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Heesuk Kang, Paul Park, Frank La Marca, Scott J. Hollister and Chia-Ying Lin

A rtificial cervical disc arthroplasty has been introduced to limit the development of ASD that can occur with ACDF. By direct decompression along with disc height and neuroforaminal restoration, ACDF has achieved a success rate of over 90%, with resolution of symptoms and return to normal daily activities after surgery. 3 However, immobility of the fused level has been associated with accelerated degeneration at levels adjacent to the fused site, which is a major long-term concern with ACDF surgery. 1 , 9 , 12 , 18 , 23 Evidence of ASD has been shown in

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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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Paul Park, Michael Y. Wang, Virginie Lafage, Stacie Nguyen, John Ziewacz, David O. Okonkwo, Juan S. Uribe, Robert K. Eastlack, Neel Anand, Raqeeb Haque, Richard G. Fessler, Adam S. Kanter, Vedat Deviren, Frank La Marca, Justin S. Smith, Christopher I. Shaffrey, Gregory M. Mundis Jr. and Praveen V. Mummaneni

, including adult spinal deformity (ASD). Anand et al. 3 initially reported the feasibility of applying several different MIS techniques to treat symptomatic lumbar scoliosis. Subsequent reports have all confirmed successful MIS treatment of ASD. 5 , 17 , 21 , 24 These studies, however, have been limited by the relatively small numbers of patients evaluated, as well as the lack of focus on sagittal alignment and spinopelvic parameters, which are factors known to significantly impact long-term disability. 12 , 18 In addition, there has been no uniform MIS technique or

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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

O ver the past several decades, surgical treatment options for adult spinal deformity (ASD) have expanded, including both minimally invasive and open techniques. 3 , 12 , 14 , 18 , 27 Determining the most suitable approach in patients should take into account the risks and benefits of each surgical technique. Unfortunately, studies comparing the different operative techniques are lacking. Moreover, outcomes and complications of ASD are largely reported in terms of patient characteristics following traditional open techniques with little published data

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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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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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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

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spinal deformity (ASD) remains a challenge for the spinal surgeon. While minimally invasive surgery (MIS) has many favorable attributes that would be of great benefit for the ASD population, improvements in lordosis and sagittal balance have remained elusive using MIS an approach. This report describes the evolution of an MIS method for treating ASD with attention to sagittal correction. Methods: Over an 18 month period 25 patients with thoracolumbar scoliosis were treated surgically. The mean patient age was 72 years, with 68% females. Patients were treated with

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Association of Neurological Surgeons 2013.4.FOC-LSRSABSTRACTS Oral Presentation Abstracts Paper 47. Age, Sagittal Deformity and Operative Correction are Risk Factors for Proximal Junctional Failure (PJF) Following Adult Spinal Deformity (ASD) Surgery Robert Hart , MD , Richard Hostin , MD , Themistocles Protopsaltis , MD , Shay Bess , MD , Frank Schwab , MD , Virginie Lafage , PhD; , Praveen Mummaneni , MD , Christopher Ames , MD , Christopher Shaffrey , MD , Justin