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Darryl Lau, Dean Chou and Praveen V. Mummaneni

degrees indicated straightening of the spine and no curvature. The need for supplemental PSF was recorded. The primary outcomes of interest were postoperative sagittal Cobb angle, adjacent-segment disease (ASD), neck pain VAS score, and Nurick score. ASD was defined as new disease affecting the level inferior and/or superior to the operated levels that required surgery. Secondary outcomes of interest included estimated blood loss (EBL), dysphagia, length of stay, perioperative complications, perioperative mortality, and pseudarthrosis rate. The EBL was recorded in

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Junseok Bae, Alexander A. Theologis, Russell Strom, Bobby Tay, Shane Burch, Sigurd Berven, Praveen V. Mummaneni, Dean Chou, Christopher P. Ames and Vedat Deviren

T reatment options for adult spinal deformity (ASD) are varied according to the patient’s baseline condition. Patients with minimal pain and mild thoracolumbar coronal deformity might benefit from conservative treatment. 18 The goal of surgical treatment for patients with ASD is to achieve sagittal and coronal balance, relieve axial and radiating pain, and achieve fusion. The surgical treatment of ASD is an effective endeavor that can be accomplished using a variety of surgical strategies. Interbody fusion has been advocated as an important surgical option in

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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 ( ). 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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Paul Park, Kai-Ming Fu, Robert K. Eastlack, Stacie Tran, Gregory M. Mundis Jr., Juan S. Uribe, Michael Y. Wang, Khoi D. Than, David O. Okonkwo, Adam S. Kanter, Pierce D. Nunley, Neel Anand, Richard G. Fessler, Dean Chou, Mark E. Oppenlander, Praveen V. Mummaneni and the International Spine Study Group

I n the surgical treatment of symptomatic adult spinal deformity (ASD), spinopelvic alignment is considered an important factor in achieving a successful result. Specifically, several parameters, including pelvic tilt (PT), pelvic incidence to lumbar lordosis (PI-LL) mismatch, and sagittal vertical axis (SVA), have been correlated with clinical outcomes. It has been proposed that optimal spinopelvic alignment goals should consist of a PT < 20°, a PI-LL mismatch ± 9°, and an SVA < 50 mm. 9 Based predominantly on correlation studies, it has been presumed that

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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.

deformity (ASD). 25 Methods Study Design and Patient Population We performed a retrospective analysis of data collected from a multicenter database of patients with ASD who had been treated with a component of minimally invasive surgical techniques between 2009 and 2013. Eleven participating institutions contributed data, and each site obtained institutional review board approval. Inclusion criteria for entry into the multicenter database were patient age of ≥ 18 years and at least 1 of the following factors: a coronal Cobb angle (CCA) of > 20°, a sagittal vertical axis

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Paul Park, Kai-Ming Fu, Praveen V. Mummaneni, Juan S. Uribe, Michael Y. Wang, Stacie Tran, Adam S. Kanter, Pierce D. Nunley, David O. Okonkwo, Christopher I. Shaffrey, Gregory M. Mundis Jr., Dean Chou, Robert Eastlack, Neel Anand, Khoi D. Than, Joseph M. Zavatsky, Richard G. Fessler and the International Spine Study Group

A dult spinal deformity (ASD) can cause significant pain and disability. When the deformity is refractory to medical management, spinal deformity surgery can effectively improve pain and function. 14 Presently, there are many options for the surgical treatment of ASD, including minimally invasive surgery (MIS). 2 , 4 , 9 , 10 , 16 , 17 The potential advantages of MIS primarily reflect a significantly diminished exposure-related morbidity resulting in decreased bleeding, length of stay, and pain, and possibly faster recovery. Initial applications of MIS for ASD

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Khoi D. Than, Paul Park, Kai-Ming Fu, Stacie Nguyen, Michael Y. Wang, Dean Chou, Pierce D. Nunley, Neel Anand, Richard G. Fessler, Christopher I. Shaffrey, Shay Bess, Behrooz A. Akbarnia, Vedat Deviren, Juan S. Uribe, Frank La Marca, Adam S. Kanter, David O. Okonkwo, Gregory M. Mundis Jr., Praveen V. Mummaneni and the International Spine Study Group

M invasive surgery (MIS) techniques are increasingly used in spine surgery, including in the treatment of adult spinal deformity (ASD). Such techniques include minimally invasive transpsoas retroperitoneal approaches for lateral lumbar interbody fusion (LLIF) and minimally invasive transforaminal lumbar interbody fusion (MI-TLIF). Previous work has suggested that minimally invasive spinal deformity correction is associated with fewer intraoperative complications than open or hybrid techniques 9 with comparable clinical outcomes. 2 However, with the

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adjacent segment disease (ASD) in the cervical spine. Methods: 888 patients received ACDFs for symptomatic degenerative disease of the cervical spine over the past 22 years at our institution. Of these, 108 patients received repeat ACDF surgeries due to symptomatic ASD. 77 received revision surgeries anteriorly, and 31 received posterior surgeries. Pre, intra, peri, and post-operative data were collected via clinical notes and patient interviews. Patients were followed up for an average of 111.8±76.5 months after the first ACDF. Results: In general, patients

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between the two forms of treatment emerge. Neurosurg Focus Neurosurgical Focus FOC 1092-0684 American Association of Neurological Surgeons 2015.3.FOC-DSPNABSTRACTS 103. A Prospective, Multi-Center Assessment of the Best Versus Worst Clinical Outcomes for Adult Spinal Deformity (ASD) Surgery Justin S. Smith , MD PhD , Christopher I. Shaffrey , MD FACS , Virginie Lafage , PhD , Frank Schwab , MD, PhD , Themistocles Protopsaltis , MD , Eric Klineberg , MD , Munish

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remains stable comparing 3 and 12-month results. Neurosurg Focus Neurosurgical Focus FOC 1092-0684 American Association of Neurological Surgeons 2014.3.FOC-DSPNABSTRACTS Abstract Outcomes Award 103. Two Year Prospective, Multicenter Analysis of Consecutive Adult Spinal Deformity (ASD) Patients Demonstrates Higher Fusion Grade, Lower Implant Failures and Greater Improvement in SRS-22r Scores for Patients Treated with Recombinant Human Bone Morpho Kai-Ming G. Fu , MD PhD , Eric Klineberg , MD , Shay