal alignment and spinal compensatory changes in adult cervical kyphotic deformity. A database of 129 adult patients undergoing cervical reconstruction was reviewed and compared with asymptomatic control patients. The results showed that cervical deformity was associated with increased C0-2 lordosis, T1S, thoracolumbar junction kyphosis, and pelvic tilt. Cervical reconstruction resulted in decreased C0-2 lordosis, increased T1S, and increased thoracic and thoracolumbar junction kyphosis. Severe cervical kyphosis was associated with greater C0-2 lordosis and postoperative reduction, while severe sagittal malalignment was associated with decreased pelvic tilt and increased lumbar lordosis.
JOURNAL OF NEUROSURGERY-SPINE
(2023)
Article
Medicine, General & Internal
Tomoyuki Asada, Kousei Miura, Masao Koda, Hideki Kadone, Toru Funayama, Hiroshi Takahashi, Hiroshi Noguchi, Yosuke Shibao, Kosuke Sato, Fumihiko Eto, Kentaro Mataki, Masashi Yamazaki
Summary: This study retrospectively included 27 ASD patients undergoing three-dimensional gait analysis before surgery. The results showed that the dynamic angle between the thoracic spine and pelvis can be a predictive factor for PJK, serving as an independent risk factor for patients undergoing corrective surgery for ASD.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Clinical Neurology
Bong Ju Moon, Moon-Soo Han, Jae-Young Kim, Jung-Kil Lee
Summary: The study found that HRQoL improved after 2 years in participants with PDSI, TLS, SVA, and T1PA were strongly correlated with ODI score, with TLS greater than -3.5 degrees predicting PDSI aggravation.
Article
Clinical Neurology
Se-Jun Park, Chong-Suh Lee, Byeong-Jik Kang, Tae Soo Shin, Il Su Kim, Jin-Sung Park, Keun-Ho Lee, Dae Hun Shin
Summary: Overcorrection relative to age-adjusted sagittal alignment increases the risk of proximal junctional failure (PJF) development and is associated with poor clinical outcomes. Older patients and those with small pelvic incidence (PI) are likely to be overcorrected in terms of the age-adjusted PI-lumbar lordosis (LL) target, therefore, the age-adjusted alignment should be considered more strictly in these patients.
Article
Clinical Neurology
Hiroshi Moridaira, Satoshi Inami, Daisaku Takeuchi, Haruki Ueda, Hiromichi Aoki, Takuya Imura, Hiroshi Taneichi
Summary: This study evaluated radiographic and clinical outcomes after short fusion for different subtypes of adult spinal deformity with lumbar kyphosis as the main deformity. For subtypes of ASD with lumbar kyphosis as the main deformity, if the pelvic incidence is less than 47 degrees, short fusion preserving mobile intervertebral segments can improve postoperative global spinal alignment and quality of life.
JOURNAL OF NEUROSURGERY-SPINE
(2021)
Article
Clinical Neurology
Damon E. Mar, Stanley Kisinde, Isador H. Lieberman, Ram Haddas
Summary: The study aimed to compare the dynamic spinal alignment during gait between ASD patients and healthy adults, finding that severe ASD patients exhibited significantly larger dynamic ranges in SVA, TPA, LL, and PT compared to mild ASD patients.
Article
Clinical Neurology
Renaud Lafage, Frank Schwab, Jonathan Elysee, Justin S. Smith, Basel Sheikh Alshabab, Peter Passias, Eric Klineberg, Han Jo Kim, Christopher Shaffrey, Douglas Burton, Munish Gupta, Gregory M. Mundis, Christopher Ames, Shay Bess, Virginie Lafage
Summary: The study conducted a retrospective cohort analysis on 433 ASD patients who underwent corrective realignment, aiming to establish focal and regional corrective guidelines. It was found that the impact of lumbar lordosis restoration is critically determined by the location of correction, with distal correction leading to a greater impact on global alignment and pelvic retroversion. Specifically, a 1 degree correction in L4-S1 lordosis is associated with a 1 degree change in TPA, a 10 mm change in SVA, and a 0.5 degree change in PT.
GLOBAL SPINE JOURNAL
(2022)
Article
Clinical Neurology
Pieter Severijns, Lieven Moke, Thomas Overbergh, Erica Beaucage-Gauvreau, Thijs Ackerman, Kaat Desloovere, Lennart Scheys
Summary: The study found that ASD patients walk with increased trunk tilt and pelvic anteversion, along with altered lower limb kinematics. After surgical correction of spinal alignment, there were no significant improvements in lower limb kinematics and spatiotemporal parameters during gait. Different sagittal alignment statuses affect the changes in patients' gait.
