Surgical considerations for major deformity correction spine surgery.

Spinal deformity is defined as abnormality in alignment, formation, or curvature of one or more segments of the spine. Its characteristic clinical presentation and radiographic appearance differ according to patient age and the underlying cause. The most common deformity in the pediatric population is adolescent idiopathic scoliosis, whereas in adults many patients present with de novo deformity secondary to degenerative disease. Although the specific goals differ between patients, the broad aims include restoration of regional and global alignment, decompression of neural elements as necessary, and establishment of a solid fusion. Surgeons perform deformity correction by various approaches and techniques to achieve the desired correction while minimizing perioperative risk.

[1]  K. Bridwell,et al.  Risk-Benefit Assessment of Surgery for Adult Scoliosis: An Analysis Based on Patient Age , 2011, Spine.

[2]  G. Mundis,et al.  Adult Deformity Correction Through Minimally Invasive Lateral Approach Techniques , 2010, Spine.

[3]  William Horton,et al.  The Impact of Positive Sagittal Balance in Adult Spinal Deformity , 2005, Spine.

[4]  Kai-Ming G. Fu,et al.  Clinical and radiographic evaluation of the adult spinal deformity patient. , 2013, Neurosurgery clinics of North America.

[5]  Munish C. Gupta,et al.  Risk factors for major peri-operative complications in adult spinal deformity surgery: a multi-center review of 953 consecutive patients , 2012, European Spine Journal.

[6]  Kai-Ming G. Fu,et al.  Prevalence, Severity, and Impact of Foraminal and Canal Stenosis Among Adults With Degenerative Scoliosis , 2011, Neurosurgery.

[7]  Munish C. Gupta,et al.  Sagittal spinal pelvic alignment. , 2013, Neurosurgery clinics of North America.

[8]  Munish C. Gupta,et al.  Complications and intercenter variability of three-column osteotomies for spinal deformity surgery: a retrospective review of 423 patients. , 2014, Neurosurgical focus.

[9]  O. Boachie-Adjei,et al.  Dual Growing Rod Technique for the Treatment of Progressive Early-Onset Scoliosis: A Multicenter Study , 2005, Spine.

[10]  O. Stokes,et al.  Growing rod construct for the treatment of early-onset scoliosis , 2015, European Spine Journal.

[11]  William Horton,et al.  Correlation of Radiographic Parameters and Clinical Symptoms in Adult Scoliosis , 2005, Spine.

[12]  L. Lenke,et al.  Degenerative Spinal Deformity. , 2015, Neurosurgery.

[13]  J. Kostuik,et al.  Posterior Only Versus Combined Anterior and Posterior Approaches to Lumbar Scoliosis in Adults: A Radiographic Analysis , 2007, Spine.

[14]  L. Lenke,et al.  Adult degenerative scoliosis: evaluation and management. , 2010, Neurosurgical focus.

[15]  O. Boachie-Adjei,et al.  Scoliosis Research Society Morbidity and Mortality of Adult Scoliosis Surgery , 2011, Spine.

[16]  James G Wright,et al.  Effects of bracing in adolescents with idiopathic scoliosis. , 2013, The New England journal of medicine.

[17]  Justin K Scheer,et al.  Impact of spinopelvic alignment on decision making in deformity surgery in adults: A review. , 2012, Journal of neurosurgery. Spine.

[18]  F. Schwab,et al.  Adult Scoliosis: Prevalence, SF-36, and Nutritional Parameters in an Elderly Volunteer Population , 2005, Spine.

[19]  L. Lenke,et al.  Does Treatment (Nonoperative and Operative) Improve the Two-Year Quality of Life in Patients With Adult Symptomatic Lumbar Scoliosis: A Prospective Multicenter Evidence-Based Medicine Study , 2009, Spine.

[20]  Juan S. Uribe,et al.  Current Status of Adult Spinal Deformity , 2012, Global Spine Journal.

[21]  Jung-Hee Lee,et al.  Posterior Vertebral Column Resection in Fixed Lumbosacral Deformity , 2005, Spine.

[22]  F. Schwab,et al.  Adult Spinal Deformity—Postoperative Standing Imbalance: How Much Can You Tolerate? An Overview of Key Parameters in Assessing Alignment and Planning Corrective Surgery , 2010, Spine.

[23]  J. Heller,et al.  Anterior Exposure of the Lumbar Spine With and Without an “Access Surgeon”: Morbidity Analysis of 265 Consecutive Cases , 2009, Journal of spinal disorders & techniques.

[24]  C. Niu,et al.  Instrumented Posterior Lumbar Interbody Fusion for Patients With Degenerative Lumbar Scoliosis , 2008, Journal of spinal disorders & techniques.

