Peter Passias

Conference Neurosurgery · April 2025 INTRODUCTION:The surgical correction of adult spinal deformity(ASD) presents a complex and multifaceted challenge, further intensified by the need for revision surgery. De ... Full text Cite

1217 Quantifying the Importance of Upper Cervical Extension Reserve in Adult Cervical Deformity Surgery and its Impact on Baseline Presentation and Outcomes

Conference Neurosurgery · April 2025 INTRODUCTION:Hyperextension of the upper cervical spine is a prominent compensatory mechanism to maintain horizontal gaze and balance in adult cervical deformity (ACD). Re ... Full text Cite

1069 Disparities in Presentation and Outcomes of Symptomatic Proximal Junctional Kyphosis Based on Over and Under Correction in Adult Spinal Deformity Corrections

Conference Neurosurgery · April 2025 INTRODUCTION:Proximal junctional kyphosis(PJK) is prevalent after adult spinal deformity(ASD) surgery. ... Full text Cite

2015 Two Good to Be Screw? The Value of Two Points of Pelvic Fixation in Adult Spinal Deformity Correction

Conference Neurosurgery · April 2025 INTRODUCTION:Spinopelvic fixation significantly enhances the stability of the lumbopelvic junction, which is particularly critical in adult spinal deformity surgeries invo ... Full text Cite

2025 Lumbar Lordosis Distribution in Adult Spinal Deformity: Targets Based on Pelvic Morphology

Conference Neurosurgery · April 2025 INTRODUCTION:The lumbar lordosis distribution index (LDI) is an important constituent of achieving adequate correction of adult spinal deformity (ASD). While previous lite ... Full text Cite

417 Optimizing Surgical Timing: Evaluating Disability, Frailty, and Deformity Severity Thresholds in Adult Spinal Deformity

Conference Neurosurgery · April 2025 INTRODUCTION:Adult spinal deformity is a complex condition with a challenging demographic that often has high frailty, disability, and deformity at the time of surgical co ... Full text Cite

Is There a Gender Disparity for Outcomes Following Minimally Invasive Surgery for Adult Spinal Deformity?

Conference NEUROSURGERY · April 2025 Link to item Cite

Contemporary guidelines for acetabular positioning in hip arthroplasty may jeopardize hip dislocation for select ASD patients

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: Lewinnek et al previously defined a safe zone for cup inclination (40° ± 10°) and anteversion (15° ± 10°) to reduce dislocations after total hip arthroplasty (THA). Despite the Lewinnek safe zone being respected, higher rates of prosthe ... Full text Cite

Who are super-utilizers in adult spine deformity surgery and how can surgeons identify them preoperatively?

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: A relatively small percentage of patients are responsible for a disproportional amount of resource utilization in adult ASD surgery and contribute to significantly elevating the average cost across the surgically treated patients. These ... Full text Open Access Cite

Three-dimensional evaluation of the dynamic interplay between pelvic anatomy, lower-limb compensation, and standing alignment in ASD

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: Previous studies have shown that lower limbs play a crucial role in compensating for sagittal spinal malalignment. However, these studies primarily focused on lower limb parameters in the sagittal plane, mainly knee flexion, leaving com ... Full text Open Access Cite

Quantifying the importance of upper cervical extension reserve in adult cervical deformity surgery and its impact on baseline presentation and outcomes

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: Hyperextension of the upper cervical spine is a prominent compensatory mechanism to maintain horizontal gaze and balance in adult cervical deformity (ACD) patients, akin to pelvic tilt in spinal deformity. The relaxation of ER and its i ... Full text Open Access Cite

Medicare's benchmarking spinal DRGs have limited utility in capturing key quality metrics for adult spinal deformity (ASD)

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: Heterogeneity of adult spinal deformity (ASD) and associated surgical options call into question Medicare's spinal-deformity-specific diagnosis-related group (DRG) to accurately capture nuances of episodes of care associated with ASD op ... Full text Cite

Does coronal plane deformity matter for cervicothoracic kyphosis surgery? The incidence of cervical scoliosis and influence on the outcomes of cervical deformity surgery

