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Neel Anand, Rebecca Rosemann, Bhavraj Khalsa and Eli M. Baron

forms of adult scoliosis seen in the elderly is lumbar degenerative scoliosis. It has been postulated to develop because of asymmetrical degeneration of discs, osteoporosis, and vertebral body compression fractures. 7 , 21 The treatment of adult scoliosis remains controversial. Although nonsurgical management is the mainstay of treatment for this condition, its efficacy is not well supported in the literature. 31 When surgery is performed, little consensus exists for optimal management because of the heterogeneous presentation of the disorder, controversial surgical

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Neel Anand, Eli M. Baron and Babak Khandehroo

M aintenance of sagittal and coronal balance has been the cornerstone radiological outcomes of adult scoliosis surgery. 12 While traditional open methods have been effective in achieving these outcomes, 25 open methods have been historically associated with high-volume blood loss 19 , 23 and relatively high rates of medical complications. Complications have been reported as occurring in as many as 70% of adult patients undergoing open deformity correction. 6 Given this, minimally invasive methods of correction, with reduced blood loss and reduced

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Praveen V. Mummaneni, Christopher I. Shaffrey, Lawrence G. Lenke, Paul Park, Michael Y. Wang, Frank La Marca, Justin S. Smith, Gregory M. Mundis Jr., David O. Okonkwo, Bertrand Moal, Richard G. Fessler, Neel Anand, Juan S. Uribe, Adam S. Kanter, Behrooz Akbarnia and Kai-Ming G. Fu

W ith the aging of the US population, adult degenerative scoliosis is increasing in incidence with significant impact on health and disability. 5 , 9–11 Surgical correction of adult degenerative scoliosis has traditionally been performed using open surgical approaches. Open spinal deformity correction surgery is associated with a large amount of intraoperative blood loss and significant complication rates. 6 A multicenter study from the International Spine Study Group reviewing 953 adult spinal deformity patients revealed a major complication rate of 7

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Michael Y. Wang, Praveen V. Mummaneni, Kai-Ming G. Fu, Neel Anand, David O. Okonkwo, Adam S. Kanter, Frank La Marca, Richard Fessler, Juan Uribe, Christopher I. Shaffrey, Virginie Lafage, Raqeeb M. Haque, Vedat Deviren and Gregory M. Mundis Jr.

S urgery for adult spinal deformity (ASD) remains a challenging proposition. Several factors contribute to create a high likelihood of intraoperative and postoperative complication rates. Medical comorbidities, patient deconditioning due to pain and immobility, associated osteoporosis, a rigid skeletal deformity, and abnormal spinal anatomy all increase the likelihood of a complication from ASD surgery. 6 , 9 Furthermore, the surgical enterprise needed to destabilize, realign, and fuse the spine over multiple segments is painful and debilitating

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Pierce D. Nunley, Gregory M. Mundis Jr., Richard G. Fessler, Paul Park, Joseph M. Zavatsky, Juan S. Uribe, Robert K. Eastlack, Dean Chou, Michael Y. Wang, Neel Anand, Kelly A. Frank, Marcus B. Stone, Adam S. Kanter, Christopher I. Shaffrey, Praveen V. Mummaneni and the International Spine Study Group

F or hospitals to continue to provide excellent care for adult spinal deformity (ASD) surgery, they must be able to adequately recover their costs for these procedures. The introduction of Medicare’s Prospective Payment System (PPS) in 1983 led to the development of a fixed payment amount for each patient upon hospital discharge ( https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/index.html ). 1 The fixed payment amount is determined based on the particular diagnosis-related group (DRG) coded at patient discharge and it is intended

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Juan S. Uribe, Armen R. Deukmedjian, Praveen V. Mummaneni, Kai-Ming G. Fu, Gregory M. Mundis Jr., David O. Okonkwo, Adam S. Kanter, Robert Eastlack, Michael Y. Wang, Neel Anand, Richard G. Fessler, Frank La Marca, Paul Park, Virginie Lafage, Vedat Deviren, Shay Bess and Christopher I. Shaffrey

about minimally invasive procedures. 27 , 32 Open techniques require extensive soft tissue mobilization ( Fig. 1A ), and long-segment fusions are associated with complication rates ranging from 10% to 75%. 4 , 8 , 10 , 11 , 15 , 19 , 23 , 25 , 30 , 31 , 33 Minimally invasive surgery (MIS) for ASD correction has become increasingly popular. As reported by Smith et al., outcome measures after ASD surgery in elderly patients improve more dramatically than in younger patients, and with an increasing elderly population, minimally invasive surgical correction will remain

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Raqeeb M. Haque, Gregory M. Mundis Jr., Yousef Ahmed, Tarek Y. El Ahmadieh, Michael Y. Wang, Praveen V. Mummaneni, Juan S. Uribe, David O. Okonkwo, Robert K. Eastlack, Neel Anand, Adam S. Kanter, Frank La Marca, Behrooz A. Akbarnia, Paul Park, Virginie Lafage, Jamie S. Terran, Christopher I. Shaffrey, Eric Klineberg, Vedat Deviren and Richard G. Fessler

the deformity severity, medical comorbidities, and surgeon experience. 13 Nonsurgical approaches among disabled patients have been shown to be less efficient and less cost-effective compared with surgical approaches. 7 , 10 , 16 Accordingly, various surgical approaches, including open surgery, minimally invasive surgery (MIS), and hybrid techniques, have gained momentum in the management of adult spinal deformity. The impact of radiographic parameters on surgical decision making for patients with adult spinal deformity cannot be overemphasized. 3 The primary

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Khoi D. Than, Praveen V. Mummaneni, Kelly J. Bridges, Stacie Tran, Paul Park, Dean Chou, Frank La Marca, Juan S. Uribe, Todd D. Vogel, Pierce D. Nunley, Robert K. Eastlack, Neel Anand, David O. Okonkwo, Adam S. Kanter and Gregory M. Mundis Jr.

of minimally invasive techniques include less disruption to the paraspinal musculature and stabilizing structures, which results in decreases in blood loss, postoperative pain, length of hospital stay, and iatrogenic morbidity. 5 , 11 , 13 , 16–18 , 22 , 26 , 29 In this study, we aimed to retrospectively analyze a large multicenter database to determine the effect of open surgery on complications compared with that of using percutaneous screws among patients who underwent minimally invasive interbody fusion procedures with supplemental fixation for adult spinal

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, MD George Washington University, Orthopedic Surgery, Washington, DC 1 2013 34 1 The Science of Neurosurgical Practice A1 A2 Copyright held by the American Association of Neurological Surgeons. You may not sell, republish, or systematically distribute any published materials without written permission from JNSPG. 2013 Study Objective To determine the differences in validated clinical outcomes following indirect lumbar decompression using an interspinous device or an interlaminar allograft combined with fusion. Summary of

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of Anesthesiology;  West Virginia University, Department of Statistics;  West Virginia University, Department of Orthopaedics  3 2015 38 3 Neurooncology: Update on Therapeutic Options A1 A1 Copyright held by the American Association of Neurological Surgeons. You may not sell, republish, or systematically distribute any published materials without written permission from JNSPG. 2015 Introduction: Ischemic optic neuropathy (ION) resulting in visual loss is a rare but devastating complication in spine surgery. Procedure time