Article
Clinical Neurology
Justin S. Smith, Elias Elias, Tolga Sursal, Breton Line, Virginie Lafage, Renaud Lafage, Eric Klineberg, Han Jo Kim, Peter Passias, Zeina Nasser, Jeffrey L. Gum, Robert Eastlack, Alan Daniels, Gregory Mundis, Richard Hostin, Themistocles S. Protopsaltis, Alex Soroceanu, David Kojo Hamilton, Michael P. Kelly, Stephen J. Lewis, Munish Gupta, Frank J. Schwab, Douglas Burton, Christopher P. Ames, Lawrence G. Lenke, Christopher I. Shaffrey, Shay Bess
Summary: A study found that about 25-30% of patients did not achieve the desired spinal alignment after adult spine deformity surgery, indicating the need for advancements to improve surgical outcomes.
GLOBAL SPINE JOURNAL
(2023)
Article
Clinical Neurology
Karen A. Weissmann, Carlos Barrios, Virginie Lafage, Renaud Lafage, Marcelo A. Costa, Diego Alvarez, Carlos M. Huaiquilaf, Bryan Ang, Ronald G. Schulz
Summary: This study compared the correction capacity of the VCA technique and the AD technique in patients with neuromuscular scoliosis. Both techniques were found to provide correction in the three planes, but the AD technique had a better effect on reducing thoracic kyphosis postoperatively.
GLOBAL SPINE JOURNAL
(2023)
Article
Clinical Neurology
Peter G. E. Passias, Katherine E. K. Pierce, Tyler K. Williamson, Oscar Krol, Renaud Lafage, Virginie J. Lafage, Andrew J. S. Schoenfeld, Themistocles S. Protopsaltis, Shaleen Vira, Breton G. Line, Bassel G. P. Diebo, Christopher P. Ames, Han Jo S. Kim, Justin S. Smith, Dean H. Chou, Alan H. L. Daniels, Jeffrey L. I. Gum, Christopher I. C. Shaffrey, Douglas C. P. Burton, Michael P. O. Kelly, Eric O. A. Klineberg, Robert A. Hart, Shay J. Bess, Frank J. C. Schwab, Munish C. Gupta, Int Spine Study Grp
Summary: This study aimed to evaluate the impact of different realignment strategies on alignment outcomes (PNR, PJK, and CD) following adult spinal deformity surgery. It was found that 24.9% of patients still had pelvic malalignment after surgery. This occurrence was often accompanied by undercorrection of lumbopelvic mismatch and less improvement of pain, while overcorrection in any strategy incurred higher rates of PJK. Surgeons are recommended to identify a middle ground using one or more of the available classifications to inform correction goals.
Article
Clinical Neurology
Peter G. Passias, Nicholas Kummer, Bailey Imbo, Virginie Lafage, Renaud Lafage, Justin S. Smith, Breton Line, Shaleen Vira, Andrew J. Schoenfeld, Jeffrey L. Gum, Alan H. Daniels, Eric O. Klineberg, Munish C. Gupta, Khaled M. Kebaish, Amit Jain, Brian J. Neuman, Dean Chou, Leah Y. Carreon, Robert A. Hart, Douglas C. Burton, Christopher Shaffrey, Christopher P. Ames, Frank J. Schwab, Richard A. Hostin, Shay Bess
Summary: A retrospective cohort study analyzed patient outcomes and cost-effectiveness of adult spinal deformity surgery from 2008 to 2019. The study found a decrease in complication rates and overall cost, as well as improvements in patient-reported outcomes, indicating improved cost effectiveness over the past decade.
Article
Clinical Neurology
Ethan W. W. Ayres, Themistocles S. S. Protopsaltis, Fares Ani, Renaud Lafage, Arnaav Walia, Gregory M. Mundis, Justin S. Smith, David K. Hamilton, Eric O. Klineberg, Daniel M. Sciubba, Robert A. A. Hart, Shay Bess, Christopher I. I. Shaffrey, Frank J. J. Schwab, Virginie Lafage, Christopher P. P. Ames
Summary: The study aimed to develop a model that can predict the postoperative DJKA using preoperative and postoperative radiographic measurements. The variables most associated with postoperative DJK were preoperative DJKA, postoperative alignment within the construct, and change in cervical lordosis. The model can be used in a clinical setting when planning for cervical deformity correction.
