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2. Cervical deformity patients with baseline hyperlordosis or hyperkyphosis differ in surgical treatment and radiographic outcomes.

Author

Passias, Peter Gust, Alas, Haddy, Kummer, Nicholas, Tretiakov, Peter, Diebo, Bassel G, Lafage, Renaud, Ames, Christopher P, Line, Breton, Klineberg, Eric O, Burton, Douglas C, Uribe, Juan S, Kim, Han Jo, Daniels, Alan H, Bess, Shay, Protopsaltis, Themistocles, Mundis, Gregory M, Shaffrey, Christopher I, Schwab, Frank J, Smith, Justin S, Lafage, Virginie, and International Spine Study Group

Subjects
Cervical deformity, cervical lordosis, hyperlordosis, spine surgery, Clinical Research, Patient Safety, Clinical Sciences, Neurosciences
Abstract

BackgroundPatients with symptomatic cervical deformity (CD) requiring surgical correction often present with hyperkyphosis (HK), although patients with hyperlordotic curves may require surgery as well. Few studies have investigated differences in CD corrective surgery with regard to HK and hyperlordosis (HL).ObjectiveThe objective of the study is to evaluate patterns in treatment for CD patients with baseline (BL) HK and HL and understand how extreme curvature of the spine may influence surgical outcomes.Materials and methodsOperative CD patients with BL and 1-year (1Y) radiographic data were included in the study. Patients were stratified based on BL C2-C7 lordosis (CL) angle: those >1 standard deviation (SD) from the mean (-6.96 ± 21.47°) were hyperlordotic (>14.51°) or hyperkyphotic (

Published
2022

4. Predictive Analytics for Determining Extended Operative Time in Corrective Adult Spinal Deformity Surgery.

Author

Passias, Peter G, Poorman, Gregory W, Vasquez-Montes, Dennis, Kummer, Nicholas, Mundis, Gregory, Anand, Neel, Horn, Samantha R, Segreto, Frank A, Passfall, Lara, Krol, Oscar, Diebo, Bassel, Burton, Doug, Buckland, Aaron, Gerling, Michael, Soroceanu, Alex, Eastlack, Robert, Kojo Hamilton, D, Hart, Robert, Schwab, Frank, Lafage, Virginie, Shaffrey, Christopher, Sciubba, Daniel, Bess, Shay, Ames, Christopher, and Klineberg, Eric

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Patient Safety, Clinical Research, Bioengineering, 6.4 Surgery, Evaluation of treatments and therapeutic interventions, adult spinal deformity, operative time, decision trees, predictive analytics, International Spine Study Group, Neurosciences, Clinical sciences
Abstract

BackgroundMore sophisticated surgical techniques for correcting adult spinal deformity (ASD) have increased operative times, adding to physiologic stress on patients and increased complication incidence. This study aims to determine factors associated with operative time using a statistical learning algorithm.MethodsRetrospective review of a prospective multicenter database containing 837 patients undergoing long spinal fusions for ASD. Conditional inference decision trees identified factors associated with skin-to-skin operative time and cutoff points at which factors have a global effect. A conditional variable-importance table was constructed based on a nonreplacement sampling set of 2000 conditional inference trees. Means comparison for the top 15 variables at their respective significant cutoffs indicated effect sizes.ResultsIncluded: 544 surgical ASD patients (mean age: 58.0 years; fusion length 11.3 levels; operative time: 378 minutes). The strongest predictor for operative time was institution/surgeon. Center/surgeons, grouped by decision tree hierarchy, a and b were, on average, 2 hours faster than center/surgeons c-f, who were 43 minutes faster than centers g-j, all P < 0.001. The next most important predictors were, in order, approach (combined vs posterior increases time by 139 minutes, P < 0.001), levels fused (

Published
2022

5. Prioritization of Realignment Associated With Superior Clinical Outcomes for Cervical Deformity Patients.

Author

Pierce, Katherine E, Passias, Peter G, Brown, Avery E, Bortz, Cole A, Alas, Haddy, Passfall, Lara, Krol, Oscar, Kummer, Nicholas, Lafage, Renaud, Chou, Dean, Burton, Douglas C, Line, Breton, Klineberg, Eric, Hart, Robert, Gum, Jeffrey, Daniels, Alan, Hamilton, Kojo, Bess, Shay, Protopsaltis, Themistocles, Shaffrey, Christopher, Schwab, Frank A, Smith, Justin S, Lafage, Virginie, Ames, Christopher, and International Spine Study Group (ISSG)

