scholarly journals ADAPTATION OF THE FRAILTY INDEX FOR BRAZILIAN PORTUGUESE IN ADULT SPINE DEFORMITY SURGERY

2020 ◽  
Vol 19 (3) ◽  
pp. 168-171
Author(s):  
RAPHAEL R PRATALI ◽  
CARLOS F W E ROMERIO ◽  
MURILO T DAHER ◽  
RODRIGO AMARAL ◽  
IGOR M CARDOSO ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Frailty Index ◽  
Brazilian Population ◽  
Original Version ◽  
Consensus Building ◽  
Spine Deformity ◽  
Level Of Evidence ◽  
New Variables ◽  
Adult Spine

ABSTRACT Objectives To adapt the adult spinal deformity frailty index (ASD-FI), which was presented as an instrument for stratification of risk of surgical complications, for application in the Brazilian population. Methods This is a consensus-building study, following the Delphi method, in which a team of six Brazilian spine surgery specialists worked alongside the International Spine Study Group (ISSG), the group responsible for preparing the original version of the ASD-FI, in order to adapt the index for the Brazilian population. The variables to be included in the new version, as well as the translation of the terminology into Portuguese, were evaluated and a consensus was considered to have been reached when all (100%) of the Brazilian experts were in agreement. Results A version of the ASD-FI was created, composed of 42 variables, with the inclusion of two new variables that were not included in the original version. The new version was then back translated into English and approved by the ISSG members, resulting in the adapted version of the ASD-FI for the Brazilian population. Conclusion This study presents an adapted version of the adult spinal deformity frailty index for the Brazilian population, for the purpose of risk stratification in the surgical treatment of these complex deformities. Level of evidence II; Study of adaptation of a valid score.

scholarly journals STANDARDIZED TERMINOLOGY OF ADULT SPINE DEFORMITY FOR BRAZILIAN PORTUGUESE

2015 ◽  
Vol 14 (4) ◽  
pp. 281-285 ◽  
Author(s):  
Raphael de Rezende Pratali ◽  
Sergio Afonso Hennemann ◽  
Rodrigo Amaral ◽  
Luis Eduardo Carelli Teixeira da Silva ◽  
Marcio Oliveira Penna de Carvalho ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Delphi Method ◽  
Adult Spinal Deformity ◽  
Brazilian Portuguese ◽  
Spine Deformity ◽  
Electronic Questionnaire ◽  
Standard Terminology ◽  
Standardized Terminology ◽  
Adult Spine ◽  
Simultaneous Translation

Objective : To develop a consensus for translation of the most relevant terms used in the study of Adult Spinal Deformity, from their original languages into Brazilian Portuguese. Methods : A panel of 12 experts in spine surgery from the five Brazilian regions was constituted. To obtain the standardization of terminology, the Delphi method with an electronic questionnaire was administered to participants about their opinion on the translation of 13 relevant terms chosen by literature review. Each term was considered standard when there was consensus, that is, concordance higher than 80% among participants as to the suggestion to be adopted, and then on the acceptance of the term and its abbreviation in Portuguese. Results : Initially there was consensus (over 80% concordance) on the translation of seven terms in the electronic questionnaire. The other six terms that have not reached consensus were discussed at a meeting among the participants, relying on the opinion of a specialized professional in simultaneous translation of orthopedic terms in Portuguese and other professional majored in Portuguese language. It was decided how these terms should be translated and there was a consensus among all participants regarding their acceptance. Finally, there was consensus among the participants, who agreed with the translation and abbreviation of the 13 propose terms, defining its standardization for Brazilian Portuguese. Conclusion : We present a standard terminology used in the study of Adult Spinal Deformity through consensus among experts, seeking uniformity in the use of these terms in Brazilian Portuguese.

scholarly journals BIPLANAR IMAGING WITH TRIDIMENSIONAL CAPABILITIES: APPLICABILITY OF THIS NEW EXAMINATION TO SPINAL DEFORMITIES

2020 ◽  
Vol 19 (1) ◽  
pp. 67-70
Author(s):  
RAPHAEL DE REZENDE PRATALI ◽  
MURILO TAVARES DAHER ◽  
ROBERT MEVES
Keyword(s):  
Spinal Deformity ◽  
Imaging System ◽  
Adult Spinal Deformity ◽  
Three Dimensional ◽  
Entire Body ◽  
Spinal Deformities ◽  
Compensatory Mechanisms ◽  
Level Of Evidence ◽  
The Individual ◽  
Bone Structures

