Maintenance of radiographic correction at 2 years following lumbar pedicle subtraction osteotomy is superior with upper thoracic compared with thoracolumbar junction upper instrumented vertebra.
dc.contributor.author | Scheer, Justin K | |
dc.contributor.author | Lafage, Virginie | |
dc.contributor.author | Smith, Justin S | |
dc.contributor.author | Deviren, Vedat | |
dc.contributor.author | Hostin, Richard | |
dc.contributor.author | McCarthy, Ian M | |
dc.contributor.author | Mundis, Gregory M | |
dc.contributor.author | Burton, Douglas C | |
dc.contributor.author | Klineberg, Eric | |
dc.contributor.author | Gupta, Munish | |
dc.contributor.author | Kebaish, Khaled | |
dc.contributor.author | Shaffrey, Christopher I | |
dc.contributor.author | Bess, Shay | |
dc.contributor.author | Schwab, Frank | |
dc.contributor.author | Ames, Christopher P | |
dc.contributor.author | International Spine Study Group (ISSG) | |
dc.date.accessioned | 2023-08-29T22:30:32Z | |
dc.date.available | 2023-08-29T22:30:32Z | |
dc.date.issued | 2015-01 | |
dc.date.updated | 2023-08-29T22:30:31Z | |
dc.description.abstract | PurposeThe goal of this study was to characterize the spino-pelvic realignment and the maintenance of that realignment by the upper-most instrumented vertebra (UIV) for adult deformity spinal (ASD) patients treated with lumbar pedicle subtraction osteotomy (PSO).MethodsASD patients were divided by UIV, classified as upper thoracic (UT: T1-T6) or Thoracolumbar (TL: T9-L1). Complications were recorded and radiographic parameters included thoracic kyphosis (TK, T2-T12), lumbar lordosis (LL, L1-S1), sagittal vertical axis (SVA), pelvic tilt, and the mismatch between pelvic incidence and LL. Patients were also classified by the Scoliosis Research Society (SRS)-Schwab modifier grades. Changes in radiographic parameters and SRS-Schwab grades were evaluated between the two groups. Additional analyses were performed on patients with pre-operative SVA ≥ 15 cm.Results165 patients were included (UT: 81 and TL: 84); 124 women, 41 men, with average age 59.9 ± 11.1 years (range 25-81). UT had a lower percentage of patients above the radiographic thresholds for disability than TL. UT had a significantly higher percentage of patients that improved in SRS-Schwab global alignment grade than the TL group at 2 years. Within the patients with pre-operative SVA ≥ 15 cm, TL developed significantly increased SVA and had a significantly higher percentage of patients above the SVA threshold at 3 months, and 1 and 2 years than UT.ConclusionsPatients undergoing a single-level PSO for ASD who have fixation extending to the UT region (T1-T6) are more likely to maintain sagittal spino-pelvic alignment, lower overall revision rates and revision rate for proximal junctional kyphosis than those with fixation terminating in the TL region (T9-L1). | |
dc.identifier.issn | 0940-6719 | |
dc.identifier.issn | 1432-0932 | |
dc.identifier.uri | ||
dc.language | eng | |
dc.publisher | Springer Science and Business Media LLC | |
dc.relation.ispartof | European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society | |
dc.relation.isversionof | 10.1007/s00586-014-3391-y | |
dc.subject | International Spine Study Group (ISSG) | |
dc.subject | Lumbar Vertebrae | |
dc.subject | Thoracic Vertebrae | |
dc.subject | Humans | |
dc.subject | Spinal Curvatures | |
dc.subject | Radiography | |
dc.subject | Spinal Fusion | |
dc.subject | Osteotomy | |
dc.subject | Reoperation | |
dc.subject | Retrospective Studies | |
dc.subject | Follow-Up Studies | |
dc.subject | Adult | |
dc.subject | Aged | |
dc.subject | Aged, 80 and over | |
dc.subject | Middle Aged | |
dc.subject | Female | |
dc.subject | Male | |
dc.title | Maintenance of radiographic correction at 2 years following lumbar pedicle subtraction osteotomy is superior with upper thoracic compared with thoracolumbar junction upper instrumented vertebra. | |
dc.type | Journal article | |
duke.contributor.orcid | Shaffrey, Christopher I|0000-0001-9760-8386 | |
pubs.begin-page | S121 | |
pubs.end-page | S130 | |
pubs.issue | 1 | |
pubs.organisational-group | Duke | |
pubs.organisational-group | School of Medicine | |
pubs.organisational-group | Clinical Science Departments | |
pubs.organisational-group | Orthopaedic Surgery | |
pubs.organisational-group | Neurosurgery | |
pubs.publication-status | Published | |
pubs.volume | 24 Suppl 1 |
Files
Original bundle
- Name:
- Maintenance of radiographic correction at 2 years following lumbar pedicle subtraction osteotomy is superior with upper thoracic compared with thoracolumbar junction upper instrumented vertebra..pdf
- Size:
- 640.37 KB
- Format:
- Adobe Portable Document Format