[25]  O. Boachie-Adjei,et al.  Pain and Disability Determine Treatment Modality for Older Patients With Adult Scoliosis, While Deformity Guides Treatment for Younger Patients , 2009, Spine.

[26]  C. Ames,et al.  VERTEBRAL COLUMN RESECTION FOR RIGID SPINAL DEFORMITY , 2008, Neurosurgery.

[27]  Oheneba Boachie-Adjei,et al.  Radiographical Spinopelvic Parameters and Disability in the Setting of Adult Spinal Deformity: A Prospective Multicenter Analysis , 2013, Spine.

[28]  H. Labelle,et al.  Pre- and post-operative sagittal balance in idiopathic scoliosis: a comparison over the ages of two cohorts of 132 adolescents and 52 adults , 2013, European Spine Journal.

[29]  Kai-Ming G. Fu,et al.  Outcomes of Operative and Nonoperative Treatment for Adult Spinal Deformity: A Prospective, Multicenter, Propensity-Matched Cohort Assessment With Minimum 2-Year Follow-up. , 2016, Neurosurgery.

[30]  Justin K Scheer,et al.  Surgical treatment of pathological loss of lumbar lordosis (flatback) in patients with normal sagittal vertical axis achieves similar clinical improvement as surgical treatment of elevated sagittal vertical axis: clinical article. , 2014, Journal of neurosurgery. Spine.

[31]  D. Armstrong,et al.  Comparison of Single and Dual Growing Rod Techniques Followed Through Definitive Surgery: A Preliminary Study , 2005, Spine.

[32]  L. Lenke,et al.  Radiographic Outcomes of Anterior Spinal Fusion Versus Posterior Spinal Fusion With Thoracic Pedicle Screws for Treatment of Lenke Type I Adolescent Idiopathic Scoliosis Curves , 2005, Spine.

[33]  R. Karia,et al.  Complication rates are reduced for revision adult spine deformity surgery among high-volume hospitals and surgeons. , 2013, The spine journal : official journal of the North American Spine Society.

[34]  K. Cho,et al.  Is anterior release necessary in severe scoliosis treated by posterior segmental pedicle screw fixation? , 2007, European Spine Journal.

[35]  J. Paul,et al.  Greater Operative Volume Is Associated With Lower Complication Rates in Adolescent Spinal Deformity Surgery , 2015, Spine.

[36]  C. Nnadi,et al.  Magnetic controlled growth rods versus conventional growing rod systems in the treatment of early onset scoliosis: a cost comparison , 2015, European Spine Journal.

[37]  Justin K Scheer,et al.  Comprehensive study of back and leg pain improvements after adult spinal deformity surgery: analysis of 421 patients with 2-year follow-up and of the impact of the surgery on treatment satisfaction. , 2015, Journal of neurosurgery. Spine.

[38]  Christopher M Graves,et al.  Selective Thoracic Fusion of Lenke I and II Curves Affects Sagittal Profiles But Not Sagittal or Spinopelvic Alignment: A Case-Control Study , 2015, Spine.

[39]  Munish C. Gupta,et al.  Does vertebral level of pedicle subtraction osteotomy correlate with degree of spinopelvic parameter correction? , 2011, Journal of neurosurgery. Spine.

[40]  L. Lenke,et al.  Osteotomies in the posterior-only treatment of complex adult spinal deformity: a comparative review. , 2010, Neurosurgical focus.

[41]  Ashish Patel,et al.  Pelvic Tilt and Truncal Inclination: Two Key Radiographic Parameters in the Setting of Adults With Spinal Deformity , 2009, Spine.

[42]  O. Boachie-Adjei,et al.  Short-term Morbidity and Mortality Associated With Correction of Thoracolumbar Fixed Sagittal Plane Deformity: A Report from the Scoliosis Research Society Morbidity and Mortality Committee , 2011, Spine.

[43]  Kai-Ming G. Fu,et al.  Operative Versus Nonoperative Treatment of Leg Pain in Adults With Scoliosis: A Retrospective Review of a Prospective Multicenter Database With Two-Year Follow-up , 2009, Spine.

[44]  A. Villavicencio,et al.  Complications in patients undergoing combined transforaminal lumbar interbody fusion and posterior instrumentation with deformity correction for degenerative scoliosis and spinal stenosis , 2012, Surgical neurology international.

[45]  Kai-Ming G. Fu,et al.  IMPROVEMENT OF BACK PAIN WITH OPERATIVE AND NONOPERATIVE TREATMENT IN ADULTS WITH SCOLIOSIS , 2009, Neurosurgery.

[46]  Ashish Patel,et al.  Sagittal Plane Considerations and the Pelvis in the Adult Patient , 2009, Spine.

[47]  C. Shaffrey,et al.  Degenerative lumbar scoliosis. , 2006, Neurosurgery clinics of North America.