Subjects
International Spine Study Group, Alignment, Cervical deformity, Spine
Abstract

ObjectiveTo prioritize the cervical parameter targets for alignment.MethodsIncluded: cervical deformity (CD) patients (C2-7 Cobb angle > 10°, cervical lordosis > 10°, cervical sagittal vertical axis [cSVA] > 4 cm, or chin-brow vertical angle > 25°) with full baseline (BL) and 1-year (1Y) radiographic parameters and Neck Disability Index (NDI) scores; patients with cervical [C] or cervicothoracic [CT] Primary Driver Ames type. Patients with BL Ames classified as low CD for both parameters of cSVA ( < 4 cm) and T1 slope minus cervical lordosis (TS-CL) ( < 15°) were excluded. Patients assessed: meeting minimum clinically important differences (MCID) for NDI ( < -15 ΔNDI). Ratios of correction were found for regional parameters categorized by primary Ames driver (C or CT). Decision tree analysis assessed cutoffs for differences associated with meeting NDI MCID at 1Y.ResultsSeventy-seven CD patients (mean age, 62.1 years; 64% female; body mass index, 28.8 kg/m2). Forty-one point six percent of patients met MCID for NDI. A backwards linear regression model including radiographic differences as predictors from BL to 1Y for meeting MCID for NDI demonstrated an R2 of 0.820 (p = 0.032) included TS-CL, cSVA, McGregor's slope (MGS), C2 sacral slope, C2-T3 angle, C2-T3 SVA, cervical lordosis. By primary Ames driver, 67.5% of patients were C, and 32.5% CT. Ratios of change in predictors for MCID NDI patients for C and CT were not significant between the 2 groups (p > 0.050). Decision tree analysis determined cutoffs for radiographic change, prioritizing in the following order: ≥ 42.5° C2-T3 angle, > 35.4° cervical lordosis, < -31.76° C2 slope, < -11.57-mm cSVA, < -2.16° MGS, > -30.8-mm C2-T3 SVA, and ≤ -33.6° TS-CL.ConclusionCertain ratios of correction of cervical parameters contribute to improving neck disability. Prioritizing these radiographic alignment parameters may help optimize patient-reported outcomes for patients undergoing CD surgery.

Published
2021

6. Risk of spinal surgery among individuals who have been re-vascularized for coronary artery disease

Author

Passias, Peter G., Ahmad, Waleed, Kapadia, Bhaveen H., Krol, Oscar, Bell, Joshua, Kamalapathy, Pramod, Imbo, Bailey, Tretiakov, Peter, Williamson, Tyler, Onafowokan, Oluwatobi O., Das, Ankita, Joujon-Roche, Rachel, Moattari, Kevin, Passfall, Lara, Kummer, Nicholas, Vira, Shaleen, Lafage, Virginie, Diebo, Bassel, Schoenfeld, Andrew J., and Hassanzadeh, Hamid

Published
2024
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7. Factors Influencing Maintenance of Alignment and Functional Improvement Following Adult Spinal Deformity Surgery: A 3-Year Outcome Analysis

Author

Passias, Peter G., Passfall, Lara, Moattari, Kevin, Krol, Oscar, Kummer, Nicholas A., Tretiakov, Peter, Williamson, Tyler, Joujon-Roche, Rachel, Imbo, Bailey, Burhan Janjua, Muhammad, Jankowski, Pawel, Paulino, Carl, Schwab, Frank J., Owusu-Sarpong, Stephane, Singh, Vivek, Ahmad, Salman, Onafowokan, Tobi, Lebovic, Jordan, Tariq, Muhammad, Saleh, Hesham, Vira, Shaleen, Smith, Justin S., Diebo, Bassel, and Schoenfeld, Andrew J.

