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Alex Soroceanu, Douglas C. Burton, Bassel Georges Diebo, Justin S. Smith, Richard Hostin, Christopher I. Shaffrey, Oheneba Boachie-Adjei, Gregory M. Mundis Jr., Christopher Ames, Thomas J. Errico, Shay Bess, Munish C. Gupta, Robert A. Hart, Frank J. Schwab, Virginie Lafage and International Spine Study Group

rates following ASD surgery, 3 , 12 , 13 , 27 , 39 , 57 , 63 , 68 with complication rates as high as 95%. 39 Several studies have examined the impact of obesity on the surgical treatment of spinal pathologies and reported increased surgical-site infections for obese patients in the context of elective lumbar spinal fusion for degenerative conditions. 15 , 47 When looking at overall complications in the context of lumbar and cervical spine surgery, the effect of obesity is more controversial. Whereas some authors have associated obesity with increased complication

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Emily K. Miller, Brian J. Neuman, Amit Jain, Alan H. Daniels, Tamir Ailon, Daniel M. Sciubba, Khaled M. Kebaish, Virginie Lafage, Justin K. Scheer, Justin S. Smith, Shay Bess, Christopher I. Shaffrey, Christopher P. Ames and the International Spine Study Group

, version 2; SRS-22r = Scoliosis Research Society-22r questionnaire. Data Analysis The primary study outcome was incidence of major complications, which were defined as those that were potentially life-threatening, required reoperation, or caused permanent injury, per Glassman et al. 8 Major complications were intraoperative vascular, visceral, or neurological injury; postoperative deep infection; pulmonary embolism; junctional failure; and other similar complications. 9 Secondary outcomes included deep wound infection rate, wound dehiscence incidence, LOS, proximal

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Michael P. Kelly, Lukas P. Zebala, Han Jo Kim, Daniel M. Sciubba, Justin S. Smith, Christopher I. Shaffrey, Shay Bess, Eric Klineberg, Gregory Mundis Jr., Douglas Burton, Robert Hart, Alex Soroceanu, Frank Schwab, Virginie Lafage and International Spine Study Group

procedures associated with PRBC transfusion in the US. 21 , 28 Transfusion of ALLO PRBCs is not without risk. Beyond the low risk of exposure to disease, a systemic inflammatory response occurs in response to proteins carried with the PRBCs. 20 , 24 , 25 The most extreme of these inflammatory responses are known as transfusion-related acute lung injury and transfusion-associated circulatory overload, which carry risks of morbidity and mortality. 22 Less extreme, but also concerning, is the increased risk of perioperative complications, particularly infections, related

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Justin K. Scheer, Jessica A. Tang, Justin S. Smith, Eric Klineberg, Robert A. Hart, Gregory M. Mundis Jr., Douglas C. Burton, Richard Hostin, Michael F. O'Brien, Shay Bess, Khaled M. Kebaish, Vedat Deviren, Virginie Lafage, Frank Schwab, Christopher I. Shaffrey, Christopher P. Ames and the International Spine Study Group

surgeries 14 , 15 and between primary and revision procedures. 6 , 11 , 12 Rates of reoperation are frequently cited, ranging from 10% to 25%, and among the many reasons behind reoperation—including infection, curve progression, proximal junction kyphosis, implant failure, and removal of painful implants 4 , 13 , 17 —pseudarthrosis emerges as one of the most commonly documented indications. 6 , 9 , 10 , 13 , 16–18 There are also studies that have investigated the effects of demographic factors, suggesting older age as a risk factor for developing pseudarthrosis, with

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Justin K. Scheer, Justin S. Smith, Frank Schwab, Virginie Lafage, Christopher I. Shaffrey, Shay Bess, Alan H. Daniels, Robert A. Hart, Themistocles S. Protopsaltis, Gregory M. Mundis Jr., Daniel M. Sciubba, Tamir Ailon, Douglas C. Burton, Eric Klineberg, Christopher P. Ames and The International Spine Study Group

°. Exclusion criteria included spinal deformity of a neuromuscular etiology and presence of active infection or malignancy. Data Collection, Radiographic Assessment, and HRQOL The demographic and clinical data collected included patient age, sex, body mass index (BMI), number of comorbidities, Charlson Comorbidity Index (CCI), 10 preoperative anemia, history of depression, osteoporosis, American Society of Anesthesiologists (ASA) physical status classification, as well as all intraoperative and perioperative complications. Surgical data collected included primary versus

