Validity of the Roussouly classification system for assessing distal junctional problems after long instrumented spinal fusion in degenerative scoliosis

2022 ◽  
Author(s):  
Hanwen Zhang ◽  
Yong Hai ◽  
Xianglong Meng ◽  
Xinuo Zhang ◽  
Tinghua Jiang ◽  
...  
Keyword(s):  
Spinal Fusion ◽  
Classification System ◽  
Degenerative Scoliosis ◽  
Roussouly Classification

Moderate Interrater and Substantial Intrarater Reproducibility of the Roussouly Classification System in Patients With Adult Spinal Deformity

2019 ◽  
Vol 7 (2) ◽  
pp. 312-318 ◽  
Author(s):  
Tanvir Johanning Bari ◽  
Dennis Winge Hallager ◽  
Niklas Tøndevold ◽  
Ture Karbo ◽  
Lars Valentin Hansen ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Classification System ◽  
Adult Spinal Deformity ◽  
Roussouly Classification

Impact of Obesity on Complications and Surgical Outcomes of Adult Degenerative Scoliosis with Long- Segment Spinal Fusion

2022 ◽  
Author(s):  
Truong Van Tri ◽  
Sunna Tarek ◽  
Al-Shakfa Fidaa ◽  
MC Graw Maude ◽  
Boubez Ghassan ◽  
...  
Keyword(s):  
Spinal Fusion ◽  
Surgical Outcomes ◽  
Degenerative Scoliosis ◽  
Adult Degenerative Scoliosis

Adult degenerative scoliosis: evaluation and management

2010 ◽  
Vol 28 (3) ◽  
pp. E1 ◽  
Author(s):  
Fernando E. Silva ◽  
Lawrence G. Lenke
Keyword(s):  
Spinal Fusion ◽  
Mechanical Stability ◽  
Treatment Options ◽  
Posterior Spinal Fusion ◽  
Clinical Analysis ◽  
Complication Rates ◽  
Degenerative Scoliosis ◽  
Anterior Spinal Fusion ◽  
Adult Degenerative Scoliosis

Degenerative scoliosis is a prevalent issue among the aging population. Controversy remains over the role of surgical intervention in patients with this disease. The authors discuss a suitable approach to help guide surgical treatment, including decompression, instrumented posterior spinal fusion, anterior spinal fusion, and osteotomy. These treatment options are based on clinical analysis, radiographic analysis of the mechanical stability of the deformity, given pain generators, and necessary sagittal balance. The high potential complication rates appear to be outweighed by the eventual successful clinical outcomes in patients suitable for operative intervention. This approach has had favorable outcomes and could help resolve the controversy.

scholarly journals Individual Lordotic Cages Implantation and Radiographic Evaluation of Segmental and Lumbar Lordosis Correction for Patients with Adult Degenerative Scoliosis

2020 ◽  
Vol 26 (2) ◽  
pp. 71-78
Author(s):  
A. A. Denisov ◽  
D. A. Ptashnikov ◽  
D. A. Mikhaylov ◽  
S. V. Masevnin ◽  
O. A. Smekalenkov ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Spinal Fusion ◽  
Lumbar Lordosis ◽  
Radiographic Evaluation ◽  
Posterior Fixation ◽  
Degenerative Scoliosis ◽  
Custom Made ◽  
Intergroup Comparison ◽  
Significant Difference ◽  
Indirect Decompression

Relevance. The development of minimally invasive surgery has led to the development of new methods for surgical treatment of the spine. Conventional surgical technique, such as vertebrotomy is accompanied by a several number of disadvantages (high blood loss, prolonged hospital stay, long intraoperative time, postoperative neurological deficit). An alternative to improve sagittal balance in the spine is to use custom-made hyperlordotic cages, which can also be used for indirect decompression of neural structures. The objective is to compare the degree of segmental and total lumbar lordosis using hyperlordotic cages through ALIF and TLIF with posterior instrumentation.Materials and Methods. A single-center retrospective cohort study using 96 patients treated from 2018 to 2019 about degenerative spinal deformities. Comparison of two groups: group 1 (A) consisted of 30 patients who were held anterior spinal fusion with individual lordotic cages from minimally invasive anterior approach (MISS ALIF) without posterior fixation. Group 2 (B) consisted of 33 patients whom were performed spinal fusion from the posterior approach (TLIF) with Smith-Peterson Osteotomy (SPO) and transpedicular fixation. Measuring segmental and lumbar lordosis, teleradiographs were used in a standing position. For an accurate assessment, the non-commercial available Surgimap software, © Nemaris, was used.Results. Segmental lordosis were superior to preoperative ones. In the intergroup comparison, the ALIF group showed an excellent increase in the enlarged lordosis segment (L3-L4 in 8 degrees; p = 0.0005, L4-L5 in 7 degrees; p = 0.0002, L5-S1 in 7 degrees; p = 0.0001). When conducting an intergroup comparison of total lumbar lordosis in the preoperative period, there was a statistically significant difference between them (p = 0.0043). At the same time, a greater degree of correction of lordosis is shown in ALIF compared to TLIF group (29,1 in comparison with 22,5; p = 0.00005).Conclusion. The results of this study confirm that the using of custom-made lordotic cages can significantly increase segmental and total lumbar lordosis for patients with degenerative scoliosis in adults.

scholarly journals Which sagittal evaluation system can effectively predict mechanical complications in the treatment of elderly patients with adult degenerative scoliosis? Roussouly classification or Global Alignment and Proportion (GAP) Score

