Spine
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Prospective cross-sectional blinded-assessor cohort study. ⋯ The inter-rater reliability of total mJOA and its subscores is good, except for UE sensory function (moderate). However, the vast majority of assessments differed between observers, indicating that this measure should be interpreted carefully, particularly when near the threshold between severity categories, or when a patient is reassessed for deterioration. Further efforts to educate clinicians on administration and to refine the UE sensory subscore may enhance the reliability of this tool.Level of Evidence: 1.
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A consecutive series of patients who underwent minimally invasive spinal surgery by a single surgeon at a high-volume academic medical center were studied. ⋯ We report a 4.1% rate of return to the operating room for failed indirect decompression after LLIF for refractory radiculopathy. Graft subsidence and osteoporosis were common in these patients. All five patients who required secondary decompressive laminectomy or foraminotomy underwent stand-alone primary LLIF, and the persistent radiculopathy was consistently contralateral to the initial side of the LLIF approach.Level of Evidence: 4.
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Retrospective multicenter study. ⋯ SDW is sometimes seen in Lenke type 5 patients with AIS who underwent selective TL/L fusion. SDW seemed to occur as a compensation mechanism for progressing deformity of unfused segments (thoracic curve and residual lumbar curve) to maintain coronal alignment. Preoperative T curve > 30° and SDA > 0° (lower-end vertebra as L4) were determined as risk factors for SDW occurrence.Level of Evidence: 3.
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Multicenter Study
Surgical Site Infection following Primary Definitive Fusion for Pediatric Spinal Deformity: A Multicenter Study of Rates, Risk Factors, and Pathogens.
A retrospective multicenter study. ⋯ The overall infection rate was low. The most common causative bacteria were methicillin-resistant followed by gram-negative rods. Independent risk factors for SSI in pediatric patients undergoing spinal deformity surgery were scoliosis etiology, ASA class 3, and administration of antibiotic therapy twice daily.Level of Evidence: 3.
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Multicenter Study
Does Achieving Global Spinal Alignment Lead to Higher Patient Satisfaction and Lower Disability in Adult Spinal Deformity?
Multicenter retrospective review of prospective database. ⋯ The ability to restore global alignment depends on the severity of the preoperative deformity as well as the correction of the main aspect of the deformity. Achieving global coronal and sagittal alignment is an independent predictor of both satisfaction and disability at 2 years post-op. Patients who continue to be disabled are also not satisfied.Level of Evidence: 3.