ABSTRACT This study presents details about the applicability of the new image acquisition system, called the biplanar imaging system, with three-dimensional capabilities (EOS®) to the treatment of spinal deformities. This system allows radiographic acquisition of the entire body, with a great reduction in the dose of radiation absorbed by the patient and three-dimensional (3D) stereoradiographic image reconstruction of bone structures, including the spine. In the case of adolescent idiopathic scoliosis, the analysis of the spinal deformity with 3D reconstruction allows better understanding of the deformity and surgical planning. In the case of adult spinal deformity, full-body analysis allows an evaluation of the spinopelvic deformity, including loss of sagittal alignment, in addition to an evaluation of compensatory mechanisms recruited by the individual in an attempt to maintain the sagittal balance. Level of evidence III; Descriptive Review.

Novel radiographic parameters for the assessment of total body sagittal alignment in adult spinal deformity patients

2019 ◽  
Vol 31 (3) ◽  
pp. 372-379 ◽  
Author(s):  
Yong-Chan Kim ◽  
Ji Hao Cui ◽  
Ki-Tack Kim ◽  
Gyu-Taek Park ◽  
Keun-Ho Lee ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Sagittal Alignment ◽  
Adult Spinal Deformity ◽  
Intraclass Correlation ◽  
Intraobserver Reliability ◽  
Distance Measures ◽  
Spine Deformity ◽  
Radiographic Parameters ◽  
Patient Reported ◽  
Total Body

OBJECTIVEIn this study, the authors’ goal was to develop and validate novel radiographic parameters that better describe total body sagittal alignment (TBSA).METHODSOne hundred sixty-six consecutive operative spinal deformity patients were evaluated using full-body stereoradiographic imaging. Seven TBSA parameters were measured and then correlated to 6 commonly used spinopelvic measurements. TBSA measures consisted of 4 distance measures relating the cranial center of mass (CCOM) to the sacrum, hips, knees, and ankles, and 3 angular measures relating the CCOM to the hips, knees, and ankles. Furthermore, each TBSA parameter was correlated to patient-reported outcome (PRO) scores using the Oswestry Disability Index (ODI) and Scoliosis Research Society–22 (SRS-22) instruments. Thirty patients were randomly selected for inter- and intraobserver reliability testing of the TBSA parameters using intraclass correlation coefficients (ICCs).RESULTSAll TBSA radiographic parameters demonstrated strong linear correlation with the currently accepted primary measure of sagittal balance, the C7 sagittal vertical axis (r = 0.55–0.96, p < 0.001). Moreover, 5 of 7 TBSA measures correlated strongly with ODI and SRS-22 total scores (r = 0.42–0.51, p < 0.001). Inter- and intraobserver reliability for all TBSA measures was good to excellent (interrater ICC = 0.70–0.98, intrarater ICC = 0.77–1.0).CONCLUSIONSIn spine deformity patients, novel TBSA radiographic parameters correlated well with PROs and with currently utilized spinal sagittal measurements. Inter- and intrarater reliability was high for these novel parameters. This is the first study to propose a reliable method for measuring head-to-toe global spinal alignment.

293. The modified adult spinal deformity frailty index (mASD-FI) is a good preoperative risk assessment tool

2020 ◽  
Vol 20 (9) ◽  
pp. S145-S146
Author(s):  
Katherine E. Pierce ◽  
Waleed Ahmad ◽  
Sara Naessig ◽  
Bassel G. Diebo ◽  
Peter G. Passias
Keyword(s):  
Risk Assessment ◽  
Spinal Deformity ◽  
Assessment Tool ◽  
Adult Spinal Deformity ◽  
Frailty Index ◽  
Risk Assessment Tool ◽  
Preoperative Risk ◽  
Preoperative Risk Assessment

Development and External Validation of the Adult Spine Deformity (ASD) Frailty Index (ASD-FI)

2016 ◽  
Vol 16 (10) ◽  
pp. S310-S311 ◽  
Author(s):  
Emily Miller ◽  
Daniel M. Sciubba ◽  
Brian J. Neuman ◽  
Justin S. Smith ◽  
Khaled M. Kebaish ◽  
...  
Keyword(s):  
Frailty Index ◽  
External Validation ◽  
Spine Deformity ◽  
Adult Spine Deformity ◽  
Adult Spine

scholarly journals A Simpler, Modified Frailty Index Weighted by Complication Occurrence Correlates to Pain and Disability for Adult Spinal Deformity Patients

