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- 저자 : Eric O. Klineberg (검색결과 2 건)
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Pope Rodnoi,Hai Le,Luke Hiatt,Joseph Wick,Joshua Barber,Yashar Javidan,Rolando Roberto,Eric O. Klineberg 대한척추신경외과학회 2021 Neurospine Vol.18 No.3
Objective: To investigate prevention of proximal junctional kyphosis (PJK) and failure (PJF) following adult spinal deformity (ASD) surgery utilizing a novel technique of posterior ligament augmentation with polyester fiber tether. Methods: This study evaluated ASD adult patients who underwent posterior decompression and instrumented fusion from the thoracolumbar junction (T9–L1) to the pelvis from 2011–2017. Basic demographic data were obtained. Radiographic outcomes included proximal junctional angle (PJA), sagittal vertical axis, PJK, and PJF. The study population was divided into patients who had ASD surgery with and without ligamentous augmentation. Results: A total of 43 subjects were evaluated, including 20 without and 23 with ligamentous augmentation. PJA increased over time for both groups. PJA was smaller for the augmented group, and rate of increase in PJA was slower in the augmented group (p<0.0001). The rate of PJK was significantly higher in the nonaugmented group (p=0.01). PJF was significantly less common in the augmented group (p=0.003). Time to revision surgery was lower in the nonaugmented group (p=0.003). Conclusion: Our novel ligament augmentation technique utilizing polyethylene tape is an effective technique to slow progression of the PJA and lower the risk for proximal junctional disease in ASD surgery.
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Justin K. Scheer,Justin S. Smith,Peter G. Passias,Han Jo Kim,Shay Bess,Douglas C. Burton,Eric O. Klineberg,Virginie Lafage,Munish Gupta,Christopher P. Ames 대한척추신경외과학회 2023 Neurospine Vol.20 No.3
Objective: The goal of this study was to determine if patients with mild scoliosis and ageappropriate sagittal alignment have favorable outcomes following surgical correction. Methods: Retrospective review of a prospective, multicenter adult spinal deformity database. Inclusion criteria: operative patients age ≥18 years, and preoperative pelvic tilt, mismatch between pelvic incidence and lumbar lordosis (PI–LL), and C7 sagittal vertical axis all within established age-adjusted thresholds with minimum 2-year follow-up. Health-related quality of life (HRQoL) scores: Oswestry Disability Index (ODI), 36-item Short Form health survey (SF-36), Scoliosis Research Society-22R (SRS22R), back/leg pain Numerical Rating Scale and minimum clinically important difference (MCID)/substantial clinical benefit (SCB). Two-year and preoperative HRQoL radiographic data were compared. Patients with mild scoliosis (Mild Scoli, Max coronal Cobb 10°–30°) were compared to those with larger curves (Scoli). Results: One hundred fifty-one patients included from 667 operative patients (82.8% women; average age, 56.4 ± 16.2 years). Forty-two patients (27.8%) included in Mild Scoli group. Mild Scoli group had significantly worse baseline leg pain, ODI, and physical composite scores (p < 0.02). Mean 2-year maximum coronal Cobb angle was significantly improved compared to baseline (p < 0.001). All 2-year HRQoL measures were significantly improved compared to (p < 0.001) except mental composite score, SRS activity and SRS mental for the Mild Scoli group (p > 0.05). From the mild Scoli group, 36%–74% met either MCID or SCB for the HRQoL measures. Sixty-four point three percent had minimum 1 complication, 28.6% had a major complication, 35.7% had reoperation. Conclusion: Mild scoliosis patients with age-appropriate sagittal alignment benefit from surgical correction, decompression, and stabilization at 2 years postoperative despite having a high complication rate.
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