Journal ArticleDOI
The Comprehensive Anatomical Spinal Osteotomy Classification
Frank J. Schwab,Benjamin Blondel,Benjamin Blondel,Edward Chay,Jason Demakakos,Lawrence G. Lenke,Patrick Tropiano,Christopher P. Ames,Justin S. Smith,Christopher I. Shaffrey,Steven D. Glassman,Jean-Pierre Farcy,Virginie Lafage +12 more
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TLDR
This proposed anatomically based classification system provides a consistent description of the various osteotomies performed in spinal deformity correction surgery and will provide a common frame for osteotomy assessment and permit comparative analysis of different treatments.Abstract:
Background Global sagittal malalignment is significantly correlated with health-related quality-of-life scores in the setting of spinal deformity. In order to address rigid deformity patterns, the use of spinal osteotomies has seen a substantial increase. Unfortunately, variations of established techniques and hybrid combinations of osteotomies have made comparisons of outcomes difficult. Objective To propose a classification system of anatomically-based spinal osteotomies and provide a common language among spine specialists. Methods The proposed classification system is based on 6 anatomic grades of resection (1 through 6) corresponding to the extent of bone resection and increasing degree of destabilizing potential. In addition, a surgical approach modifier is added (posterior approach or combined anterior and posterior approaches). Reliability of the classification system was evaluated by an analysis of 16 clinical cases, rated 2 times by 8 different readers, and calculation of Fleiss kappa coefficients. Results Intraobserver reliability was classified as "almost perfect"; Fleiss kappa coefficient averaged 0.96 (range, 0.92-1.0) for resection type and 0.90 (0.71-1.0) for the approach modifier. Results from the interobserver reliability for the classification were 0.96 for resection type and 0.88 for the approach modifier. Conclusion This proposed anatomically based classification system provides a consistent description of the various osteotomies performed in spinal deformity correction surgery. The reliability study confirmed that the classification is simple and consistent. Further development of its use will provide a common frame for osteotomy assessment and permit comparative analysis of different treatments.read more
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Journal ArticleDOI
The SRS-Schwab adult spinal deformity classification: assessment and clinical correlations based on a prospective operative and nonoperative cohort.
Jamie S. Terran,Frank J. Schwab,Christopher I. Shaffrey,Justin S. Smith,Pierre Devos,Christopher P. Ames,Kai-Ming G. Fu,Douglas Burton,Richard A. Hostin,Eric O. Klineberg,Munish C. Gupta,Vedat Deviren,Gregory M. Mundis,Robert A. Hart,Shay Bess,Virginie Lafage +15 more
TL;DR: This study demonstrates that the SRS-Schwab classification reflects severity of disease state based on multiple measures of HRQOL and significantly correlates with the important decision of whether to pursue operative or nonoperative treatment.
Journal ArticleDOI
Adult spinal deformity.
Bassel G. Diebo,Neil V. Shah,Oheneba Boachie-Adjei,Feng Zhu,Dominique A. Rothenfluh,Carl B. Paulino,Frank J. Schwab,Virginie Lafage +7 more
TL;DR: Evidence and knowledge are presented that represent the evolution of data related to spinal deformity in adults over the past several decades that represent an area requiring further investigation.
Journal ArticleDOI
Use of Surgimap Spine in Sagittal Plane Analysis, Osteotomy Planning, and Correction Calculation
TL;DR: A new method for a treatment approach to sagittal malalignment by incorporating new digital tools for surgical planning is proposed, which offers a consistent approach to adult spinal deformity with sagittal-plane components, and can permit optimization in consistently achieving proper postoperative spinopelvic alignment.
Journal ArticleDOI
Complications and intercenter variability of three-column osteotomies for spinal deformity surgery: a retrospective review of 423 patients
Kristina Bianco,Robert P. Norton,Frank J. Schwab,Justin S. Smith,Eric O. Klineberg,Ibrahim Obeid,Gregory MundisJr,Christopher I. Shaffrey,Khaled M. Kebaish,Richard A. Hostin,Robert A. Hart,Munish C. Gupta,Douglas Burton,Christopher P. Ames,Oheneba Boachie-Adjei,Themistocles S. Protopsaltis,Virginie Lafage +16 more
TL;DR: The overall incidence of major complications following 3CO procedures was 42%.
Journal ArticleDOI
Degenerative Spinal Deformity
Tamir Ailon,Justin S. Smith,Christopher I. Shaffrey,Lawrence G. Lenke,Darrel S. Brodke,James S. Harrop,Michael G. Fehlings,Christopher P. Ames +7 more
TL;DR: A narrative review of the recent literature on the epidemiology, evaluation, management, and outcomes of degenerative adult spinal deformity (ASD), characterized by malalignment in the sagittal and/or coronal plane, which is increasing in prevalence in North America due to an aging population and demographic shifts.
References
More filters
Journal ArticleDOI
The measurement of observer agreement for categorical data
J. R. Landis,Gary G. Koch +1 more
TL;DR: A general statistical methodology for the analysis of multivariate categorical data arising from observer reliability studies is presented and tests for interobserver bias are presented in terms of first-order marginal homogeneity and measures of interob server agreement are developed as generalized kappa-type statistics.
Journal ArticleDOI
ASSESSMENT OF COMA AND IMPAIRED CONSCIOUSNESS: A Practical Scale
Graham M. Teasdale,Bryan Jennett +1 more
TL;DR: A clinical scale has been evolved for assessing the depth and duration of impaired consciousness and coma that facilitates consultations between general and special units in cases of recent brain damage, and is useful also in defining the duration of prolonged coma.
Journal ArticleDOI
The three column spine and its significance in the classification of acute thoracolumbar spinal injuries
TL;DR: The author introduces the concept of middle column or middle osteoligamentouscomplex between the traditionally recognized posterior ligamentous complex and the anterior longitudinal ligament, and the correlation between the three-column system, the classification, the stability, the therapeutic indications are presented.
Journal ArticleDOI
A revision of the Trauma Score.
Howard R. Champion,William J. Sacco,Wayne S. Copes,Donald S. Gann,Thomas A. Gennarelli,Maureen E. Flanagan +5 more
TL;DR: T-RTS, the sum of coded values of GCS, SBP, and RR, demonstrated increased sensitivity and some loss in specificity when compared with a triage criterion based on TS and GCS values, and RTS demonstrated substantially improved reliability in outcome predictions compared to the TS.
Journal ArticleDOI
Adolescent Idiopathic Scoliosis: A New Classification to Determine Extent of Spinal Arthrodesis
Lawrence G. Lenke,Randal R. Betz,Jürgen Harms,Keith H. Bridwell,David H. Clements,Thomas G. Lowe,Kathy Blanke +6 more
TL;DR: A new two-dimensional classification of adolescent idiopathic scoliosis, as tested by two groups of surgeons, was shown to be much more reliable than the King system.