10.14444/7154 ◽  
2020 ◽  
Vol 14 (6) ◽  
pp. 1031-1036
Author(s):  
PETER G. PASSIAS ◽  
COLE A. BORTZ ◽  
KATHERINE E. PIERCE ◽  
HADDY ALAS ◽  
AVERY BROWN ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Frailty Index ◽  
Modified Frailty Index

scholarly journals Cost-Effectiveness in Adult Spinal Deformity Surgery

Neurosurgery ◽  
2018 ◽  
Vol 83 (4) ◽  
pp. 597-601 ◽  
Author(s):  
Grigoriy G Arutyunyan ◽  
Peter D Angevine ◽  
Sigurd Berven
Keyword(s):  
Cost Effectiveness ◽  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Cost Effective ◽  
Treatment Method ◽  
Quality Adjusted Life Year ◽  
Cost Utility ◽  
Spine Deformity ◽  
Healthcare Provision ◽  
Economic Analyses

Abstract The complexity and heterogeneity of adult spinal deformity (ASD) creates significant difficulties in performing high-quality, complete economic analyses. For the same reasons, however, such studies are immensely valuable to clinicians and health policy experts. There has been a paradigm shift towards value-based healthcare provision and as such, there is an increasing focus on demonstrating not just the value ASD surgery, but the provision of care at large. Health-related quality of life measures are an important tool for assessing value of an intervention and its effect on a quality-adjusted life year (QALY). Currently, there are no definitive criteria in regard to assigning the appropriate value to a QALY. A general accepted threshold discussed in literature is $100 000 per QALY gained. However, this figure may be variable across populations, and may not necessarily be applicable in today's economy, or in all healthcare economies. Fundamentally, an effective treatment method may be associated with a high upfront cost, however, if durable, will be cost-effective over time. The emphasis on cost-effectiveness and cost-utility analysis in the field of adult spine deformity is relatively recent; therefore, there is a limited amount of data on cost-effectiveness analyses. Continued efforts with emphasis on value-based outcomes are needed with long-term follow-up studies.

scholarly journals Male sex may not be associated with worse outcomes in primary all-posterior adult spinal deformity surgery: a multicenter analysis

2017 ◽  
Vol 43 (6) ◽  
pp. E9 ◽  
Author(s):  
David B. Bumpass ◽  
Lawrence G. Lenke ◽  
Jeffrey L. Gum ◽  
Christopher I. Shaffrey ◽  
Justin S. Smith ◽  
...  
Keyword(s):  
Sex Differences ◽  
Spinal Deformity ◽  
Operative Time ◽  
Adult Spinal Deformity ◽  
Deformity Correction ◽  
Spine Deformity ◽  
Complication Rates ◽  
Female Patients ◽  
Male Patients

OBJECTIVEAdolescent spine deformity studies have shown that male patients require longer surgery and have greater estimated blood loss (EBL) and complications compared with female patients. No studies exist to support this relationship in adult spinal deformity (ASD). The purpose of this study was to investigate associations between sex and complications, deformity correction, and health-related quality of life (HRQOL) in patients with ASD. It was hypothesized that male ASD patients would have greater EBL, longer surgery, and more complications than female ASD patients.METHODSA multicenter ASD cohort was retrospectively queried for patients who underwent primary posterior-only instrumented fusions with a minimum of 5 levels fused. The minimum follow-up was 2 years. Primary outcomes were EBL, operative time, intra-, peri-, and postoperative complications, radiographic correction, and HRQOL outcomes (Oswestry Disability Index, SF-36, and Scoliosis Research Society-22r Questionnaire). Poisson multivariate regression was used to control for age, comorbidities, and levels fused.RESULTSNinety male and 319 female patients met the inclusion criteria. Male patients had significantly greater mean EBL (2373 ml vs 1829 ml, p = 0.01). The mean operative time, transfusion requirements, and final radiographic measurements did not differ between sexes. Similarly, changes in HRQOL showed no significant differences. Finally, there were no sex differences in the incidence of complications (total, major, or minor) at any time point after controlling for age, body mass index, comorbidities, and levels fused.CONCLUSIONSDespite higher EBL, male ASD patients did not experience more complications or require less deformity correction at the 2-year follow-up. HRQOL scores similarly showed no sex differences. These findings differ from adolescent deformity studies, and surgeons can counsel patients that sex is unlikely to influence the outcomes and complication rates of primary all-posterior ASD surgery.

scholarly journals Safe and effective performance of pediatric spinal deformity surgery in patients unwilling to accept blood transfusion: a clinical study and review of literature

