scholarly journals Etiology, diagnosis, and treatment of iatrogenic spinal deformity

2021 ◽  
Vol 64 (11) ◽  
pp. 748-752
Author(s):  
Nam-Su Chung
Keyword(s):  
Spinal Fusion ◽  
Spinal Deformity ◽  
Deformity Correction ◽  
Global Alignment ◽  
Spine Deformity ◽  
Common Procedure ◽  
Fusion Surgery ◽  
Spinal Fusion Surgery ◽  
Spinopelvic Alignment ◽  
Compensation Mechanisms

Background: Spinal fusion is a common procedure that provides spinal stability by connecting vertebral segments using a bone graft. Because the spinal alignment is fixed permanently after spinal fusion, a mal-aligned fusion can produce iatrogenic spinal deformity and imbalance with significant disability.Current Concepts: Failure to restore adequate segmental lordosis in lumbar spinal fusion is a common cause of iatrogenic spine deformity. Local and regional spinal deformities can affect the global alignment; accordingly, spinal imbalance can occur when the compensation mechanisms fail. Diagnosis and surgical planning should be made on a thorough analysis of global and spinopelvic parameters on the standing whole-spine radiographs. Surgical treatment includes neural decompression, spinal fusion, and deformity correction. Spinal osteotomy provides a favorable surgical outcome, although the complication rate is high.Discussion and Conclusion: Iatrogenic spine deformity is increasing due to the increased occurrence of spinal fusion surgery. To prevent iatrogenic spine deformity, the index fusion surgery should be performed based on a comprehensive analysis of spinopelvic alignment and balance.

scholarly journals Machine Learning Prediction of Length of Stay in Adult Spinal Deformity Patients Undergoing Posterior Spine Fusion Surgery

2021 ◽  
Vol 10 (18) ◽  
pp. 4074
Author(s):  
Andrew S Zhang ◽  
Ashwin Veeramani ◽  
Matthew S. Quinn ◽  
Daniel Alsoof ◽  
Eren O. Kuris ◽  
...  
Keyword(s):  
Machine Learning ◽  
Length Of Stay ◽  
Spinal Fusion ◽  
Learning Algorithms ◽  
Posterior Spinal Fusion ◽  
Machine Learning Algorithms ◽  
Gradient Boosting ◽  
Spine Deformity ◽  
Fusion Surgery ◽  
Spinal Fusion Surgery

(1) Background: Length of stay (LOS) is a commonly reported metric used to assess surgical success, patient outcomes, and economic impact. The focus of this study is to use a variety of machine learning algorithms to reliably predict whether a patient undergoing posterior spinal fusion surgery treatment for Adult Spine Deformity (ASD) will experience a prolonged LOS. (2) Methods: Patients undergoing treatment for ASD with posterior spinal fusion surgery were selected from the American College of Surgeon’s NSQIP dataset. Prolonged LOS was defined as a LOS greater than or equal to 9 days. Data was analyzed with the Logistic Regression, Decision Tree, Random Forest, XGBoost, and Gradient Boosting functions in Python with the Sci-Kit learn package. Prediction accuracy and area under the curve (AUC) were calculated. (3) Results: 1281 posterior patients were analyzed. The five algorithms had prediction accuracies between 68% and 83% for posterior cases (AUC: 0.566–0.821). Multivariable regression indicated that increased Work Relative Value Units (RVU), elevated American Society of Anesthesiologists (ASA) class, and longer operating times were linked to longer LOS. (4) Conclusions: Machine learning algorithms can predict if patients will experience an increased LOS following ASD surgery. Therefore, medical resources can be more appropriately allocated towards patients who are at risk of prolonged LOS.

Fatal pulmonary fat embolism after posterior spinal fusion surgery

2006 ◽  
Vol 11 (2) ◽  
pp. 217-220 ◽  
Author(s):  
Yoshimasa Takahashi ◽  
Ken’ichiro Narusawa ◽  
Kenji Shimizu ◽  
Masakazu Takata ◽  
Toshitaka Nakamura
Keyword(s):  
Spinal Fusion ◽  
Posterior Spinal Fusion ◽  
Fat Embolism ◽  
Fusion Surgery ◽  
Spinal Fusion Surgery ◽  
Pulmonary Fat Embolism

scholarly journals Sagittal Deformity Correction in a Patient Suffering From Diffuse Idiopathic Skeletal Hyperostosis Who Previously Underwent a Total Hip and Bilateral Knee Replacement

2021 ◽  
Vol 12 ◽  
pp. 215145932199274
Author(s):  
Victor Garcia-Martin ◽  
Ana Verdejo-González ◽  
David Ruiz-Picazo ◽  
José Ramírez-Villaescusa
Keyword(s):  
Knee Replacement ◽  
Spinal Deformity ◽  
Diffuse Idiopathic Skeletal Hyperostosis ◽  
Deformity Correction ◽  
Pedicle Subtraction Osteotomy ◽  
Lower Limbs ◽  
Sagittal Imbalance ◽  
Total Hip ◽  
Correction Technique ◽  
Compensation Mechanisms

Introduction: Physiological aging frequently leads to degenerative changes and spinal deformity. In patients with hypolordotic fusions or ankylosing illnesses such as diffuse idiopathic skeletal hyperostosis or ankylosing spondylitis, compensation mechanisms can be altered causing severe pain and disability. In addition, if a total hip replacement and/or knee replacement is performed, both pelvic and lower limbs compensation mechanisms could be damaged and prosthetic dislocation or impingement syndrome could be present. Pedicle subtraction osteotomy has proven to be the optimal correction technique for spinal deformation in patients suffering from a rigid spine. Case Presentation: A 70-year-old male patient with diffuse idiopathic skeletal hyperostosis criteria and a rigid lumbar kyphosis, who previously underwent a total hip and knee replacement, had severe disability. We then performed corrective surgery by doing a pedicle subtraction osteotomy. The procedure and outcomes are presented here. Conclusion: In symptomatic patients with sagittal imbalance and a rigid spine, pedicle subtraction osteotomy can indeed correct spinal deformity and re-establish sagittal balance.

Spinal-Fusion Surgery — The Case for Restraint

2004 ◽  
Vol 350 (7) ◽  
pp. 722-726 ◽  
Author(s):  
Richard A. Deyo ◽  
Alf Nachemson ◽  
Sohail K. Mirza
Keyword(s):  
Spinal Fusion ◽  
Fusion Surgery ◽  
Spinal Fusion Surgery

Timing of Complications After Spinal Fusion Surgery

Spine ◽  
2015 ◽  
Vol 40 (19) ◽  
pp. 1527-1535 ◽  
Author(s):  
Daniel D. Bohl ◽  
Matthew L. Webb ◽  
Adam M. Lukasiewicz ◽  
Andre M. Samuel ◽  
Bryce A. Basques ◽  
...  
Keyword(s):  
Spinal Fusion ◽  
Fusion Surgery ◽  
Spinal Fusion Surgery
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