Long adult deformity fusions to L5 and the sacrum. A matched cohort analysis

Spine
Charles C EdwardsLawrence G Lenke

Abstract

A matched cohort analysis of long adult deformity fusions according to distal fusion level (L5 vs. S1). OBJECTIVE.: To compare the results of long adult deformity fusions to either L5 or the sacrum in the presence of a "healthy" 5-1 disc using a matched cohort analysis. For adult spinal deformity, the decision often arises whether to terminate a long fusion at L5 or the sacrum. The decision is especially challenging in the presence of a "healthy" (Grade 0 to 1 degeneration) 5-1 disc. A total of 95 adult deformity patients that underwent fusion from the thoracic spine to either L5 or the sacrum were sorted according to five preoperative criteria: 5-1 disc status, patient age, smoking status, number of levels fused, and sagittal balance. Two cohorts (L5, 27 patients; sacrum, 12 patients) were precisely matched according to the five criteria. Patients were evaluated at 2-year minimum follow-up according to radiographic data, complications, and SRS-24 outcomes. Correction of sagittal imbalance was superior for sacrum patients (C7 plumb line: L5, 0.9 cm; sacrum, 3.2 cm; P = 0.03). At latest follow-up (L5, 5.2 years; sacrum, 3.7 years), 67% of L5 patients had radiographic evidence of advanced 5-1 disc degeneration and the L5 cohort t...Continue Reading

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Citations

Jan 24, 2009·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Kyu-Jung ChoMan-Hee Won
Apr 26, 2012·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Qingan ZhuPeter A Cripton
Mar 20, 2013·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·F ZhuY Qiu
Jan 16, 2014·HSS Journal : the Musculoskeletal Journal of Hospital for Special Surgery·Dennis S MeredithVishal V Hegde
Sep 2, 2006·Spine·Behrooz A AkbarniaK W Hammerberg
Sep 2, 2006·Spine·David W PollyKeith H Bridwell
Jul 2, 2009·Journal of Pediatric Orthopedics·Kevin W FarmerMichael C Ain
Sep 2, 2008·Spine·Elias C PapadopoulosFederico P Girardi
May 21, 2009·Spine·Joseph R O'BrienKhaled M Kebaish
Jun 16, 2009·Spine·Martin QuirnoThomas J Errico
Apr 17, 2012·Spine·Sebastien CharoskyUNKNOWN Study Group on Scoliosis
Oct 23, 2012·Journal of Biomechanical Engineering·Andrew L FreemanJoan E Bechtold
Apr 7, 2010·Journal of Neurosurgery. Spine·Jordan M CloydChristopher P Ames
Mar 3, 2010·Neurosurgical Focus·Lauren E MatteiniJoseph R O'Brien
Aug 3, 2010·Journal of Neurosurgery. Spine·Rani NasserJohn K Ratliff
Aug 5, 2008·Neurosurgical Focus·Justin S SmithRichard G Fessler
Dec 10, 2013·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Kingsley Abode-IyamahPatrick W Hitchon
Jan 1, 2014·Journal of Medical Case Reports·Gerald My Quan, Peter Wilde
Jul 13, 2013·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Loyola V GressotAndrew Jea
May 3, 2014·Neurosurgical Focus·Juan S UribeUNKNOWN International Spine Study Group
Apr 10, 2013·World Neurosurgery·Jeremy L Fogelson, William E Krauss
Feb 2, 2016·The Spine Journal : Official Journal of the North American Spine Society·Patrick D KellyClinton J Devin
Jan 29, 2016·Journal of Korean Neurosurgical Society·Jong-Hwa ParkTae-Ahn Jahng
Dec 10, 2013·The Spine Journal : Official Journal of the North American Spine Society·Adam L WollowickRonald A Lehman
Apr 30, 2013·The Spine Journal : Official Journal of the North American Spine Society·Dennis S MeredithFederico P Girardi

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