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Darryl Lau, Andrew K. Chan, Vedat Deverin and Christopher P. Ames

A dult spinal deformity (ASD) can result in sagittal and/or coronal imbalance, which is generally the result of asymmetrical degeneration of vertebral bodies, intervertebral discs, and facet joints. 9 This progressive degenerative process can be hastened in the setting of concurrent spinal disease (chronic fractures and remote infection) or in patients with a history of prior spinal surgery with or without spinal instrumentation. Patients with ASD typically present with debilitating axial back and neck pain, neurological deficits, and functional impairment

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Darryl Lau, Vedat Deviren and Christopher P. Ames

A dult spinal deformity (ASD) arises from multiple etiologies, but most commonly it arises from arthritic spondylosis and iatrogenic causes that lead to asymmetrical degeneration of discs, facet joints, and other spinal elements. Imbalance and spinal misalignment are strongly correlated with disability and pain outcomes—greater imbalance results in greater functional disability. 14 , 22 , 39 Fortunately, the surgical correction and reestablishment of age-appropriate global spinal alignment and spinopelvic parameters have been demonstrated to significantly

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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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Cecilia L. Dalle Ore, Christopher P. Ames, Vedat Deviren and Darryl Lau

study compares perioperative and long-term outcomes of RA adult spinal deformity (ASD) patients to a matched cohort of non-RA ASD patients based on demographics, comorbidities, surgical approach, and spinal construct similarity. Methods This study was formally approved by the Committee of Human Research at the University of California, San Francisco. Patient Cohort Patients were identified via a comprehensive retrospective review of the electronic medical record. This study included all adult patients (over age 18 years at time of surgery) who underwent a posterior

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Darryl Lau, Alexander F. Haddad, Vedat Deviren and Christopher P. Ames

A dult spinal deformity (ASD) is an extremely heterogenous disease, with many cases involving multiplanar deformity. 1 , 2 Much ASD research and clinical concentration has gone into the understanding and treatment of sagittal deformity in adults. 3 However, there has been a greater accumulation of data supporting the clinical importance of coronal imbalance and malalignment. 2 While most ASD cases of coronal imbalance are secondary to severe scoliosis, significant coronal imbalance can also occur in cases of uncompensated mild scoliosis (fractional curve). In

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Darryl Lau, Joseph A. Osorio, Vedat Deviren and Christopher P. Ames

A dult spinal deformity (ASD) arises from multiple etiologies, but most commonly from arthritic spondylosis leading to asymmetrical degeneration of discs, facet joints, and other spinal elements. 13 This degenerative process can be hastened by iatrogenic factors (such as prior spine surgery) that result in instability, which further leads to instrumentation failure and junctional kyphosis/failure. ASD can be asymptomatic but is most often progressive, leading to severe axial back pain and neurological deficits in the setting of compression of neural elements

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Darryl Lau, Alexander F. Haddad, Vedat Deviren and Christopher P. Ames

A dult spinal deformity (ASD) is a heterogeneous disease that encompasses a variety of structural deformities mainly due to degenerative disease and iatrogenic causes. In ASD, worse deformity has been correlated to worse functional disability, especially for sagittal plane deformity and spinopelvic imbalance. 1–3 As a result, the Scoliosis Research Society Schwab classification has set the standard for sagittal correction goals with pelvic incidence–lumbar lordosis (PI-LL) mismatch within 10°, sagittal vertical axis (SVA) < 40 mm, and PI < 20°. However

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Darryl Lau, Cecilia L. Dalle Ore, Patrick Reid, Michael M. Safaee, Vedat Deviren, Justin S. Smith, Christopher I. Shaffrey and Christopher P. Ames

surgical interventions. Pediatric cases often involve scoliosis, coronal imbalance, and the thoracic region, whereas adult spinal deformity (ASD) cases more often involve sagittal imbalance, spinopelvic mismatch, and the lumbar spine. Thus, the results from pediatric studies may not be directly applicable to an ASD population. MEP use is best understood in spine surgery as a measure for spinal cord monitoring, and the true utility of using transcranial MEPs when operating in the lumbar spine (a region of thecal sac and nerve roots without spinal cord) remains

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Alex Soroceanu, Justin S. Smith, Darryl Lau, Michael P. Kelly, Peter G. Passias, Themistocles S. Protopsaltis, Jeffrey L. Gum, Virginie Lafage, Han-Jo Kim, Justin K. Scheer, Munish Gupta, Gregory M. Mundis Jr., Eric O. Klineberg, Douglas Burton, Shay Bess, Christopher P. Ames and the International Spine Study Group

T he pathogenesis and surgical correction of thoracolumbar deformity in patients with adult spinal deformity (ASD) is now a well-studied entity. There are numerous landmark studies and published literature describing its surgical treatment and patient outcomes, resulting in a validated classification system. 1 On the other hand, adult cervical deformity (ACD) is a more recently characterized pathology, with a newly developed and validated classification system. 2 Recent studies have demonstrated that ACD, defined as the disruption of normal cervical alignment

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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