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Alexander Mihas ◽  
Subaraman Ramchandran ◽  
Sebastian Rivera ◽  
Ali Mansour ◽  
Jahangir Asghar ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Spinal Deformity ◽  
Intraoperative Complications ◽  
Spine Deformity ◽  
Blood Conservation ◽  
Level Of Evidence ◽  
Estimated Blood Loss ◽  
Spinal Deformity Surgery

Abstract Background Pediatric deformity surgery traditionally involves major blood loss. Patients refusing blood transfusion add extra clinical and medicolegal challenges; specifically the Jehovah’s witnesses population. The objective of this study is to review the safety and effectiveness of blood conservation techniques in patients undergoing pediatric spine deformity surgery who refuse blood transfusion. Methods After obtaining institutional review board approval, we retrospectively reviewed 20 consecutive patients who underwent spinal deformity surgery and refused blood transfusion at a single institution between 2014 and 2018. We collected pertinent preoperative, intraoperative and most recent clinical and radiological data with latest follow-up (minimum two-year follow-up). Results Twenty patients (13 females) with a mean age of 14.1 years were identified. The type of scoliotic deformities were adolescent idiopathic (14), juvenile idiopathic (1), neuromuscular (3) and congenital (2). The major coronal Cobb angle was corrected from 55.4° to 11.2° (80% correction, p <  0.001) at the latest follow-up. A mean of 11.4 levels were fused and 5.6 levels of Pontes osteotomies were performed. One patient underwent L1 hemivertebra resection and three patients had fusion to pelvis. Estimated blood loss, percent estimated blood volume loss, and cell saver returned averaged 307.9 mL, 8.5%, and 80 mL, respectively. Average operative time was 214 min. The average drop in hemoglobin after surgery was 2.9 g/dL. The length of hospital stay averaged 5.1 days. There were no intraoperative complications. Three postoperative complications were identified, none related to their refusal of transfusion. One patient had in-hospital respiratory complication, one patient developed a late infection, and one patient developed asymptomatic radiographic distal junctional kyphosis. Conclusions Blood conservation techniques allow for safe and effective spine deformity surgery in pediatric patients refusing blood transfusion without major anesthetic or medical complications, when performed by an experienced multidisciplinary team. Level of evidence Level IV.

scholarly journals Safe and Effective Performance of Pediatric Spinal Deformity Surgery in Patients Unwilling to Accept Blood Transfusion: A Clinical Study and Review of Literature

2020 ◽  
Author(s):  
Alexander Mihas ◽  
Ramchandran Subaraman ◽  
Sebastian Rivera ◽  
Ali Mansour ◽  
Jahangir Asghar ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Spinal Deformity ◽  
Intraoperative Complications ◽  
Spine Deformity ◽  
Blood Conservation ◽  
Level Of Evidence ◽  
Estimated Blood Loss ◽  
Spinal Deformity Surgery

Abstract Background: Pediatric deformity surgery traditionally involves major blood loss. Patients refusing blood transfusion add extra clinical and medicolegal challenges; specifically the Jehovah’s witnesses population. The objective of this study is to review the safety and effectiveness of blood conservation techniques in patients undergoing pediatric spine deformity surgery who refuse blood transfusion Methods: After obtaining institutional review board approval, we retrospectively reviewed 20 consecutive patients who underwent spinal deformity surgery and refused blood transfusion at a single institution between 2014 and 2018.We collected pertinent preoperative, intraoperative and most recent clinical and radiological data with latest follow-up (minimum two-year follow-up).Results: Twenty patients (13 females) with a mean age of 14.1 years were identified. The type of scoliotic deformities were adolescent idiopathic (15), neuromuscular (3) and congenital (2). The major coronal Cobb angle was corrected from 55.40 to 11.20 (80% correction, p< 0.001) at the latest follow-up. A mean of 11.4 levels were fused, 5.6 levels of Pontes osteotomies and 2.8 levels of thoracoplasty performed. 1 patient underwent L1 VCR and 3 patients had fusion to pelvis. Estimated blood loss and cell saver returned an average of 307.9 ml and 80ml, respectively. Operative times average at 214 min. The average drop in hemoglobin after surgery was 2.1mg/dl. The length of hospital stay averaged 5.1 days. There were no intraoperative complications. Three postoperative compilations were identified, none related to their refusal of transfusion. One patient had in-hospital respiratory complication, one patient developed a late infection, and one patient developed asymptomatic radiographic distal junctional kyphosis.Conclusions: Blood conservation techniques allow safe and effective spine deformity surgery in pediatric patients refusing blood transfusion without major anesthetic or medical complications.Level of Evidence: Level IV.

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