The comprehensive anatomical spinal osteotomy and anterior column realignment classification

Journal of Neurosurgery. Spine
Juan S UribePraveen V Mummaneni

Abstract

OBJECTIVESpinal osteotomies and anterior column realignment (ACR) are procedures that allow preservation or restoration of spine lordosis. Variations of these techniques enable different degrees of segmental, regional, and global sagittal realignment. The authors propose a comprehensive anatomical classification system for ACR and its variants based on the level of technical complexity and invasiveness. This serves as a common language and platform to standardize clinical and radiographic outcomes for the utilization of ACR.METHODSThe proposed classification is based on 6 anatomical grades of ACR, including anterior longitudinal ligament (ALL) release, with varying degrees of posterior column release or osteotomies. Additionally, a surgical approach (anterior, lateral, or posterior) was added. Reliability of the classification was evaluated by an analysis of 16 clinical cases, rated twice by 14 different spine surgeons, and calculation of Fleiss kappa coefficients.RESULTSThe 6 grades of ACR are as follows: grade A, ALL release with hyperlordotic cage, intact posterior elements; grade 1 (ACR + Schwab grade 1), additional resection of the inferior facet and joint capsule; grade 2 (ACR + Schwab grade 2), additional resection of bo...Continue Reading

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Citations

Jun 13, 2020·Global Spine Journal·Jakub GodzikJuan S Uribe
Aug 16, 2019·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·Luigi La BarberaMarco Brayda-Bruno
Aug 8, 2020·Spine Deformity·Ibrahim HussainPraveen V Mummaneni
May 3, 2019·Journal of Neurosurgery. Spine·Justin S SmithLawrence G Lenke
Aug 14, 2019·Operative Neurosurgery·Joshua T Wewel, Juan S Uribe
Feb 7, 2021·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·Jae Taek HongIl Sup Kim
Feb 26, 2021·Revista Brasileira De Ortopedia·Alexandre Fogaça CristanteRaphael Martus Marcon
Jan 4, 2022·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·Nathan HanCharles Sansur
Mar 13, 2021·Journal of Neurosurgery. Spine·Praveen V MummaneniUNKNOWN International Spine Study Group

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