Browsing by Author "Mummaneni, PV"
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Item Open Access Evolving concepts in pelvic fixation in adult spinal deformity surgery(Seminars in Spine Surgery, 2023-01-01) Turner, JD; Schupper, AJ; Mummaneni, PV; Uribe, JS; Eastlack, RK; Mundis, GM; Passias, PG; DiDomenico, JD; Harrison Farber, S; Soliman, MAR; Shaffrey, CI; Klineberg, EO; Daniels, AH; Buell, TJ; Burton, DC; Gum, JL; Lenke, LG; Bess, S; Mullin, JPLong-segment adult spinal deformity (ASD) constructs carry a high risk of mechanical complications. Pelvic fixation was introduced to improve distal construct mechanics and has since become the standard for long constructs spanning the lumbosacral junction. Pelvic fixation strategies have evolved substantially over the years. Numerous techniques now use a variety of entry points, screw trajectories, and construct configurations. We review the various strategies for pelvic fixation in ASD in a systematic review of the literature and update the techniques employed in the International Spine Study Group Complex Adult Deformity Surgery database.Item Open Access Expanding lateral access spine surgery(Neurosurgical Focus: Video, 2022-07-01) Snyder, LA; Erickson, M; Smith, JS; Mummaneni, PVItem Open Access Radiographic outcomes of adult spinal deformity correction: A critical analysis of variability and failures across deformity patterns(Spine Deformity, 2014-01-01) Moal, B; Schwab, F; Ames, CP; Smith, JS; Ryan, D; Mummaneni, PV; Mundis, GM; Terran, JS; Klineberg, E; Hart, RA; Boachie-Adjei, O; Shaffrey, CI; Skalli, W; Lafage, VStudy Design Multicenter, prospective, consecutive, surgical case series from the International Spine Study Group. Objectives To evaluate the effectiveness of surgical treatment in restoring spinopelvic (SP) alignment. Summary of Background Data Pain and disability in the setting of adult spinal deformity have been correlated with global coronal alignment (GCA), sagittal vertical axis (SVA), pelvic incidence/lumbar lordosis mismatch (PI-LL), and pelvic tilt (PT). One of the main goals of surgery for adult spinal deformity is to correct these parameters to restore harmonious SP alignment. Methods Inclusion criteria were operative patients (age greater than 18 years) with baseline (BL) and 1-year full-length X-rays. Thoracic and thoracolumbar Cobb angle and previous mentioned parameters were calculated. Each parameter at BL and 1 year was categorized as either pathological or normal. Pathologic limits were: Cobb greater than 30°, GCA greater than 40 mm, SVA greater than 40 mm, PI-LL greater than 10°, and PT greater than 20°. According to thresholds, corrected or worsened alignment groups of patients were identified and overall radiographic effectiveness of procedure was evaluated by combining the results from the coronal and sagittal planes. Results A total of 161 patients (age, 55 ± 15 years) were included. At BL, 80% of patients had a Cobb angle greater than 30°, 25% had a GCA greater than 40 mm, and 42% to 58% had a pathological sagittal parameter of PI-LL, SVA, and/or PT. Sagittal deformity was corrected in about 50% of cases for patients with pathological SVA or PI-LL, whereas PT was most commonly worsened (24%) and least often corrected (24%). Only 23% of patients experienced complete radiographic correction of the deformity. Conclusions The frequency of inadequate SP correction was high. Pelvic tilt was the parameter least likely to be well corrected. The high rate of SP alignment failure emphasizes the need for better preoperative planning and intraoperative imaging. © 2014 Scoliosis Research Society.Item Open Access “Selection, planning and execution of minimally invasive surgery in adult spinal deformity correction”(Seminars in Spine Surgery, 2023-01-01) Alan, N; Uribe, JS; Turner, JD; Park, P; Anand, N; Eastlack, RK; Okonkwo, DO; Le, VP; Nunley, P; Mundis, GM; Passias, PG; Chou, D; Kanter, AS; Fu, KMG; Wang, MY; Fessler, RG; Shaffrey, CI; Bess, S; Mummaneni, PVMinimally invasive surgery (MIS) for correction of adult spinal deformity was developed to address the high rate of medical and surgical complications rate in open surgical treatment of increasingly aging and frail patient population. In the past decade, MIS group within the International Spine Study Group (ISSG) has been in the forefront of the application of MIS techniques to fulfill the well-established principles of ASD surgery. These efforts have resulted in landmark studies. Here, we review these studies that encompass all aspects of MIS surgical treatment of ASD including patient selection with Minimally Invasive Spinal Deformity Surgery (MISDEF) and MISDEF-2 algorithms, surgical planning with anterior column realignment classification and the Minimally Invasive Interbody Selection Algorithm (MIISA), and surgical execution with Spinal Deformity Complexity Checklist (SDCC). We will highlight that with careful selection, diligent planning and meticulous execution the MIS techniques can treat patients with ASD, abiding to correction principles and radiographic parameters.