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: Cervical deformity (CD) patients may have both cervical kyphosis (CK) and coronal plane cervical deformity, ie, cervical scoliosis (CS). Although the deformity with the greatest influence on the clinical outcomes is CK, few studies have ... Full text Cite

Late to extubate? Risk factors & associations for delayed extubation after adult cervical deformity

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: Due to the proximity of the surgical site to important respiratory and oropharyngeal structures, patients may undergo delayed extubation after adult cervical deformity (ACD) surgery to manage postoperative airway edema/obstruction and r ... Full text Cite

Factors associated with timing for revision surgery for proximal junctional kyphosis (PJK)

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: Proximal junctional kyphosis (PJK) is a radiographic complication following adult spinal deformity (ASD) surgery. The decision-making process for PJK revision surgery is multi-faceted, involving the evaluation of clinical symptoms, radi ... Full text Cite

Fractional curve behavior following adult idiopathic scoliosis correction

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: Despite being a potential common cause of poor functional outcomes, few studies have assessed lumbosacral fractional curves (FC) behavior in adults. In particular, little is known about the temporal progression of FC in adults undergoin ... Full text Cite

Analysis of success versus failed realignment in patients with cervical deformity: in-construct angles provide novel targets for correction

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: Correction of cervical deformity (CD) has the potential to improve patient function significantly. However, previously described radiographic parameters cannot be measured intraoperatively. The present study investigates in-construct me ... Full text Cite

The cervical lordosis distribution index and its consideration of upper cervical region and morphology

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: The cervical lordosis distribution in relation to its apex has not been characterized, nor has the impact of morphologic differences and upper cervical segments. PURPOSE: The goal of this study is assess whether tailored correction of c ... Full text Open Access Cite

Do interbody devices that traverse the lumbar apex result in improved outcomes and alignment in adult spinal deformity

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: Interbody devices (IBD) are commonly used to correct deformity and are more often employed distally at the lumbosacral junction. Assessment of the impact on alignment and outcomes for IBD placed distal to the lumbar lordosis apex relati ... Full text Cite

Selection of upper instrumented vertebra in adult spinal deformity: risk calculator and recommendations based on proximal junctional kyphosis

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: The surgical correction of adult spinal deformity (ASD) presents a complex and multifaceted challenge, further intensified by the need for revision surgery. Determination of the upper instrumented vertebra can often be challenging. PURP ... Full text Open Access Cite

Contemporary treatment of complex adult spine deformity using bone morphogenic protein: a comparative analysis of outcome and complication profiles

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: There is controversy surrounding the use of bone morphogenic protein (BMP-2) in spine surgery with multiple off-label uses. The widespread use of BMP-2 is spine deformity surgery remains unsupported by literature. PURPOSE: To assess out ... Full text Cite

Sarcopenic obesity: an underrated phenomenon impacting adult spinal deformity intervention outcomes

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: The amount and quality of tissue do not always positively correlate as is the case with sarcopenic obesity. As the population of elderly people with adult spinal deformity (ASD) continues to increase, sarcopenia (decreased muscle mass) ... Full text Open Access Cite

Severe hip and knee osteoarthritis worsens patient-reported disability in adult spinal deformity patients

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: The complex interplay between lower extremity osteoarthritis and sagittal alignment in adult spinal deformity patients is of growing clinical interest. PURPOSE: To quantify the sequential effects of lower extremity OA on PROMs in ASD pa ... Full text Open Access Cite

A hard pill to swallow: factors associated with dysphagia following adult cervical deformity surgery

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: Dysphagia has long been intertwined with cervical interventions and significantly impacts patients’ quality of life. Still, the development and evolution of dysphagia is difficult to predict. PURPOSE: To discern which factors affect the ... Full text Cite

Preoperative dysphonia and dysphagia improve following cervical deformity surgery

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: Twenty-five percent of adult cervical deformity patients undergoing deformity correction have impairment due to a voice problem prior to surgery. Prior work has shown that these patients tend to be more frail and more likely to report p ... Full text Open Access Cite

Clinical and Patient-Reported Outcomes of Adult Spinal Deformity Surgery with 10-Year Follow-Up