Published
2024
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8. “Reverse roussouly”: cervicothoracic curvature ratios define characteristic shapes in adult cervical deformity

Author

Passias, Peter G., Pierce, Katherine E., Williamson, Tyler, Vira, Shaleen, Owusu-Sarpong, Stephane, Singh, Ravinderjit, Krol, Oscar, Passfall, Lara, Kummer, Nicholas, Imbo, Bailey, Joujon-Roche, Rachel, Tretiakov, Peter, Moattari, Kevin, Abola, Matthew V., Ahmad, Waleed, Naessig, Sara, Ahmad, Salman, Singh, Vivek, Diebo, Bassel, and Lafage, Virginie

Published
2022
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9. Factors Influencing Maintenance of Alignment and Functional Improvement Following Adult Spinal Deformity Surgery: A 3-Year Outcome Analysis

Author

Passias, Peter G., Passfall, Lara, Moattari, Kevin, Krol, Oscar, Kummer, Nicholas A., Tretiakov, Peter, Williamson, Tyler, Joujon-Roche, Rachel, Imbo, Bailey, Burhan Janjua, Muhammad, Jankowski, Pawel, Paulino, Carl, Schwab, Frank J., Owusu-Sarpong, Stephane, Singh, Vivek, Ahmad, Salman, Onafowokan, Tobi, Lebovic, Jordan, Tariq, Muhammad, Saleh, Hesham, Vira, Shaleen, Smith, Justin S., Diebo, Bassel, and Schoenfeld, Andrew J.

Published
2023
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10. Health-related quality of life measures in adult spinal deformity: can we replace the SRS-22 with PROMIS?

Author

Passias, Peter G., Pierce, Katherine E., Krol, Oscar, Williamson, Tyler, Naessig, Sara, Ahmad, Waleed, Passfall, Lara, Tretiakov, Peter, Imbo, Bailey, Joujon-Roche, Rachel, Lebovic, Jordan, Owusu-Sarpong, Stephane, Moattari, Kevin, Kummer, Nicholas A., Maglaras, Constance, O’Connell, Brooke K., Diebo, Bassel G., Vira, Shaleen, Lafage, Renaud, Lafage, Virginie, Buckland, Aaron J., and Protopsaltis, Themistocles

Published
2022
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14. The Clinical Impact of Failing to Achieve Ideal Proportional Realignment in Adult Spinal Deformity Patients

Author

Passias, Peter G., Passfall, Lara, Williamson, Tyler K., Schoenfeld, Andrew J., Owusu-Sarpong, Stephane, Dhillon, Ekamjeet, Krol, Oscar, Kummer, Nicholas A., Tretiakov, Peter, Imbo, Bailey, Joujon-Roche, Rachel, Moattari, Kevin, Lebovic, Jordan, Vira, Shaleen, Diebo, Bassel, Smith, Justin S., Park, Paul, Mummaneni, Praveen, Shabani, Saman, Chou, Dean, Lafage, Renaud, and Lafage, Virginie

Published
2022
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15. Comparing and Contrasting the Clinical Utility of Sagittal Spine Alignment Classification Frameworks: Roussouly vs. SRS-Schwab

Author

Passias, Peter G., Bortz, Cole, Pierce, Katherine E., Passfall, Lara, Kummer, Nicholas A., Krol, Oscar, Lafage, Renaud, Diebo, Bassel G., Lafage, Virginie, Ames, Christopher P., Burton, Douglas C., Gupta, Munish C., Sciubba, Daniel M., Schoenfeld, Andrew J., Bess, Shay, Hostin, Richard, Shaffrey, Christopher I., Line, Breton G., Klineberg, Eric O., Smith, Justin S., and Schwab, Frank J.

Published
2021
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17. Appropriate Risk Stratification and Accounting for Age-Adjusted Reciprocal Changes in the Thoracolumbar Spine Reduces the Incidence and Magnitude of Distal Junctional Kyphosis in Cervical Deformity Surgery

Author

Passias, Peter G., Bortz, Cole, Pierce, Katherine E., Kummer, Nicholas A., Lafage, Renaud, Diebo, Bassel G., Line, Breton G, Lafage, Virginie, Burton, Douglas C., Klineberg, Eric O., Kim, Han Jo, Daniels, Alan H., Mundis, Gregory M, Protopsaltis, Themistocles S., Eastlack, Robert K., Sciubba, Daniel M., Bess, Shay, Schwab, Frank J., Shaffrey, Christopher I., Smith, Justin S., and Ames, Christopher P.

