FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W4386041704> ?p ?o ?g. }

• W4386041704 endingPage "S157" @default.
• W4386041704 startingPage "S157" @default.
• W4386041704 abstract "BACKGROUND CONTEXT Harmonizing the various ideal parameters defined in adult spinal deformity (ASD) surgery has recently come into prominence. GAP scoring, defined by relative pelvic incidence, relative lumbar lordosis, relative spinopelvic alignment, and the lordosis distribution index, was itself superseded by the SAAS system, which incorporated GAP and age-adjusted parameters to predict associations with proximal junctional kyphosis and postoperative outcomes. However, the incorporation of Roussouly typing into such schema has not been fully explored, and may be necessary in order to prevent postoperative complications and improve patients’ quality of life. PURPOSE To quantify spinal shape as defined by the Roussouly classification, in conjunction with existing Global Alignment and Proportion (GAP) parameters and the novel Sagittal Age-Adjusted Score (SAAS), to identify unique schema associated with optimal post-operative outcomes. STUDY DESIGN/SETTING Retrospective, single-center. PATIENT SAMPLE A total of 689 ASD patients. OUTCOME MEASURES Radiographics, complications, Health-Related Quality of Life (HRQLs) measures METHODS Surgical ASD patients (SVA≥5cm, PT≥25°, or TK ≥60°, >3 levels fused) ≥18 years old with available baseline (BL) radiographic data at baseline (BL) and 2-years (2Y) were isolated. Patients were grouped by “theoretical” Roussouly type (Type I: PI<45°, LL apex below L4; Type II: PI<45°, LL apex above L4, L4-L5 space; Type III: 45°<PI60°) at baseline. Crosstabulation and univariate analysis determined distribution of BL GAP and sagittal age-adjusted score (SAAS) parameters within each group. Logistic predictive modeling while achieving optimal outcomes, defined as ≥2 of the following: 1) no PJK or PJF by 2Y, 2) no major surgical complication or reoperation by 2Y, 3) achieving MCID in ODI or Smith et al. Best Clinical Outcomes (BCO) in ODI. Conditional Inference Tree (CIT) analysis determined GAP and SAAS scores associated with matching target Roussouly typing by 6W. RESULTS There were 244 ASD patients included (61.38±13.66 years, 77% female, 27.90±5.89kg/m2, mean CCI: 1.85±1.73). At BL theoretical Roussouly classification, 51.4% of patients were classified as Type II, 34.2% were classified as Type III, 14.4% were classified as Type IV, and none were classified as Type I. GAP proportionality at BL was significantly different between groups, with increasing Roussouly classification significantly associated with increasing probability of categorization as GAP-Severely Disproportioned (p<.001). BL SAAS scores also differed by theoretical Roussouly types (p<.001), with Bonferroni-adjustment demonstrating significantly lower scores between Type II vs Type III or Type IV patients (both p<.001). CIT analysis revealed that for Type II, 6W GAP scores 0 (p3 (p<.001) were predictive of meeting optimal outcome. For Type IV, 6W GAP scores ≤4 (p<.001) were also predictive of meeting optimal outcome. CONCLUSIONS Unification of the various alignment schema within adult spinal deformity (ASD) surgery continues to be a challenging issue, yet incorporation of pelvic-incidence based on Roussouly classification remains understudied. Our study demonstrates that adaptation of GAP and SAAS goals in alignment of patients’ spinal morphology may increase probability of achieving optimal outcomes post-operatively. In addition, with the lower Roussouly types (Type I, II) associated with a greater need for adhering to stricter alignment by the GAP and SAAS parameters to achieve optimal outcomes and maintain spinal morphology. FDA Device/Drug Status This abstract does not discuss or include any applicable devices or drugs. Harmonizing the various ideal parameters defined in adult spinal deformity (ASD) surgery has recently come into prominence. GAP scoring, defined by relative pelvic incidence, relative lumbar lordosis, relative spinopelvic alignment, and the lordosis distribution index, was itself superseded by the SAAS system, which incorporated GAP and age-adjusted parameters to predict associations with proximal junctional kyphosis and postoperative outcomes. However, the incorporation of Roussouly typing into such schema has not been fully explored, and may be necessary in order to prevent postoperative complications and improve patients’ quality of life. To quantify spinal shape as defined by the Roussouly classification, in conjunction with existing Global Alignment and Proportion (GAP) parameters and the novel Sagittal Age-Adjusted Score (SAAS), to identify unique schema associated with optimal post-operative outcomes. Retrospective, single-center. A total of 689 ASD patients. Radiographics, complications, Health-Related Quality of Life (HRQLs) measures Surgical ASD patients (SVA≥5cm, PT≥25°, or TK ≥60°, >3 levels fused) ≥18 years old with available baseline (BL) radiographic data at baseline (BL) and 2-years (2Y) were isolated. Patients were grouped by “theoretical” Roussouly type (Type I: PI<45°, LL apex below L4; Type II: PI<45°, LL apex above L4, L4-L5 space; Type III: 45°<PI60°) at