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Robert A. Hart, Christopher M. Domes, Brady Goodwin, Charles R. D'Amato, Jung U. Yoo, Ronald J. Turker, and Matthew F. Halsey

resulted in L-5 nerve root palsies in some patients, as well as instrumentation failures, particularly at the sacrum. Some authors now advocate supplementary pelvic fixation to avoid S-1 pedicle screw failures. 7 , 13 , 25 Addition of transsacral and/or pedicle screw instrumentation to supplement a Bohlman oblique interbody fusion may help address the previous issues of late graft failure and incomplete reduction of lumbosacral kyphosis. 32 Titanium mesh cages used in place of the fibular graft may also reduce late failures. The objective of this study was to evaluate

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Thomas J. Buell, Justin S. Smith, Christopher I. Shaffrey, Han Jo Kim, Eric O. Klineberg, Virginie Lafage, Renaud Lafage, Themistocles S. Protopsaltis, Peter G. Passias, Gregory M. Mundis Jr., Robert K. Eastlack, Vedat Deviren, Michael P. Kelly, Alan H. Daniels, Jeffrey L. Gum, Alex Soroceanu, D. Kojo Hamilton, Munish C. Gupta, Douglas C. Burton, Richard A. Hostin, Khaled M. Kebaish, Robert A. Hart, Frank J. Schwab, Shay Bess, Christopher P. Ames, and the International Spine Study Group (ISSG)

patients often have concurrent severe global sagittal malalignment, which seems to be the significant driver for worse HRQOL. Surgical correction of severe ASD often entails complex reconstruction with long-segment posterior fusion, multiple osteotomies, and pelvic fixation. 39 This description accurately characterizes the operations in this study, with over a third (36%) of patients undergoing 3CO, a mean of 13.2 ± 3.8 fused levels, upper thoracic (T2–5) UIV in 55% of patients, lower thoracic (T9–11) UIV in 39%, and iliac fixation in 90%. Increased sagittal

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Low Dose BMP-2 and Pelvic Fixation in Adult Deformity Surgery Prokopis Annis , MD , William R. Spiker , MD , Brandon D. Lawarence , MD , Michael D. Daubs , MD , and Darrel S. Brodke University of Utah, Department of Orthopaedics Disclosures: P. Annis: None. W.R. Spiker: None. B.D. Lawarence: None. M.D. Daubs: 1; I; Synthes Spine. 4; I; Synthes Spine. D.S. Brodke: 1; I; Amedica, DePuy Synthes, Medtronic. 4; I; DePuy Synthes. 6; I; Amedica, Vertiflex. 4 2014 36 4 A3 A3 Copyright held by the