Article
Clinical Neurology
Bruno Lazaro, Juan Pablo Sardi, Justin S. Smith, Michael P. Kelly, Elizabeth L. Yanik, Brian Dial, Jeffrey Hills, Munish C. Gupta, Christine R. Baldus, Chun Po Yen, Virginie Lafage, Christopher P. Ames, Shay Bess, Frank Schwab, Christopher I. Shaffrey, Keith H. Bridwell
Summary: The objective of this study was to identify risk factors for proximal junctional failure (PJF) and assess its long-term incidence and revision rates. The study found that PJF was associated with age, BMI, and preoperative and postoperative patient-reported outcome measures. Additionally, the use of UIV hooks was found to be protective against PJF.
JOURNAL OF NEUROSURGERY-SPINE
(2023)
Article
Surgery
Waleed Ahmad, Joshua Bell, Oscar Krol, Lara Passfall, Pramod Kamalapathy, Bailey Imbo, Peter Tretiakov, Tyler Williamson, Rachel Joujon-Roche, Kevin Moattari, Nicholas Kummer, Shaleen Vira, Virginie Lafage, Carl Paulino, Andrew J. Schoenfeld, Bassel Diebo, Hamid Hassanzadeh, Peter Passias
Summary: The study investigates the impact of coronary stents on postoperative outcomes in elective spine fusion patients. It finds that patients with 3 or more stents have a significantly increased risk of mortality at 90 days postoperatively.
INTERNATIONAL JOURNAL OF SPINE SURGERY
(2023)
Article
Clinical Neurology
Peter G. Passias, Nicholas J. Frangella, Tyler K. Williamson, Kevin A. Moattari, Renaud Lafage, Virginie Lafage, Justin S. Smith, Khaled M. Kebaish, Douglas C. Burton, Robert A. Hart, Christopher P. Ames, Shay Bess, Christopher I. Shaffrey, Frank J. Schwab
Summary: This study explored the changes in health-related quality of life parameters in patients with varying degrees of proximal junctional kyphosis following corrective adult spinal deformity surgery. The results showed that the presence or absence of proximal junctional kyphosis had similar effects on the health-related quality of life of patients, and SRS-22 Satisfaction may be correlated with the degree of proximal junctional kyphosis. Future research needs to use different assessments.
Correction
Clinical Neurology
Renaud Lafage, Justin S. Smith, Jonathan Elysee, Peter Passias, Shay Bess, Eric Klineberg, Han Jo Kim, Christopher Shaffrey, Douglas Burton, Richard Hostin, Gregory Mundis, Christopher Ames, Frank Schwab, Virginie Lafage
Article
Clinical Neurology
Bailey Imbo, Tyler Williamson, Rachel Joujon-Roche, Oscar Krol, Peter Tretiakov, Salman Ahmad, Claudia Bennett-Caso, Andrew J. Schoenfeld, Michael Dinizo, Rafael de la Garza-Ramos, M. Burhan Janjua, Shaleen Vira, Rivka Ihejirika-Lomedico, Tina Raman, Brooke O'Connell, Constance Maglaras, Carl Paulino, Bassel Diebo, Renaud Lafage, Virginie Lafage, Peter G. Passias
Summary: This retrospective study aimed to describe the rate of postoperative morbidity before and after a two-year follow-up for patients undergoing surgical correction of adult spinal deformity (ASD). The study found that there was a significant reduction in complications after two years, and most of the complications beyond this time period were mechanical issues.
Article
Clinical Neurology
Renaud Lafage, Priya Duvvuri, Jonathan Elysee, Bassel Diebo, Shay Bess, Douglas Burton, Alan Daniels, Munish Gupta, Richard Hostin, Khaled Kebaish, Michael Kelly, Han Jo Kim, Eric Klineberg, Lawrence Lenke, Stephen Lewis, Christopher Ames, Peter Passias, Themistocles Protopsaltis, Christopher S. Shaffrey, Justin Smith, Frank Schwab, Virginie Lafage, Int Spine Study Grp
Summary: This is a multicenter, prospective cohort study aimed at testing the hypothesis that the elimination of lower limb compensation in patients with adult spinal deformity (ASD) will significantly increase the magnitude of sagittal malalignment. The study revealed that removing lower limb compensation led to a significant increase in trunk misalignment.
