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Alexander R. Vaccaro and Luke Madigan

graft improves on some of the inherent weaknesses associated with the use of bone graft alone. Through its structure and inherent stability, an interbody cage assists in creating an environment conducive to bone healing, assists in maintaining sagittal alignment and neuroforaminal distraction, and decreases the risk of adjunctive graft displacement. 7, 11, 29, 47 Cages have disadvantages, however. Long-term clinical follow-up studies have demonstrated less than satisfactory results in multilevel stand-alone procedures. 40, 53, 54 Reported complications of metallic

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Gregory D. Schroeder, Christopher K. Kepler, MD MBA and Alexander R. Vaccaro

A rthrodesis of the lumbosacral junction is a common surgical procedure used successfully in the treatment of multiple spinal diseases such as scoliosis and spondylolisthesis. Several techniques to fuse this segment have been described; however, an interbody technique is commonly used. This method has a large surface area for new bone formation, provides anterior column support, and can reestablish the disc height, which can both indirectly decompress the nerve roots and aid in the correction of local and global sagittal alignment. 13 While this procedure

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Shannon Hann, Nohra Chalouhi, Ravichandra Madineni, Alexander R. Vaccaro, Todd J. Albert, James Harrop and Joshua E. Heller

increases with aging, but a typical normal range is 15°–25° (± 15° [SD]). 1 Successful cervical deformity correction needs to focus not only on restoring proper CL but also on achieving global balance of the cervical spine with other parts of the spine. Translation of the cervical spine in the sagittal plane is measured through the cervical sagittal vertical axis (SVA). Both C-2 SVA and C-7 SVA have been used to define sagittal alignment globally by measuring the distance between the C-2 and C-7 plumb lines from the superior corner of the sacrum ( Fig. 3 ). Ideal

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Alexander R. Vaccaro, John A. Carrino, Benjamin H. Venger, Todd Albert, Peter M. Kelleher, Alan Hilibrand and Kush Singh

bridging between the graft and host vertebral endplates, motion between the spinous processes on dynamic radiographs, and the presence of a lucent line at the graft—vertebral endplate junctions. In addition, soft-tissue response (prevertebral soft-tissue space) at the location of the resorbable plate was assessed on follow-up plain radiographs. The prevertebral soft-tissue space was measured as the AP soft-tissue shadow between the anterior cervical VB cortex and the border of the esophageal shadow ( Fig. 2 ). The sagittal alignment of the cervical spine was measured

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Jeffrey D. Coe, Alexander R. Vaccaro, Andrew T. Dailey, Rick C. Sasso, Steven C. Ludwig, James S. Harrop, Joseph R. Dettori, Christopher I. Shaffrey, Sanford E. Emery and Michael G. Fehlings

, Koeppen D , Kroppenstedt S , Woiciechowsky C : Comparison between anterior and posterior decompression with instrumentation for cervical spondylotic myelopathy: sagittal alignment and clinical outcome . Neurosurg Focus 28 : 3 E15 , 2010 5 Coe JD , Vaccaro AR , Dailey AT , Skolasky RL , Sasso RC , Brodt ED , : Lateral mass screw fixation in the cervical spine: a systematic review . J Bone Joint Surg Am 95 : 2136 – 2143 , 2013 6 Coe JD , Warden KE , Sutterlin CE III , McAfee PC : Biomechanical evaluation of cervical

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examined include presence of interbody fusion, rod diameter, rod material, age and preop sagittal alignment. Methods: A retrospective review of a multicenter, prospective ASD database was conducted. Inclusion criteria: age=18yr, ASD, no revisions between >6wk and <2yrs postop. Spinal pelvic parameters, thoracic kyphosis (TK:T2-T12) and lumbar lordosis (LL:L1-S1) were measured overall and within and outside of the instrumented segments. Changes for SVA, PT, PI-LL, TK, and LL between 6wks-2yrs postop were calculated. Of these pts, the amount of thoracic loss and TL

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surveys than NONOP (p<0.05). OP and NONOP had similar coronal alignment (p<0.05). OP had worse sagittal spinopelvic alignment for all measures than NONOP except cervical lordosis, TK and pelvic incidence (PI). OP had greater percentage of pure sagittal classification (type S; OP=23%, NON=14%; p<0.05). OP had worse grades for all modifier categories: PT (26% vs 16%), PI-lumbar lordosis mismatch (37% vs 21%) and global sagittal alignment (29% vs 9%), OP vs NONOP, respectively (p<0.05). Conclusion: Prospective analysis of OP vs NONOP treated ASD patients demonstrated

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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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30; p<0.001). Conclusions The addition of PPI seems to have a protective effect on the development of PJK. The analysis controlled for preoperative sagittal alignment as well as for correction of PI-LL. HYB was effective in restoring sagittal global alignment and cMIS in maintaining it. Neurosurg Focus Neurosurgical Focus FOC 1092-0684 American Association of Neurological Surgeons 2014.3.FOC-DSPNABSTRACTS Abstract Mayfield Clinical Science 243. Microendoscopic Decompression for Cervical Spondylotic Myelopathy

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deformation of non-operative spine fractures and identify predictive variables of angular change. Summary of Background Data Loss of normal sagittal alignment of the spine is a common sequela following thoracolumbar injuries. Patients treated non-operatively are especially at risk; however knowledge of the natural history of these injuries and predictors of deformation over time remains limited. Methods Patients with thoracolumbar fractures were identified via a trauma database. The angular change about the fracture site was determined comparing initial CT