该【letter to the editor adult spinal deformity surgery is it always worthwhile enrico tessitore资料 】是由【四婆子】上传分享,文档一共【3】页,该文档可以免费在线阅读,需要了解更多关于【letter to the editor adult spinal deformity surgery is it always worthwhile enrico tessitore资料 】的内容,可以使用淘豆网的站内搜索功能,选择自己适合的文档,以下文字是截取该文章内的部分文字,如需要获得完整电子版,请下载此文档到您的设备,方便您编辑和打印。NeurosurgicalForumletterstotheeditorAdultspinaldeformitysurgery:isitthermore,ithasbeenwidelyreportedthatsurgeriesnotoalwaysworthwhile?,theindustryembracessurgeriesthatin-volvemultipleoperatedvertebrallevels,whichmayhaveTOTHEEDITOR:Wereadwithgreatinterestthear-aneconomicimpactthatcannotbequantified,(SmithJS,KlinebergE,LafageV,ountdirectandindirectcostsofASDrevi-etal:Prospectivemulticenterassessmentofperioperativesionsurgery(acaveat:accordingtothepaperbySmithandminimum2-plicationratesas-etal.,therewasatleastonerevisionsurgeryin28%).Unfortunately,wehavetheimpressionthattheSpine25:1–14,July2016).Theauthorsconductedastudyspineindustryispushinginthisdirectionbypopulariz--ingtheconceptofsagittalbalanceandsupportingtrainingplicationsassociatedwithadultspinaldeformity(ASD)coursesstaffedwithrenownedexpertsonsagittalbalancesurgerywithaminimum2-yearfollow-,theideathatifsurgeonsmulticenterstudydesign;plicationarenotrespectingthesagittalbalancerulesthentheyareratesbyageandprovidedageneralassessmentoffactorsnotdoingagoodjobisdangerouslytakingholdinthesur-,,8,12plications(207minorand262major)plicationsofASDsurgeryareoftenunder-in203(%),-,plicationsinASDrevisionsurgerywasrequiredin82patients(%)%.%.Therewasahigh-greaterbodymassindex,orbidities,previ-plicationsinrevisioncasesandousspinesurgerywithfusion,and3-.-Withgreatpleasureandcontentment,ethisplicationsin7patientsoutof28patientswhounderwentpaperwrittenbyworld-,-plicationsinapproximately10%ofcases,ad-,easshownbyadeteriorationinalargepercentageofaffectedpatientsarenot“posterSF-”andareoftenaged,obese,plicationsnotonlyhaveanegativeimpactonpaincomorbidities,andhavepreviouslyundergonebacksur-intensity,functionalimpairment,,,354patientswithplicationrateoraputativeunfavorable11,,plicationwithanaveragetreat-follows:Issurgeryalwaysworthwhileandwhatshouldwementcostrangingfrom$15,817to$38,?forpatientswithdeepveinthrombosis,pulmonarythrom-eextremelypopularfol-boembolism,–“Frenchrevolution”,plicationsorparameters(.,pelvictilt,pelvicincidence,)ountinthetreatmentplan-,cardiacandpulmonaryfunctionneedtobethatrestoringsagittalbalanceisrelatedtoabetterpostop-assessed,coagulationpatternchecked,andeventuallyerativehealth-relatedqualityoflife(HRQOL).7,11,15Fur-,amodelthatpredictsJNeurosurgSpine?December2,20161NeurosurgicalforumplicationafterASDsurgery,Referencesratherthanrelativeriskoroddsratiovalues,wouldgreat-?,AhmadianA,DeukmedjianA,UribeJS:,forexample,isapredictivedeformity::1749–1761,2014?,BridwellKH,LenkeLG,BaldusCR,BlankeKM:Registry(SERR),essfultreat-registryforallpatientswhounderwentspinesurgeryatmentofflatbackdeformity(fixedsagittalimbalance).SpineHarborviewMedicalCenterandUniversityofWashing-(PhilaPa1976)24:1712–1720,?,ZadnikPL,RodriguezST,GokaslanZL,pli-SciubbaDM:Minimallyinvasivespinesurgeryforadultcation,suchascardiacfailureandinfection,(5):E7,complication,suchasincidentaldurotomy,accordingto2014thepatient’sriskfactorsandtheinvasivenessofsurgery.?,HamillCL,BridwellKH,SchwabFJ,DimarJR,LoweTG:(,further1976)32:2764–2770,2007validationstudiesaremandatorytotestthetool’sapplica-?,IyerS,ZebalaLP,KellyMP,SciubbaD,,etal:plicationsinadultMorerecently,expertsinthefieldhavereportedthatspinaldeformitysurgery:incidenceandriskfactorsin564theapplicationofminimallyinvasivesurgical(MIS)(PhilaPa1976)[epubaheadofprint],2016plication?,BerjanoP:Osteotomiesofthespine:“tech-,10However,MIStechniquesniqueofthedecade”?EurSpineJ24(Suppl1):S1–S2,2015?,FaundezA,DominguezD,HoffmeyerP,arenotsuitableforeveryASDcase,andingeneralitisAunobleS:Evidenceshowingtherelationshipbetweensagit-indicatedmostlyforcasesinvolvingnonfixedsagittalim-,thedefiniteroleofMIStechniquesdegenerativespinaldiseases::87–95,,?,KimKT,LeeSH,KangKC,OhHS,KimYJ,etal:ordingOvercorrectionoflumbarlordosisforadultspinaldefor-tovisualanalogscaleleg/backpainscores,OswestryDis-,treatmentintensityscale,andHRQOLmea-SpineJ25:2668–2275,2016suredwiththeSF-?,HacquebordJ,VarshneyA,CizikAM,%to100%,how-RJ,BellabarbaC,etal:plicationever,only4of10studiesreportingradiographicresultsonafterlumbarspinesurgery:(PhilaPa1976)36:1801–1806,-,OkonkwoDO,NguyenS,MundisGMJr,Thanportedamongthe258patients(45%),including37neuro-KD,DevirenV,etal:Canaminimalclinicallyimportantplications(14%).Thesedataclearlyshowthatdifferencebeachievedinelderlypatientswithadultspinaldeformitywhoundergominimallyinvasivespinalsurgery?MIStechniquesareassociatedwithaprobablylower,butWorldNeurosurg86:168–172,2016stillhigh,,HostinR,RobinsonC,SchwabF,LafageV,Bur-Wepersonallythinkthatsagittalbalanceisanappeal-tonDC,etal:Operativemanagementofadultspinaldeformi-ingconcept,,weonlytonon-operativemanagement:analysisof479patientswithhaveresultsaftera2-yearfollow-up,%ofpa-minimum2-yearfollow-(PhilaPa1976)[],,PatelA,UngarB,FarcyJP,LafageV:Adultspinaldeformity–postoperativestandingimbalance:,theprojectedlifeexpectancyofthesepatientsyoutolerate?Anoverviewofkeyparametersinassessingmaybe20–,(PhilaPaplicationsinthelong-termfollow-upmightbe1976)35:2224–2231,,-,KlinebergE,LafageV,ShaffreyCI,SchwabmendedfortheirhonestmulticenterreportshowingaF,LafageR,etal:Prospectivemulticenterassessmentofplicationratethanpreviouslyre-perioperativeandminimum2-plica-,weshouldtellourpatientsthetruth:NeurosurgSpine25:1–14,,RobinsonC,HostinR:ImpactofspineIftheymayhavesagittalimbalancewecanhelpthem,.“Primumnonnocere”and“dono9:327–332,2016furtherharm”conceptsshouldalwaysbekeptinmindbe-,BoissiereL,LarrieuD,BourghliA,VitalJM,,etal:Advantagesanddisadvantagesofadultspinaldeformitysurgeryanditsimpactonhealth-(PhilaPa1976)[epubaheadofprint],2016EnricoTessitore,,MDDisclosuresUniversityHospitalGeneva,?December2,2016NeurosurgicalforumResponseNoresponsewasreceivedfromtheauthorsoftheorigi-?PublishedonlineDecember2,2016;DOI:.SPINE16882.?AANS,2016JNeurosurgSpine?December2,20163
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