scholarly journals The effect of upper instrumented vertebra level (T9 vs T10) on radiologic and functional outcomes in the surgical treatment of adult spinal deformity in osteoporotic patients over 60 years of age

2021 ◽  
Vol 1 ◽  
pp. 100134
Author(s):  
Sina Coskun ◽  
Sinan Kahraman ◽  
Mustafa Eltayep ◽  
Recep Dincer ◽  
Ahmet Ates ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Spinal Deformity ◽  
Functional Outcomes ◽  
Adult Spinal Deformity ◽  
Upper Instrumented Vertebra

Primary versus Revision Surgery: Multicenter Analysis of Clinical and Functional Outcomes Following Surgery for Adult Spinal Deformity

2012 ◽  
Vol 12 (9) ◽  
pp. S39-S40
Author(s):  
Khaled M. Kebaish ◽  
Eric O. Klineberg ◽  
Mostafa H. El Dafrawy ◽  
Christopher P. Ames ◽  
R. Shay Bess ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Revision Surgery ◽  
Functional Outcomes ◽  
Adult Spinal Deformity ◽  
Multicenter Analysis

Total hospital costs of surgical treatment for adult spinal deformity: an extended follow-up study

2014 ◽  
Vol 14 (10) ◽  
pp. 2326-2333 ◽  
Author(s):  
Ian M. McCarthy ◽  
Richard A. Hostin ◽  
Christopher P. Ames ◽  
Han J. Kim ◽  
Justin S. Smith ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Hospital Costs ◽  
Total Hospital ◽  
Follow Up Study

The Cost of Implants in the Surgical Treatment of Adult Spinal Deformity (ASD)

2013 ◽  
Vol 13 (9) ◽  
pp. S108
Author(s):  
Ian McCarthy ◽  
Michael O’Brien ◽  
Elaheh Naseri ◽  
Erin McCullough ◽  
Christopher P. Ames ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
The Cost

scholarly journals Upper instrumented vertebra–femoral angle and correlation with proximal junctional kyphosis in adult spinal deformity

2021 ◽  
Author(s):  
Hao-Hua Wu ◽  
Dean Chou ◽  
Kevork Hindoyan ◽  
Jeremy Guinn ◽  
Joshua Rivera ◽  
...  
Keyword(s):  
Femoral Head ◽  
Spinal Deformity ◽  
Lumbar Lordosis ◽  
Adult Spinal Deformity ◽  
Surgical Correction ◽  
Proximal Junctional Kyphosis ◽  
Upper Instrumented Vertebra ◽  
Femoral Head Center ◽  
Junctional Kyphosis

Abstract Introduction Although matching lumbar lordosis (LL) with pelvic incidence (PI) is an important surgical goal for adult spinal deformity (ASD), there is concern that overcorrection may lead to proximal junctional kyphosis (PJK). We introduce the upper instrumented vertebra–femoral angle (UIVFA) as a measure of appropriate postoperative position in the setting of lower thoracic to pelvis surgical correction for patients with sagittal imbalance. We hypothesize that a more posterior UIV position in relation to the center of the femoral head is associated with an increased risk of PJK given compensatory hyperkyphosis above the UIV. Methods In this retrospective cohort study, adult patients undergoing lower thoracic (T9–T12) to pelvis correction of ASD with a minimum of 2-year follow-up were included. UIVFA was measured as the angle subtended by a line from the UIV centroid to the femoral head center to the vertical axis. Patients who developed PJK and those who did not were compared with preoperative and postoperative UIVFA as well as change between postoperative and preoperative UIVFA (deltaUIVFA). Results Of 119 patients included with an average 3.6-year follow-up, 51 (42.9%) had PJK and 24 (20.2%) had PJF. Patients with PJK had significantly higher postoperative UIVFA (12.6 ± 4.8° vs. 9.4 ± 6.6°, p = 0.04), deltaUIVFA (6.1 ± 7.6° vs. 2.1 ± 5.6°, p < 0.01), postoperative pelvic tilt (27.3 ± 9.2 vs. 23.3 ± 11, p = 0.04), postoperative lumbar lordosis (47.7 ± 13.9° vs. 42.4 ± 13.1, p = 0.04) and postoperative thoracic kyphosis (44.9 ± 13.2 vs. 31.6 ± 18.8) than patients without PJK. With multivariate logistic regression, postoperative UIVFA and deltaUIVFA were found to be independent risk factors for PJK (p < 0.05). DeltaUIVFA was found to be an independent risk factor for PJF (p < 0.05). A receiver operating characteristic (ROC) curve for UIVFA as a predictor for PJK was established with an area under the curve of 0.67 (95% CI 0.59–0.76). Per the Youden index, the optimal UIVFA cut-off value is 11.5 degrees. Conclusion The more posterior the UIV is from the femoral head center after lower thoracic to pelvis surgical correction for ASD, the more patients are at risk for PJK. The greater the magnitude of posterior translation of the UIV from the femoral head center from preop to postop, the greater the likelihood for PJF.

scholarly journals Health insurance policy on surgical treatment of adult spinal deformity

2021 ◽  
Vol 64 (11) ◽  
pp. 722-726
Author(s):  
Ho-Joong Kim
Keyword(s):  
Health Insurance ◽  
Surgical Treatment ◽  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Surgical Indication ◽  
Surgical Results ◽  
Proximal Junctional Kyphosis ◽  
Scoliosis Research Society ◽  
Spinal Sagittal Alignment ◽  
Junctional Kyphosis

Background: Recent burgeoning research on adult spinal deformity (ASD) has unveiled the benefits of surgical treatment and how to gain the benefits although these have only been around for 10 years.Current Concepts: During the last decade, the significance of pelvic incidence in the global spinal sagittal alignment and introductions of the Scoliosis Research Society-Schwab classification for ASD have been the guidelines of surgical treatment for ASD and the milestones for promising surgical results. However, one of the unsolved problems for the surgical treatment of ASD is the proximal junctional kyphosis, for which multifactorial causative factors have been suggested. Recent studies have focused on dynamic natures in patients with ASD during daily activities, which might be a clue for both prevention of proximal junctional kyphosis and a better level of surgical results. Even though a recent remarkable advancement for surgical treatment for ASD is present, the national guideline for reimbursement is still following the surgical indication for lumbar degenerative kyphosis published in 1988.Discussion and Conclusion: A significant gap exists between the national reimbursement guideline and generally held surgical indication for ASD surgery. Consequently, this huge gap raises trouble in both patients and surgeons. The patients with ASD cannot take an appropriate surgery for ASD, while the spine surgeons experience unreasonable adjustment of the cost by the Health Insurance Review and Assessment Service.

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