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Tatsuya Yasuda, Tomohiko Hasegawa, Yu Yamato, Daisuke Togawa, Sho Kobayashi, Go Yoshida, Tomohiro Banno, Hideyuki Arima, Shin Oe and Yukihiro Matsuyama

R ecent studies have shown that sagittal spinopelvic alignment, including pelvic position, plays a critical role in the health-related quality of life of patients with adult spinal deformity (ASD). 4 , 7 , 12 , 13 Therefore, the goal of corrective surgery for ASD is to achieve and maintain optimal spinopelvic alignment. Lumbar lordosis (LL) is one of the important parameters for optimal sagittal alignment. The achievement of adequate LL is necessary for good results in corrective surgeries in spinal fusion. Additionally, LL is one of the main parameters that

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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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Chikezie I. Eseonu, Francisco Eguia, Oscar Garcia, Peter W. Kaplan and Alfredo Quiñones-Hinojosa

hypoxia. 27 , 28 , 30 From the patient’s perspective, these complications can lead to longer hospitalizations, increased hospital costs, permanent morbidity, and diminished quality of life and have a negative effect on survival. 9 , 17 , 33 Antiseizure drugs (ASDs) following an awake craniotomy are important for the management of postoperative seizures, although there is varying evidence about their efficacy. 16 , 19 , 26 , 28–30 , 34 , 43 Following cortical stimulation and tumor resection in an awake surgery, ASD management must be carefully handled. Inadequate ASD

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Owoicho Adogwa, Ryan Owens, Isaac Karikari, Vijay Agarwal, Oren N. Gottfried, Carlos A. Bagley, Robert E. Isaacs and Joseph S. Cheng

population continue to mount, governmental agencies and third-party payers are aiming to preferentially support higher value care and decrease spending on disease states with less impact on their population's health. Accordingly, there is a growing need to clearly define the treatment cost as well as the cost-effectiveness of revision decompression and extension of fusion for symptomatic pseudarthrosis, ASD, and same-level recurrent stenosis for this elderly population. Recently, funding of the Patient-Centered Outcomes Research Institute in the Patient Protection and

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Ferran Pellisé, Miquel Serra-Burriel, Justin S. Smith, Sleiman Haddad, Michael P. Kelly, Alba Vila-Casademunt, Francisco Javier Sánchez Pérez-Grueso, Shay Bess, Jeffrey L. Gum, Douglas C. Burton, Emre Acaroğlu, Frank Kleinstück, Virginie Lafage, Ibrahim Obeid, Frank Schwab, Christopher I. Shaffrey, Ahmet Alanay, Christopher Ames, the International Spine Study Group and the European Spine Study Group

A dult spinal deformity (ASD) can be a debilitating disease. Recent studies have shown that the burden of ASD in patients seeking specialized medical attention is substantial compared to that of other severe chronic conditions (i.e., diabetes, congestive heart failure, chronic lung disease, or arthritis). 3 , 26 Nonoperative care has not shown a significant impact on health-related quality of life (HRQOL), 5 , 9 while surgery is associated with HRQOL improvements 17 that are maintained over time. 18 , 30 Aging populations, the high prevalence of ASD, and an

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Martin H. Pham, Vivek A. Mehta, Neil N. Patel, Andre M. Jakoi, Patrick C. Hsieh, John C. Liu, Jeffrey C. Wang and Frank L. Acosta

D ynamic stabilization of the spine is a potential alternative to rigid lumbar fusion for lumbar degenerative spinal disease. 34 , 40 , 41 , 51 , 59 Recently, a nonfusion stabilization system with motion preservation (Dynesys system, Zimmer Spine) has been explored as an alternative to fusion in an effort to reduce adjacent-segment disease (ASD) and maintain greater physiological movement and function. 31 , 32 , 47 , 61 Dynesys is a pedicle screw–based dynamic stabilization system that has been used since 1994 and consists of pedicle screws, flexible

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Michael P. Kelly, Michael A. Kallen, Christopher I. Shaffrey, Justin S. Smith, Douglas C. Burton, Christopher P. Ames, Virginie Lafage, Frank J. Schwab, Han Jo Kim, Eric O. Klineberg, Shay Bess and the International Spine Study Group

M easurement of health-related quality of life (HRQOL) outcomes in medicine is a necessary endeavor, as it makes possible comparisons of intervention effectiveness and evaluations of quality of care. 14 , 15 HRQOL measurements also aid healthcare-related decision making. In adult spinal deformity (ASD) surgery, for example, HRQOL measurements support patient and surgeon decision making with respect to both appropriate timing for surgery and the outcome expectations of patients and surgeons alike. HRQOL instruments may be generic measures of health, such as the

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Lisheng Kan, Jian Kang, Rui Gao, Xiongsheng Chen and Lianshun Jia

A nterior cervical decompression and fusion, commonly including anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF), has proven to be effective in the treatment of cervical spondylosis. 23 However, many authors have reported that the increased biomechanical stress on the motion segment adjacent to the fused segment after fusion may accelerate the incidence of degenerative pathology at these adjacent levels, that is, so-called adjacent-segment degeneration (ASD). 13 , 14 Therefore, cervical disc arthroplasty

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Ali A. Baaj, Juan S. Uribe, Fernando L. Vale, Mark C. Preul and Neil R. Crawford

. 2–4 A better understanding of ASD, however, has been slowly changing attitudes toward fusion. Hilibrand et al. 17 demonstrated an ASD rate of 2.9%/year, leading to a significant number of reoperations. Similar studies by Katsuura et al. 18 and Goffin et al. 13 reported ASD rates as high as 50 and 36%, respectively. With biomechanical 10 and clinical 13 , 17 , 18 , 30 data demonstrating progression of ASD in the cervical spine after arthrodesis, interest in motion-preserving technology is likely to continue. The goal of this review was to highlight the

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Sanghyun Han, Seung-Jae Hyun, Ki-Jeong Kim, Tae-Ahn Jahng and Hyun-Jib Kim

their mobile segments might be flexible. The factors effecting deformity correction, especially angle change, obtained by PCO in the treatment of adult spinal deformity (ASD) remain unknown. The purpose of this study was to identify the factors that effect a gain of ≥ 10° angular change (AC) through PCO by comparing radiographic measurements between 2 groups, an AC group and a control group, before and after ASD surgery. We not only investigated the sagittal and pelvic parameters in ASD patients but also studied the radiographic parameters and radiological