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Alexander A. Theologis, Gregory M. Mundis Jr., Stacie Nguyen, David O. Okonkwo, Praveen V. Mummaneni, Justin S. Smith, Christopher I. Shaffrey, Richard Fessler, Shay Bess, Frank Schwab, Bassel G. Diebo, Douglas Burton, Robert Hart, Vedat Deviren and Christopher Ames

respect to the percentages of patients who required revision operations and had minor complications. Significantly more patients in the LS+Apex group had a major complication (56% vs 12.5% in the LS-Only group, p = 0.02). Patients in the LS+Apex group had more leg weakness (31.3% vs 6.3%, p = 0.17), and more minor radiographic complications (25% vs 0%, p = 0.11) than patients in the LS-Only group. All infections in the LS+Apex group were associated with posterior incisions; no lateral incisions became infected. There were no differences in pseudarthrosis rates between

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Micheal Raad, Brian J. Neuman, Amit Jain, Hamid Hassanzadeh, Peter G. Passias, Eric Klineberg, Gregory M. Mundis Jr., Themistocles S. Protopsaltis, Emily K. Miller, Justin S. Smith, Virginie Lafage, D. Kojo Hamilton, Shay Bess, Khaled M. Kebaish, Daniel M. Sciubba and the International Spine Study Group

cardiac arrest. Venous thrombotic complications were deep vein thrombosis and pulmonary embolisms. Gastrointestinal complications were postoperative ileus and Clostridium difficile infection. Finally, wound complications included surgical site infection (superficial and deep) as well as dehiscence. Univariate Analysis The 2 groups were compared with respect to previously established risk factors for poor outcomes in ASD patients 16 (demographics, Charlson Comorbidity Index [CCI], surgical invasiveness, and postoperative complications) and baseline radiographic

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Justin K. Scheer, Virginie Lafage, Justin S. Smith, Vedat Deviren, Richard Hostin, Ian M. McCarthy, Gregory M. Mundis, Douglas C. Burton, Eric Klineberg, Munish C. Gupta, Khaled M. Kebaish, Christopher I. Shaffrey, Shay Bess, Frank Schwab, Christopher P. Ames and the International Spine Study Group (ISSG)

consisted of spinal deformity having a neuromuscular etiology and the presence of active infection or malignancy. Information regarding age, sex, body mass index, operation time, estimated blood loss, major intraoperative and postoperative complications, and HRQOL outcomes was collected. The major intraoperative complications recorded were as follows: cardiac arrest, spinal cord injury, death, nerve root injury, optical deficit, vessel and/or organ injury, blood loss > 4 L, pneumothorax, and having an unplanned staged surgery. The major postoperative complications were as

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Shayan Fakurnejad, Justin K. Scheer, Virginie Lafage, Justin S. Smith, Vedat Deviren, Richard Hostin, Gregory M. Mundis Jr., Douglas C. Burton, Eric Klineberg, Munish Gupta, Khaled Kebaish, Christopher I. Shaffrey, Shay Bess, Frank Schwab, Christopher P. Ames and The International Spine Study Group

kyphosis ≥ 60°. Exclusion criteria included spinal deformity stemming from a neuromuscular etiology and presence of an active infection or malignant disease. Patients were categorized into 2 groups according to the anatomical location of their UIV procedure as upper thoracic or thoracolumbar. A UIV in the upper thoracic region was defined as a fixation terminating between T-1 and T-6 and a UIV in the thoracolumbar region as a fixation between T-9 and L-1. Patients were also categorized according to the type of 3CO they received, that is, either a PSO or a VCR. All

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Justin S. Smith, Christopher I. Shaffrey, Virginie Lafage, Benjamin Blondel, Frank Schwab, Richard Hostin, Robert Hart, Brian O'Shaughnessy, Shay Bess, Serena S. Hu, Vedat Deviren, Christopher P. Ames and International Spine Study Group

analysis: adults (>18 years) who were surgically treated for ASD with treatment including lumbar PSO, preoperative global positive sagittal malalignment (C-7 plumb line relative to S-1 [C7–S1 plumb line] >5 cm), and availability of pre- and postoperative full-length anteroposterior and lateral standing radiographs that included visualization from C-2 through S-1 and visualization of the femoral heads. Patients with ankylosing spondylitis or spinal deformity resulting from neuromuscular conditions, tumor, or infection were excluded from analysis. Radiological