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xiangyao Sun ◽  
Wenzhi Sun ◽  
Siyuan Sun ◽  
Hailiang Hu ◽  
Sitao Zhang ◽  
...  
Keyword(s):  
Evaluation System ◽  
Treatment Strategies ◽  
Area Under The Curve ◽  
Global Alignment ◽  
Mechanical Complication ◽  
Degenerative Scoliosis ◽  
Evaluation Systems ◽  
Mechanical Complications ◽  
Adult Degenerative Scoliosis ◽  
Roussouly Classification

Abstract Background To achieve the proper sagittal alignment, previous studies have developed different assessment systems for adult degenerative scoliosis (ADS) which could help the spine surgeon in making treatment strategies. The purpose of our study is to evaluate whether Roussouly classification or global alignment and proportion (GAP) score is more appropriate in the prediction of mechanical complications after surgical treatment of ADS. Methods ADS patients who received long segmental fusion in the treatment during the period from December 2016 to December 2018 were evaluated in this study. Basic information and radiologic measurements were collected for analysis. Patients were divided into two groups according to occurrence or absence of mechanical complications for comparison. Mechanical complications included proximal junctional kyphosis (PJK), proximal junctional failure (PJF). GAP categories divided GAP score into proportioned spinopelvic position, moderately disproportioned position, and severely disproportioned position according to the cut-off values. The correlation between evaluation systems and mechanical complications was analyzed through a logistic regression model via stepwise backward elimination based on the Wald statistics. Receiver operator characteristic (ROC) curve was used to determine the predictability of the evaluation systems in the occurrence of mechanical complications and calculate their cut-off value. Area under the curve (AUC) was used to evaluate the validity of the thresholds. Results A total of 80 patients were included in this study. There were 41 patients in mechanical complication group and 39 patients in no mechanical complication group. GAP score (P = 0.008) and GAP categories (P = 0.007) were positively correlated with mechanical complications; Roussouly score was negatively correlated with mechanical complications (P = 0.034); GAP score was positively correlated with PJK (P = 0.021); Roussouly score was negatively correlated with implant-related complications (P = 0.018); GAP categories were correlated with implant loosening (P = 0.023). Results of ROC showed that GAP score was more effective in predicting PJK (AUC = 0.863) and PJF (AUC = 0.724) than Roussouly score; GAP categories (AUC = 0.561) was more effective than GAP score (AUC = 0.555) in predicting implant-related complications. Conclusions Roussouly classification could only be a rough estimate of optimal spinopelvic alignment. Quantitative parameters in GAP score made it more effective in predicting mechanical complications, PJK and PJF than Roussouly classification.

scholarly journals Use of Nitinol Rods in Surgical Treatment of Degenerative Scoliosis

2014 ◽  
Vol 21 (4) ◽  
pp. 38-42
Author(s):  
S. V Kolesov ◽  
V. V Shvets ◽  
D. A Kolobovskiy ◽  
A. I Kaz’min ◽  
N. S Morozova
Keyword(s):  
Spinal Fusion ◽  
Spinal Canal Stenosis ◽  
Degenerative Lumbar Scoliosis ◽  
X Rays ◽  
Adjacent Level ◽  
Degenerative Scoliosis ◽  
Group Mobility ◽  
Standard Methods ◽  
Canal Stenosis ◽  
Spine Mobility

Seventy two patients, aged 39 - 84 years, with degenerative lumbar scoliosis were operated on. In 30 patients (1 st group) nitinol rods 5.5 mm in diameter and standard transpedicular screws were used. In 20 patients fixation at L1 - S1 and in 10 patients at L1 - L5 level was performed. In presence of spinal canal stenosis additional decompression was performed. Spinal fusion was not performed. Forty two patients (2 nd group) were treated by standard methods using titanium rods in combination with lumbosacral spinal fusion. Out of them in 20 patients fixation at L1 - S1 and in 22 patients at L1 - L5 level was performed. Results were followed up in 1.5 years after intervention at minimum. Correction of the deformity in two groups was almost equal and averaged 25° (from 10° to 38°). No one case of implant instability, bone tissue resorption around the screws and adjacent level involvement was recorded. Functional X-rays showed 21° of lumbar spine mobility (from 15° to30°) at average. In 2 nd group mobility in fixed segment was absent; pseudarthrosis was diagnosed in 3 and proximal kyphosis - in 1 patient. Revision intervention was required in 2 cases.

International Research and Variation in Views of Ethnicity

2012 ◽  
Vol 2 (2) ◽  
pp. 66-72
Author(s):  
Ella Inglebret ◽  
Amy Skinder-Meredith ◽  
Shana Bailey ◽  
Carla Jones ◽  
Ashley France
Keyword(s):  
United States ◽  
Classification System ◽  
International Research ◽  
The United States ◽  
Research Articles ◽  
Journal Articles ◽  
Research Participants ◽  
The Past ◽  
International Scale ◽  
Publication Patterns

The authors in this article first identify the extent to which research articles published in three American Speech-Language-Hearing Association (ASHA) journals included participants, age birth to 18 years, from international backgrounds (i.e., residence outside of the United States), and go on to describe associated publication patterns over the past 12 years. These patterns then provide a context for examining variation in the conceptualization of ethnicity on an international scale. Further, the authors examine terminology and categories used by 11 countries where research participants resided. Each country uses a unique classification system. Thus, it can be expected that descriptions of the ethnic characteristics of international participants involved in research published in ASHA journal articles will widely vary.

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