Article
Clinical Neurology
Mitchell Fourman, Renaud Lafage, Christopher S. Ames, Justin G. Smith, Peter I. Passias, Christopher Shaffrey, Gregory Mundis, Themistocles Protopsaltis, Munish O. Gupta, Eric Klineberg, Shay Bess, Virginie Lafage, Han Jo Kim
Summary: The study aimed to assess the impact of a short-term return to the operating room after adult cervical spine deformity surgery. The findings showed that reoperation within 1 year did not have any influence on the radiographic outcomes or health-related quality of life at 1 year.
Article
Clinical Neurology
Shay Bess, Breton Line, Christopher Ames, Douglas Burton, Gregory Mundis, Robert Eastlack, Robert Hart, Munish Gupta, Eric Klineberg, Han Jo Kim, Richard Hostin, Khaled Kebaish, Virgine Lafage, Renaud Lafage, Frank Schwab, Christopher Shaffrey, Justin S. Smith, International Spine Study Grp
Summary: The study aimed to evaluate whether patients who underwent adult spinal deformity surgery would choose to undergo the same surgery again and to compare the opinions of patients and surgeons. The study found that 18.6% of patients were unsure or unwilling to undergo the surgery again. Patients who were unwilling to undergo the surgery again had preoperative depression, higher preoperative opioid use, worse postoperative patient reported outcomes, more complications requiring surgery, and higher postoperative opioid use. More research is needed to understand patient expectations and improve patient experiences following ASD surgery.
Article
Clinical Neurology
Ayman Assi, Guillaume Rebeyrat, Rami El Rachkidi, Karl Semaan, Eddy Saad, Elio Mekhael, Nabil Nassim, Abir Massaad, Virginie Lafage, Ismat Ghanem, Helene Pillet, Wafa Skalli
Summary: This study aimed to investigate the relationship between pelvic retroversion and increased hip loading in adults with spinal deformity. The findings showed that patients with pelvic retroversion exhibited more severe postural malalignment in both static and dynamic conditions, along with increased acetabular anteversion, external coverage, and decreased anterior coverage during gait. These changes in acetabular orientation were found to be associated with hip osteoarthritis.
Article
Clinical Neurology
Peter G. Passias, Tyler K. Williamson, Nicholas A. Kummer, Ferran Pellise, Virginie Lafage, Renaud Lafage, Miguel Serra-Burriel, Justin S. Smith, Breton Line, Shaleen Vira, Jeffrey L. Gum, Sleiman Haddad, Francisco Javier Sanchez Perez-Grueso, Andrew J. Schoenfeld, Alan H. Daniels, Dean Chou, Eric O. Klineberg, Munish C. Gupta, Khaled M. Kebaish, Michael P. Kelly, Robert A. Hart, Douglas C. Burton, Frank Kleinstueck, Ibrahim Obeid, Christopher I. Shaffrey, Ahmet Alanay, Christopher P. Ames, Frank J. Schwab, Richard A. Hostin, Shay Bess
Summary: This study evaluated the cost-utility of adverse events in spinal deformity surgery and found that patient-specific and surgical risk factors significantly impact surgical costs and cost-utility. Efforts to minimize surgical risk and optimize patient physiology could lead to reduced healthcare expenditures and improved cost-utility profile for spinal deformity interventions.
GLOBAL SPINE JOURNAL
(2023)
Article
Clinical Neurology
Justin S. Smith, Michael P. Kelly, Thomas J. Buell, David Ben-Israel, Bassel Diebo, Justin K. Scheer, Breton Line, Virginie Lafage, Renaud Lafage, Eric Klineberg, Han Jo Kim, Peter Passias, Jeffrey L. Gum, Khal Kebaish, Jeffrey P. Mullin, Robert Eastlack, Alan Daniels, Alex Soroceanu, Gregory Mundis, Richard Hostin, Themistocles S. Protopsaltis, D. Kojo Hamilton, Munish Gupta, Stephen J. Lewis, Frank J. Schwab, Lawrence G. Lenke, Christopher I. Shaffrey, Douglas Burton, Christopher P. Ames, Shay Bess
Summary: Compared with ATLD patients, ACD patients had worse baseline characteristics on all measures assessed (comorbidities/disability/frailty). These differences may help account for greater risk of complications and all-cause mortality previously observed in ACD patients and facilitate strategies for better preoperative optimization.
GLOBAL SPINE JOURNAL
(2023)