PMID- 34114020
OWN - NLM
STAT- MEDLINE
DCOM- 20211004
LR  - 20211004
IS  - 2332-4260 (Electronic)
IS  - 2332-4252 (Linking)
VI  - 21
IP  - 3
DP  - 2021 Aug 16
TI  - Outcomes of Surgical Treatment for 138 Patients With Severe Sagittal Deformity at 
      a Minimum 2-Year Follow-up: A Case Series.
PG  - 94-103
LID - 10.1093/ons/opab153 [doi]
AB  - BACKGROUND: Operative treatment of adult spinal deformity (ASD) can be very 
      challenging with high complication rates. It is well established that patients 
      benefit from such treatment; however, the surgical outcomes for patients with 
      severe sagittal deformity have not been reported. OBJECTIVE: To report the 
      outcomes of patients undergoing surgical correction for severe sagittal 
      deformity. METHODS: Retrospective review of a prospective, multicenter ASD 
      database. Inclusion criteria: operative patients age >/=18, sagittal vertical axis 
      (SVA) >/=15 cm, mismatch between pelvic incidence and lumbar lordosis (PI-LL) >/=30 degrees , 
      and/or lumbar kyphosis >/=5 degrees  with minimum 2 yr follow-up. Health-related quality of 
      life (HRQOL) scores including minimal clinically important difference 
      (MCID)/substantial clinical benefit (SCB), sagittal and coronal radiographic 
      values, demographic, frailty, surgical, and complication data were collected. 
      Comparisons between 2 yr postoperative and baseline HRQOL/radiographic data were 
      made. P < .05 was significant. RESULTS: A total of 138 patients were included 
      from 502 operative patients (54.3% Female, Average (Avg) age 63.3 +/- 11.5 yr). Avg 
      operating room (OR) time 386.2 +/- 136.5 min, estimated blood loss (EBL) 
      1829.8 +/- 1474.6 cc. A total of 71(51.4%) had prior fusion. A total of 89.9% were 
      posterior fusion only. Mean posterior levels fused 11.5 +/- 4.1. A total of 44.9% 
      had a 3-column osteotomy. All 2 yr postoperative radiographic parameters were 
      significantly improved compared to baseline (P < .001 for all). All 2yr HRQOL 
      measures were significantly improved compared to baseline (P < .004 for all). A 
      total of 46.6% to 73.8% of patients met either MCID/SCB for all HRQOL. A total of 
      74.6% of patients had at least 1 complication, 11.6% had 4 or more complications, 
      33.3% had minimum 1 major complication, and 42(30.4%) had a postop revision. 
      CONCLUSION: Patients with severe sagittal malalignment benefit from surgical 
      correction at 2 yr postoperative both radiographically and clinically despite 
      having a high complication rate.
CI  - (c) Congress of Neurological Surgeons 2021.
FAU - Scheer, Justin K
AU  - Scheer JK
AD  - Department of Neurological Surgery, University of California, San Francisco, San 
      Francisco, California, USA.
FAU - Lenke, Lawrence G
AU  - Lenke LG
AD  - The Och Spine Hospital at New York-Presbyterian, Columbia University Department 
      of Orthopaedic Surgery, New York, New York, USA.
FAU - Smith, Justin S
AU  - Smith JS
AD  - Department of Neurosurgery, University of Virginia Health System, 
      Charlottesville, Virginia, USA.
FAU - Lau, Darryl
AU  - Lau D
AD  - Department of Neurological Surgery, University of California, San Francisco, San 
      Francisco, California, USA.
FAU - Passias, Peter G
AU  - Passias PG
AD  - Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New 
      York, USA.
FAU - Kim, Han Jo
AU  - Kim HJ
AD  - Department of Orthopaedic Surgery, Hospital for Special Surgery, New York City, 
      New York, USA.
FAU - Bess, Shay
AU  - Bess S
AD  - Presbyterian St. Lukes Medical Center, Denver, Colorado, USA.
FAU - Protopsaltis, Themistocles S
AU  - Protopsaltis TS
AD  - Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New 
      York, USA.
FAU - Burton, Douglas C
AU  - Burton DC
AD  - Department of Orthopaedic Surgery, University of Kansas Medical Center, Kansas 
      City, Kansas, USA.
FAU - Klineberg, Eric O
AU  - Klineberg EO
AD  - Department of Orthopaedic Surgery, University of California, Davis, Davis, 
      California, USA.
FAU - Lafage, Virginie
AU  - Lafage V
AD  - Department of Orthopaedic Surgery, Hospital for Special Surgery, New York City, 
      New York, USA.
FAU - Schwab, Frank
AU  - Schwab F
AD  - Department of Orthopaedic Surgery, Hospital for Special Surgery, New York City, 
      New York, USA.
FAU - Shaffrey, Christopher I
AU  - Shaffrey CI
AD  - Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, USA.
FAU - Ames, Christopher P
AU  - Ames CP
AD  - Department of Neurological Surgery, University of California, San Francisco, San 
      Francisco, California, USA.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Oper Neurosurg (Hagerstown)
JT  - Operative neurosurgery (Hagerstown, Md.)
JID - 101635417
SB  - IM
CIN - Oper Neurosurg (Hagerstown). 2021 Aug 16;21(3):E176-E177. PMID: 34114028
MH  - Adult
MH  - Aged
MH  - Female
MH  - Humans
MH  - *Lordosis/diagnostic imaging/surgery
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Quality of Life
MH  - Retrospective Studies
MH  - *Spinal Fusion
OTO - NOTNLM
OT  - Adult spinal deformity
OT  - Complications
OT  - MCID
OT  - Outcomes
OT  - SCB
OT  - Sagittal malalignment
OT  - Severe
EDAT- 2021/06/12 06:00
MHDA- 2021/10/05 06:00
CRDT- 2021/06/11 06:55
PHST- 2020/10/08 00:00 [received]
PHST- 2021/03/15 00:00 [accepted]
PHST- 2021/06/12 06:00 [pubmed]
PHST- 2021/10/05 06:00 [medline]
PHST- 2021/06/11 06:55 [entrez]
AID - 6296079 [pii]
AID - 10.1093/ons/opab153 [doi]
PST - ppublish
SO  - Oper Neurosurg (Hagerstown). 2021 Aug 16;21(3):94-103. doi: 10.1093/ons/opab153.