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Christopher P. Ames, Justin S. Smith, Robert Eastlack, Donald J. Blaskiewicz, Christopher I. Shaffrey, Frank Schwab, Shay Bess, Han Jo Kim, Gregory M. Mundis Jr., Eric Klineberg, Munish Gupta, Michael O’Brien, Richard Hostin, Justin K. Scheer, Themistocles S. Protopsaltis, Kai-Ming G. Fu, Robert Hart, Todd J. Albert, K. Daniel Riew, Michael G. Fehlings, Vedat Deviren, Virginie Lafage and International Spine Study Group

posterosuperior corner of the C-7 vertebral body. The horizontal line with an arrow represents the C2–7 SVA. Given the significant impact of sagittal alignment on HRQOL among patients with thoracolumbar spinal deformities, and the studies of Tang et al. 54 and Smith et al. 45 demonstrating correlations between cervical sagittal alignment and multiple measures of HRQOL, the C2–7 SVA was selected as a modifier for the CSD classification. Based on regression analysis from Tang et al., a C2–7 SVA threshold of 4 cm was found to correlate with moderate disability based on the

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Taemin Oh, Justin K. Scheer, Robert Eastlack, Justin S. Smith, Virginie Lafage, Themistocles S. Protopsaltis, Eric Klineberg, Peter G. Passias, Vedat Deviren, Richard Hostin, Munish Gupta, Shay Bess, Frank Schwab, Christopher I. Shaffrey and Christopher P. Ames

A dult spinal deformity (ASD) is a pathological condition defined as spinal malalignment in the axial, coronal, or sagittal plane and is derivative of congenital, iatrogenic, degenerative, or idiopathic etiology. 30 The restoration of sagittal alignment, as established by the sagittal vertical axis (SVA; target < 5 cm) and pelvic tilt (PT; target < 20°) on sagittal radiography, is important in surgical deformity correction. 6 , 21 , 22 Although coronal plane correction also has clinical relevance, sagittal corrections appear to have greater importance, 5

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The comprehensive anatomical spinal osteotomy and anterior column realignment classification

Presented at the 2018 AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves

Juan S. Uribe, Frank Schwab, Gregory M. Mundis Jr., David S. Xu, Jacob Januszewski, Adam S. Kanter, David O. Okonkwo, Serena S. Hu, Deviren Vedat, Robert Eastlack, Pedro Berjano and Praveen V. Mummaneni

lordosis (LL) within 10° of the pelvic incidence (PI). 5 , 12 , 13 , 15 , 18 , 28 , 29 Traditionally, varying posterior shortening osteotomies were performed to release and reconstruct the spine to achieve appropriate sagittal alignment and spinopelvic harmony. Schwab et al. recently classified osteotomies from the posterior approach. 27 The classification is anatomically based with graduated complexity that ranges from simple inferior facet resection to those including pedicle subtraction osteotomy and vertebral column resection at 1 or more levels. Minimally invasive

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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

involved either a combination of approaches, such as multilevel lateral lumbar interbody fusion (LLIF), and/or MIS transforaminal lumbar interbody fusion (TLIF) followed by percutaneous fixation or hybrid surgeries typically involving LLIF combined with open posterior surgery. However, one of the potential disadvantages of MIS is that if more advanced techniques, such as anterior column realignment, are not performed, inadequate sagittal correction is a possibility. In the treatment of spinal deformity, there is substantial evidence that sagittal alignment is correlated

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Gregory W. Poorman, Peter G. Passias, Samantha R. Horn, Nicholas J. Frangella, Alan H. Daniels, D. Kojo Hamilton, Hanjo Kim, Daniel Sciubba, Bassel G. Diebo, Cole A. Bortz, Frank A. Segreto, Michael P. Kelly, Justin S. Smith, Brian J. Neuman, Christopher I. Shaffrey, Virginie LaFage, Renaud LaFage, Christopher P. Ames, Robert Hart, Gregory M. Mundis Jr. and Robert Eastlack

kyphosis (C2–7 sagittal Cobb angle ≥ 10°), cervical scoliosis (C2–7 coronal Cobb angle ≥ 10°), C2–7 sagittal vertical axis (SVA; C2–7) ≥ 4 cm, or chin-brow vertical angle ≥ 25° ( Fig. 1 ). Patients with an active spinal neoplasm, spinal infection, or pregnancy were excluded. FIG. 1. Schematic of the sagittal alignment parameters measured for the cervical ( left ) and global spinopelvic ( right ) spinal regions. C2–7 CL = cervical lordosis; CBVA = chin-brow vertical angle; LL = lumbar lordosis; PI = pelvic incidence; PT = pelvic tilt; TK = thoracic kyphosis. Patient

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-0684 American Association of Neurological Surgeons 10.3171/2017.3.FOC-DSPNabstracts 2017.3.FOC-DSPNABSTRACTS Charles Kuntz Scholar Award Presentations (Abstracts 104–123) 119. Laminoplasty vs. Laminectomy-Fusion for the Treatment of Cervical Myelopathy: Preliminary Results from the CSM-Study Comparing Cervical Sagittal Alignment and Clinical Outcomes Vijay Ravindra , MD, MSPH , Jill Curran , MS , Praveen V. Mummaneni , MD , Adam S. Kanter , MD , Erica Fay Bisson , MD, MPH , Robert F. Heary , MD

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thoracolumbar spine describes a subset of fractures with posterior ligamentous complex disruption in response to a flexion and distraction moment imparted to the thoracolumbar spine. These injuries are mechanically and neurologically unstable and surgical stabilization is frequently necessary to prevent neurological deterioration and maintain sagittal alignment. Conventionally, open posterior fixation and fusion have been utilized as the standard surgical treatment. Recently, percutaneous techniques with pedicle screws insertion are becoming popular as they provide

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Background/Introduction: Transforaminal lumbar interbody fusion (TLIF) has become a popular surgical option to complement posterolateral fusion (PLF) for treatment of degenerative spinal conditions. Purported advantages of TLIF over PLF alone include enhanced fusion rates, improved sagittal alignment, and direct decompression of the neuroforamen. Earlier studies have examined these issues and yielded inconclusive results. Another often suggested advantage, that TLIF provides superior immediate stability and protects against early pedicle screw loosening, has never been

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kyphosis correction and in a maintenance of the sagittal alignment similar to a long-segment instrumentation allowing to save two or more segments of vertebral motion. J Neurosurg Journal of Neurosurgery JNS 0022-3085 1933-0693 American Association of Neurological Surgeons 10.3171/2017.4.JNS.AANS2017abstracts 2017.4.JNS.AANS2017ABSTRACTS Oral Presentations 645: Enhanced Preoperative Prediction of Discharge Disposition for Neurosurgical Patients Nikhil Sharma , Matthew Piazza , MD , Rebecca DeMoor