baseline. Crosstabulation and univariate analysis determined distribution of BL GAP and sagittal age-adjusted score (SAAS) parameters within each group. Logistic predictive modeling while achieving optimal outcomes, defined as ≥2 of the following: 1) no PJK or PJF by 2Y, 2) no major surgical complication or reoperation by 2Y, 3) achieving MCID in ODI or Smith et al. Best Clinical Outcomes (BCO) in ODI. Conditional Inference Tree (CIT) analysis determined GAP and SAAS scores associated with matching target Roussouly typing by 6W. There were 244 ASD patients included (61.38±13.66 years, 77% female, 27.90±5.89kg/m2, mean CCI: 1.85±1.73). At BL theoretical Roussouly classification, 51.4% of patients were classified as Type II, 34.2% were classified as Type III, 14.4% were classified as Type IV, and none were classified as Type I. GAP proportionality at BL was significantly different between groups, with increasing Roussouly classification significantly associated with increasing probability of categorization as GAP-Severely Disproportioned (p<.001). BL SAAS scores also differed by theoretical Roussouly types (p<.001), with Bonferroni-adjustment demonstrating significantly lower scores between Type II vs Type III or Type IV patients (both p<.001). CIT analysis revealed that for Type II, 6W GAP scores 0 (p3 (p<.001) were predictive of meeting optimal outcome. For Type IV, 6W GAP scores ≤4 (p<.001) were also predictive of meeting optimal outcome. Unification of the various alignment schema within adult spinal deformity (ASD) surgery continues to be a challenging issue, yet incorporation of pelvic-incidence based on Roussouly classification remains understudied. Our study demonstrates that adaptation of GAP and SAAS goals in alignment of patients’ spinal morphology may increase probability of achieving optimal outcomes post-operatively. In addition, with the lower Roussouly types (Type I, II) associated with a greater need for adhering to stricter alignment by the GAP and SAAS parameters to achieve optimal outcomes and maintain spinal morphology." @default.
• W4386041704 created "2023-08-22" @default.
• W4386041704 creator A5002990814 @default.
• W4386041704 creator A5033588320 @default.
• W4386041704 creator A5036688363 @default.
• W4386041704 creator A5042278898 @default.
• W4386041704 creator A5045070551 @default.
• W4386041704 creator A5069140493 @default.
• W4386041704 creator A5080429360 @default.
• W4386041704 creator A5083749002 @default.
• W4386041704 creator A5083789813 @default.
• W4386041704 date "2023-09-01" @default.
• W4386041704 modified "2023-10-09" @default.
• W4386041704 title "P102. Quantifying the impact of spinal shape: incorporating Roussouly criteria into novel alignment schemata increases probability of optimal radiographic alignment in adult spinal deformity surgery" @default.
• W4386041704 doi "https://doi.org/10.1016/j.spinee.2023.06.327" @default.
• W4386041704 hasPublicationYear "2023" @default.
• W4386041704 type Work @default.
• W4386041704 citedByCount "0" @default.
• W4386041704 crossrefType "journal-article" @default.
• W4386041704 hasAuthorship W4386041704A5002990814 @default.
• W4386041704 hasAuthorship W4386041704A5033588320 @default.
• W4386041704 hasAuthorship W4386041704A5036688363 @default.
• W4386041704 hasAuthorship W4386041704A5042278898 @default.
• W4386041704 hasAuthorship W4386041704A5045070551 @default.
• W4386041704 hasAuthorship W4386041704A5069140493 @default.
• W4386041704 hasAuthorship W4386041704A5080429360 @default.
• W4386041704 hasAuthorship W4386041704A5083749002 @default.
• W4386041704 hasAuthorship W4386041704A5083789813 @default.
• W4386041704 hasConcept C141071460 @default.
• W4386041704 hasConcept C2779982284 @default.
• W4386041704 hasConcept C29694066 @default.
• W4386041704 hasConcept C2992931878 @default.
• W4386041704 hasConcept C2994406423 @default.
• W4386041704 hasConcept C36454342 @default.
• W4386041704 hasConcept C71924100 @default.
• W4386041704 hasConceptScore W4386041704C141071460 @default.
• W4386041704 hasConceptScore W4386041704C2779982284 @default.
• W4386041704 hasConceptScore W4386041704C29694066 @default.
• W4386041704 hasConceptScore W4386041704C2992931878 @default.
• W4386041704 hasConceptScore W4386041704C2994406423 @default.
• W4386041704 hasConceptScore W4386041704C36454342 @default.
• W4386041704 hasConceptScore W4386041704C71924100 @default.
• W4386041704 hasIssue "9" @default.
• W4386041704 hasLocation W43860417041 @default.
• W4386041704 hasOpenAccess W4386041704 @default.
• W4386041704 hasPrimaryLocation W43860417041 @default.
• W4386041704 hasRelatedWork W2123828266 @default.
• W4386041704 hasRelatedWork W2125675543 @default.
• W4386041704 hasRelatedWork W2218755231 @default.
• W4386041704 hasRelatedWork W2321595462 @default.
• W4386041704 hasRelatedWork W2355728328 @default.
• W4386041704 hasRelatedWork W2762417713 @default.
• W4386041704 hasRelatedWork W2764125701 @default.
• W4386041704 hasRelatedWork W2943064258 @default.
• W4386041704 hasRelatedWork W4386041946 @default.
• W4386041704 hasRelatedWork W4387329420 @default.
• W4386041704 hasVolume "23" @default.
• W4386041704 isParatext "false" @default.
• W4386041704 isRetracted "false" @default.
• W4386041704 workType "article" @default.