PMID- 32059971
OWN - NLM
STAT- MEDLINE
DCOM- 20200817
LR  - 20200817
IS  - 1878-8769 (Electronic)
IS  - 1878-8750 (Linking)
VI  - 137
DP  - 2020 May
TI  - Minimally Invasive Spinal Deformity Surgery: Analysis of Patients Who Fail to 
      Reach Minimal Clinically Important Difference.
PG  - e499-e505
LID - S1878-8750(20)30290-4 [pii]
LID - 10.1016/j.wneu.2020.02.025 [doi]
AB  - BACKGROUND: It is well known that clinical improvements following surgical 
      intervention are variable. While all surgeons strive to maximize reliability and 
      degree of improvement, certain patients will fail to achieve meaningful gains. We 
      aim to analyze patients who failed to reach minimal clinically important 
      difference (MCID) in an effort to improve outcomes for minimally invasive 
      deformity surgery. METHODS: Data were collected on a multicenter registry of 
      minimally invasive surgery adult spinal deformity surgeries. Patient inclusion 
      criteria were age >/=18 years, coronal Cobb >/=20 degrees, pelvic incidence-lumbar 
      lordosis >/=10 degrees, or a sagittal vertical axis >5 cm. All patients had minimum 
      2 years' follow-up (N = 222). MCID was defined as 12.8 or more points of 
      improvement in the Oswestry Disability Index. Up to 2 different etiologies for 
      failure were allowed per patient. RESULTS: We identified 78 cases (35%) where the 
      patient failed to achieve MCID at long-term follow-up. A total of 82 identifiable 
      causes were seen in these patients with 14 patients having multiple causes. In 6 
      patients, the etiology was unclear. The causes were subclassified as neurologic, 
      medical, structural, under treatment, degenerative progression, traumatic, 
      idiopathic, and floor effects. In 71% of cases, an identifiable cause was related 
      to the spine, whereas in 35% the cause was not related to the spine. CONCLUSIONS: 
      Definable causes of failed MIS ASD surgery are often identifiable and similar to 
      open surgery. In some cases the cause is treatable and structural. However, it is 
      also common to see failure due to pathologies unrelated to the index surgery.
CI  - Copyright (c) 2020. Published by Elsevier Inc.
FAU - Wang, Michael Y
AU  - Wang MY
AD  - Department of Neurological Surgery, University of Miami Miller School of 
      Medicine, Miami, Florida, USA. Electronic address: MWang2@med.miami.edu.
FAU - Uribe, Juan
AU  - Uribe J
AD  - Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
FAU - Mummaneni, Praveen V
AU  - Mummaneni PV
AD  - Department of Neurological Surgery, University of California, San Francisco, 
      California, USA.
FAU - Tran, Stacie
AU  - Tran S
AD  - Department of Orthopedic Surgery, San Diego Center for Spinal Disorders, La 
      Jolla, USA.
FAU - Brusko, G Damian
AU  - Brusko GD
AD  - Department of Neurological Surgery, University of Miami Miller School of 
      Medicine, Miami, Florida, USA.
FAU - Park, Paul
AU  - Park P
AD  - Department of Neurological Surgery, University of Michigan, Ann Arbor, Michigan, 
      USA.
FAU - Nunley, Pierce
AU  - Nunley P
AD  - Department of Orthopedic Surgery, Spine Institute of Louisiana, Shreveport, 
      Louisiana, USA.
FAU - Kanter, Adam
AU  - Kanter A
AD  - Department of Neurological Surgery, University of Pittsburgh Medical Center, 
      Pittsburgh, Pennsylvania, USA.
FAU - Okonkwo, David
AU  - Okonkwo D
AD  - Department of Neurological Surgery, University of Pittsburgh Medical Center, 
      Pittsburgh, Pennsylvania, USA.
FAU - Anand, Neel
AU  - Anand N
AD  - Department of Orthopedic Surgery, Cedars Sinai Hospital, Los Angeles, California, 
      USA.
FAU - Chou, Dean
AU  - Chou D
AD  - Department of Neurological Surgery, University of California, San Francisco, 
      California, USA.
FAU - Shaffrey, Christopher I
AU  - Shaffrey CI
AD  - Department of Neurological Surgery, Duke University, Durham, North Carolina, USA.
FAU - Fu, Kai-Ming
AU  - Fu KM
AD  - Department of Orthopedic Surgery, Weill Cornell Medical College, New York, New 
      York, USA.
FAU - Mundis, Gregory M Jr
AU  - Mundis GM Jr
AD  - Department of Orthopedic Surgery, Scripps Clinic Torrey Pines, La Jolla, USA.
FAU - Eastlack, Robert
AU  - Eastlack R
AD  - Department of Neurological Surgery, Scripps Clinic Torrey Pines, La Jolla, USA.
CN  - Minimally Invasive Surgery-International Spine Study Group
LA  - eng
PT  - Journal Article
DEP - 20200212
PL  - United States
TA  - World Neurosurg
JT  - World neurosurgery
JID - 101528275
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Humans
MH  - Lordosis/*surgery
MH  - Male
MH  - Middle Aged
MH  - Minimal Clinically Important Difference
MH  - *Minimally Invasive Surgical Procedures
MH  - Patient Reported Outcome Measures
MH  - Quality of Life
MH  - Registries
MH  - Reproducibility of Results
MH  - Retrospective Studies
MH  - Scoliosis/*surgery
MH  - *Spinal Fusion
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - Minimal clinically important difference
OT  - Minimally invasive
OT  - Patient-reported outcome measures
OT  - Percutaneous
OT  - Scoliosis
OT  - Spinal deformity
EDAT- 2020/02/16 06:00
MHDA- 2020/08/18 06:00
CRDT- 2020/02/16 06:00
PHST- 2019/11/02 00:00 [received]
PHST- 2020/02/03 00:00 [revised]
PHST- 2020/02/04 00:00 [accepted]
PHST- 2020/02/16 06:00 [pubmed]
PHST- 2020/08/18 06:00 [medline]
PHST- 2020/02/16 06:00 [entrez]
AID - S1878-8750(20)30290-4 [pii]
AID - 10.1016/j.wneu.2020.02.025 [doi]
PST - ppublish
SO  - World Neurosurg. 2020 May;137:e499-e505. doi: 10.1016/j.wneu.2020.02.025. Epub 
      2020 Feb 12.