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Less invasive surgery for treating adult spinal deformities: ceiling effects for deformity correction with 3 different techniques.

Publication ,  Journal Article
Wang, MY; Mummaneni, PV; Fu, K-MG; Anand, N; Okonkwo, DO; Kanter, AS; La Marca, F; Fessler, R; Uribe, J; Shaffrey, CI; Lafage, V; Haque, RM ...
Published in: Neurosurg Focus
May 2014

OBJECT: Minimally invasive surgery (MIS) options for the treatment of adult spinal deformity (ASD) have advanced significantly over the past decade. However, a wide array of options have been described as being MIS or less invasive. In this study the authors investigated a multiinstitutional cohort of patients with ASD who were treated with less invasive methods to determine the extent of deformity correction achieved. METHODS: This study was a retrospective review of multicenter prospectively collected data in 85 consecutive patients with ASD undergoing MIS surgery. Inclusion criteria were as follows: age older than 45 years; minimum 20° coronal lumbar Cobb angle; and 1 year of follow-up. Procedures were classified as follows: 1) stand-alone (n = 7); 2) circumferential MIS (n = 43); or 3) hybrid (n = 35). RESULTS: An average of 4.2 discs (range 3-7) were fused, with a mean follow-up duration of 26.1 months in this study. For the stand-alone group the preoperative Cobb range was 22°-51°, with 57% greater than 30° and 28.6% greater than 50°. The mean Cobb angle improved from 35.7° to 30°. A ceiling effect of 23° for curve correction was observed, regardless of preoperative curve severity. For the circumferential MIS group the preoperative Cobb range was 19°-62°, with 44% greater than 30° and 5% greater than 50°. The mean Cobb angle improved from 32° to 12°. A ceiling effect of 34° for curve correction was observed. For the hybrid group the preoperative Cobb range was 23°-82°, with 74% greater than 30° and 23% greater than 50°. The mean Cobb angle improved from 43° to 15°. A ceiling effect of 55° for curve correction was observed. CONCLUSIONS: Specific procedures for treating ASD have particular limitations for scoliotic curve correction. Less invasive techniques were associated with a reduced ability to straighten the spine, particularly with advanced curves. These data can guide preoperative technique selection when treating patients with ASD.

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Published In

Neurosurg Focus

DOI

EISSN

1092-0684

Publication Date

May 2014

Volume

36

Issue

5

Start / End Page

E12

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Spine
  • Spinal Fusion
  • Retrospective Studies
  • Neurology & Neurosurgery
  • Minimally Invasive Surgical Procedures
  • Middle Aged
  • Male
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
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Wang, M. Y., Mummaneni, P. V., Fu, K.-M., Anand, N., Okonkwo, D. O., Kanter, A. S., … Minimally Invasive Surgery Section of the International Spine Study Group, . (2014). Less invasive surgery for treating adult spinal deformities: ceiling effects for deformity correction with 3 different techniques. Neurosurg Focus, 36(5), E12. https://doi.org/10.3171/2014.3.FOCUS1423
Wang, Michael Y., Praveen V. Mummaneni, Kai-Ming G. Fu, Neel Anand, David O. Okonkwo, Adam S. Kanter, Frank La Marca, et al. “Less invasive surgery for treating adult spinal deformities: ceiling effects for deformity correction with 3 different techniques.Neurosurg Focus 36, no. 5 (May 2014): E12. https://doi.org/10.3171/2014.3.FOCUS1423.
Wang MY, Mummaneni PV, Fu K-MG, Anand N, Okonkwo DO, Kanter AS, et al. Less invasive surgery for treating adult spinal deformities: ceiling effects for deformity correction with 3 different techniques. Neurosurg Focus. 2014 May;36(5):E12.
Wang, Michael Y., et al. “Less invasive surgery for treating adult spinal deformities: ceiling effects for deformity correction with 3 different techniques.Neurosurg Focus, vol. 36, no. 5, May 2014, p. E12. Pubmed, doi:10.3171/2014.3.FOCUS1423.
Wang MY, Mummaneni PV, Fu K-MG, Anand N, Okonkwo DO, Kanter AS, La Marca F, Fessler R, Uribe J, Shaffrey CI, Lafage V, Haque RM, Deviren V, Mundis GM, Minimally Invasive Surgery Section of the International Spine Study Group. Less invasive surgery for treating adult spinal deformities: ceiling effects for deformity correction with 3 different techniques. Neurosurg Focus. 2014 May;36(5):E12.

Published In

Neurosurg Focus

DOI

EISSN

1092-0684

Publication Date

May 2014

Volume

36

Issue

5

Start / End Page

E12

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Spine
  • Spinal Fusion
  • Retrospective Studies
  • Neurology & Neurosurgery
  • Minimally Invasive Surgical Procedures
  • Middle Aged
  • Male
  • Humans
  • Female