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Hiroki Ushirozako, Tomohiko Hasegawa, Yu Yamato, Go Yoshida, Tatsuya Yasuda, Tomohiro Banno, Hideyuki Arima, Shin Oe, Yuki Mihara, Tomohiro Yamada, Koichiro Ide, Yuh Watanabe, Keichi Nakai, Takaaki Imada, and Yukihiro Matsuyama

.013 * Alcohol consumer 113 (18.1%) 128 (20.1%) 0.385 Smoker 134 (21.5%) 144 (22.6%) 0.649 Revision status 95 (15.2%) 51 (8.0%) <0.001 * ASA score 2.0 ± 0.5 1.9 ± 0.5 <0.001 * Preoperative complications  Hypertension 234 (37.6%) 260 (40.8%) 0.246  Diabetes mellitus 92 (14.8%) 102 (16.0%) 0.548  Chronic obstructive pulmonary disease 49 (7.9%) 34 (5.3%) 0.069  Asthma 49 (7.9%) 35 (5.5%) 0.090  Collagen disease 33 (5.3%) 29 (4.5%) 0.537  Chronic renal dysfunction 66 (10.6%) 48 (7.5%) 0.057 Current medication  Steroid 43 (6.9%) 68 (10.7%) 0.019 *  Immunosuppressant 20 (3.2%) 14 (2

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Rafael De la Garza-Ramos, Amit Jain, Khaled M. Kebaish, Ali Bydon, Peter G. Passias, and Daniel M. Sciubba

variances, and categorical data were compared via the chi-square or Fisher's exact test as appropriate. A binary logistic regression analysis was performed to identify the independent effect of hospital teaching status on inpatient morbidity and mortality. Regression analyses were adjusted for patient age (> 65 years), sex, comorbidities (congestive heart failure, chronic lung disease, coagulopathy, diabetes, obesity, liver disease, and renal failure), primary payer, case complexity, revision status, and diagnosis. Statistical significance was set at p < 0.05. Results

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Peter G. Passias, Bassel G. Diebo, Bryan J. Marascalchi, Cyrus M. Jalai, Samantha R. Horn, Peter L. Zhou, Karen Paltoo, Olivia J. Bono, Nancy Worley, Gregory W. Poorman, Vincent Challier, Anant Dixit, Carl Paulino, and Virginie Lafage

and lumbar fusions or re-fusions (81.06–81.08 and 81.36–81.38). Data Collection Demographic data for patient age, sex, race, mortality, comorbidity status, expected primary payer, total charges, length of hospital stay, and discharge/admission type were collected. Surgical factors collected included approach, number of levels fused/re-fused, osteotomy usage (77.39, 77.29), and revision status. Procedure-related complications resulting from surgical and medical care were determined using ICD-9-CM codes specific for individual complications. SCs included postoperative

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institution from 2005 to 2010 with a minimum follow-up period of 2 years. Inclusion criteria included a minimum age at surgery of 20 years and fusions ≥ 5 levels. Data included patient-based measures of health status, radiographic data, and revision status. Results: The cohort included 145 consecutive patients (mean age 59 years; female 122, male 23). The cumulative reoperation rate was 53.8% (78 patients) for all patients. The survival rate (avoidance of revision surgery) was 68% at 1 year, 57% at 2 years, and 52% at 3 years. Revision patients were as likely to

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created two groups similar in overall correction of the surgery. STA patients underwent more ALIF and LLIF interbody procedures while SIM patients had longer fusions. Charlson Comorbidity Index and revision status were similar between groups (p>0.05). There were significantly more complications causing reoperation in STA procedures (STA: 47% SIM: 8%, p=0.021). STA had a greater number of peri-op complications requiring a return to the OR (STA: 9.9% SIM: 1.4% p=0.029). There was no difference in intra-op complications, mortality, or peri-op infection or wound

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Sagittal balance is correlated with outcomes in adult deformity patients. The LSDI is a validated measure of functional impacts of lumbar spine stiffness. We correlated LSDI scores with other outcomes instruments and with sagittal balance in adult deformity patients. Methods: LSDI, ODI, SF-36, and SRS-22 were completed by adult spinal deformity patients across 12 centers. Surgical vs. non-operative treatment, revision status were recorded. SVA and Pelvic Incidence - Lumbar Lordosis (PI-LL) were measured. Pearson correlation coefficients of LSDI with SVA, PI-LL, ODI

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Rafael De la Garza Ramos, Jonathan Nakhla, Rani Nasser, Jacob F. Schulz, Taylor E. Purvis, Daniel M. Sciubba, Merritt D. Kinon, and Reza Yassari

(sickle cell disease, thalassemia, hereditary spherocytosis, and so forth). Operative data included number of spinal levels fused (7–12 vs ≥ 13 levels), revision status, combined anteroposterior approach, use of decompression (laminectomy), use of pelvic fixation, use of osteotomy, use of blood transfusion, average operative time, and average length of hospital stay. Thirty-day outcomes included the development of at least 1 perioperative complication, readmission, and reoperation. Examined complications included coma, pneumonia, reintubation, stroke, pulmonary embolism

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Kai-Ming G. Fu, Justin S. Smith, David W. Polly Jr., Christopher P. Ames, Sigurd H. Berven, Joseph H. Perra, Steven D. Glassman, Richard E. McCarthy, D. Raymond Knapp Jr., Christopher I. Shaffrey, and Scoliosis Research Society Morbidity and Mortality Committee

infection or tumor. Figure 1 illustrates the numbers of cases with each diagnosis and the percentage of procedures within each diagnosis that were revision procedures. F ig . 1. Case distribution by diagnosis and revision status. A total of 2040 complications were reported, for an overall complication rate of 8.5%. Table 1 presents the distribution of complications. Infection was the most common source of morbidity, with an overall rate of 2.7% (1% superficial and 1.7% deep wound infections). Implant-related complications were reported in 1.6% of patients

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Jian Guan, Chad D. Cole, Meic H. Schmidt, and Andrew T. Dailey

undergoing fusions of 7 or more segments during this period who had ROTEM-guided intraoperative blood management were identified ( Fig. 1 ). These patients were then matched based on age, surgical levels, osteotomy levels, interbody fusion levels, tranexamic acid (TXA) use, and revision status with historical controls operated on between March 1, 2012, and March 1, 2016, who had intraoperative blood management without ROTEM guidance ( Fig. 2 ). All included ROTEM-guided operations were performed sequentially over the study period with a single exception: 1 control case was

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Hugh K. Richards, Helen M. Seeley, and John D. Pickard

diagnosis data shown in Table 1 are identical for both cohorts. The way that controls are chosen ensures that they are contemporary but still random, allowing a reduction in bias attributable to any unknown risk factors. TABLE 1: Summary of demographic data in patients who underwent shunt procedures * Characteristic % sex  F 49.6  M 50.4 age in yrs  <10 33.5  10–20 8.5  20–30 4.9  30–40 8.0  40–50 9.4  50–60 10.9  60–70 13.5  >70 11.3 revision status  primary insertion