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: Adult spinal deformity (ASD) has been demonstrated to negatively influence patients’ physical and mental health. Yet, previous literature has described that ASD corrective surgery to significantly improve patients’ quality of life and r ... Full text Cite

Optimizing surgical timing: evaluating disability, frailty, and deformity severity thresholds in adult spinal deformity

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: Adult spinal deformity is a complex condition with a challenging demographic that often has high frailty, disability, and deformity at the time of surgical correction. Thresholds at which there is a point of diminishing returns can help ... Full text Cite

Cost-benefit of Enhanced Recovery After Surgery protocols in adult spine deformity surgery

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: Enhanced Recovery After Surgery (ERAS) has been shown to accelerate patient recovery while reducing costs and maintaining high-quality patient care. The long-term effects after implementation in adult spine deformity (ASD) patients rema ... Full text Cite

Proximal junctional kyphosis and failure: How much can we attribute to known risk factors?

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: Despite advancements in the understanding of spinal alignment and in instrumentation for adult spine deformity (ASD) surgery, complications such as proximal junctional kyphosis and proximal junctional failure (PJK/PJF) continue to be a ... Full text Open Access Cite

Interbody device placement in thoracolumbar scoliosis malalignment affects mechanical complications and outcomes

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: Focal coronal malalignment in the lower lumbar spine can place significant forces on the construct and can be a challenge to correct. The use of supplemental rods and interbody devices (IBD) can potentially reduce rates of mechanical fa ... Full text Cite

Optimal octogenarians: which elderly patients best tolerate adult spinal deformity corrective surgery?

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: Intervention for adult spinal deformity (ASD) can be invasive, and often as patients age, they are more susceptible to the physiological burden imposed by such extensive surgeries. Still studies have proven that rigorous realignment is ... Full text Cite

Impact of Enhanced Recovery After Surgery (ERAS) protocols in adult spinal deformity corrective surgery utilizing three-column osteotomies

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: Spine surgery for ASD is often highly invasive, especially when requiring three column osteotomies, that can often coincide with a prolonged recovery phase. These patients might benefit from ERAS, an evidence-based multidisciplinary app ... Full text Cite

Determinants of cost-effectiveness in minimally invasive surgery for adult spinal deformity correction

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: The substantial financial implications of minimally invasive surgery (MIS) for adult spinal deformity (ASD) necessitate a thorough assessment of its inherent value and efficacy. Previously, factors contributing to both short-term and pr ... Full text Cite

Enhanced cost utility in adult deformity corrections can be achieved by application of contemporary age-adjusted realignment criteria

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: Studies have evaluated outcomes for sagittal age-adjusted alignment score (SAAS) in adult spinal deformity (ASD) corrective surgery, yet no study to date evaluated its cost-utility. PURPOSE: Our study aims to evaluate the cost-utility a ... Full text Cite

Does social deprivation index (SDI) portend predictive value of perioperative outcomes after adult spinal deformity (ASD) surgery?

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: The ASD population is extremely heterogeneous, and the condition is not confined to any one sociodemographic class. Still, considerable disparities exist in equitable distribution of health care resources and availability of interventio ... Full text Cite

Outcomes comparison between novel hydroxyapatite enhanced PEEK and titanium implants after anterior lumbar interbody fusion

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: Interbody implants have evolved to reduce the risk of nonunion with polyetheretherketone (PEEK) and titanium devices. Two novel ALIF implants, hydroxyapatite (HA) infused PEEK (HA PEEK) and titanium alloy with microtextured surface inte ... Full text Cite

Should pelvic incidence influence realignment strategy? A detailed analysis in adult spinal deformity

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: Pelvic incidence (PI) serves as the cornerstone for realignment schema to create a more individualized realignment target. Yet, it is not known if outcomes of realignment schema are dependent on the amount of pelvic incidence. The purpo ... Full text Open Access Cite

Alignment schematic impact on complications and outcomes in adult spinal deformity corrective surgery

Conference Spine Journal · September 1, 2024 BACKGROUND CONTEXT: Multiple alignment schematics have been proposed and utilized in adult spinal deformity (ASD). The utility of SRS-Schwab, GAP, SAAS, and Roussouly targets on reducing complications and improving outcomes in a cohort remains to be evalua ... Full text Cite