Published
2021
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19. Predictors of Complication Severity Following Adult Spinal Deformity Surgery: Smoking Rate, Diabetes, and Osteotomy Increase Risk of Severe Adverse Events

Author

Bortz, Cole A., Pierce, Katherine E., Krol, Oscar, Kummer, Nicholas, Passfall, Lara, Egers, Max, Oh, Cheongeun, Horn, Samantha R., Segreto, Frank A., Vasquez-Montes, Dennis, Frangella, Nicholas J., Buza, John A., Raman, Tina, Kuprys, Tomas, Lafage, Renaud, Jankowski, Pawel P., Hassanzadeh, Hamid, Vira, Shaleen N., Diebo, Bassel G., Gerling, Michael C., and Passias, Peter G.

Subjects
Orthopedics and Sports Medicine, Surgery, Lumbar Spine
Abstract

BACKGROUND: Given the physical and economic burden of complications in spine surgery, reducing the prevalence of perioperative adverse events is a primary concern of both patients and health care professionals. This study aims to identify specific perioperative factors predictive of developing varying grades of postoperative complications in adult spinal deformity (ASD) patients, as assessed by the Clavien-Dindo complication classification (Cc) system. METHODS: Surgical ASD patients ≥18 years were identified in the American College of Surgeons’ National Surgical Quality Improvement Program from 2005 to 2015. Postoperative complications were stratified by Cc grade severity: minor (I, II, and III) and severe (IV and V). Stepwise regression models generated dataset-specific predictive models for Cc groups. Model internal validation was achieved by bootstrapping and calculating the area under the curve (AUC) of the model. Significance was set at P < 0.05. RESULTS: Included were 3936 patients (59 ± 16 years, 63% women, 29 ± 7 kg/m(2)) undergoing surgery for ASD (4.4 ± 4.7 levels, 71% posterior approach, 11% anterior, and 18% combined). Overall, 1% of cases were revisions, 39% of procedures involved decompression, 27% osteotomy, and 15% iliac fixation. Additionally, 66% of patients experienced at least 1 complication, 0% of which were Cc grade I, 51% II, 5% III, 43% IV, and 1% V. The final model predicting severe Cc (IV–V) complications yielded an AUC of 75.6% and included male sex, diabetes, increased operative time, central nervous system tumor, osteotomy, cigarette pack-years, anterior decompression, and anterior lumbar interbody fusion. Final models predicting specific Cc grades were created. CONCLUSIONS: Specific predictors of adverse events following ASD-corrective surgery varied for complications of different severities. Multivariate modeling showed smoking rate, osteotomy, diabetes, anterior lumbar interbody fusion, and higher operative time, among other factors, as predictive of severe complications, as classified by the Clavien-Dindo Cc system. These factors can help in the identification of high-risk patients and, consequently, improve preoperative patient counseling. CLINICAL RELEVANCE: The findings of this study provide a foundation for identifying ASD patients at high risk of postoperative complications . LEVEL OF EVIDENCE: 4.

Published
2023

20. Concurrent Presence of Thoracolumbar Scoliosis and Chiari Malformation: Is Operative Risk Magnified?

Author

Naessig, Sara, primary, Tretiakov, Peter, additional, Patel, Karan, additional, Ahmad, Waleed, additional, Pierce, Katherine, additional, Kummer, Nicholas, additional, Joujon-Roche, Rachel, additional, Imbo, Bailey, additional, Williamson, Tyler, additional, Krol, Oscar, additional, Janjua, Muhammad Burhan, additional, Vira, Shaleen, additional, Diebo, Bassel, additional, Sciubba, Daniel, additional, and Passias, Peter, additional

Published
2023
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21. External Validation of the National Surgical Quality Improvement Program Calculator Utilizing a Single Institutional Experience for Adult Spinal Deformity Corrective Surgery

Author

Naessig, Sara, primary, Pierce, Katherine, additional, Ahmad, Waleed, additional, Passfall, Lara, additional, Krol, Oscar, additional, Kummer, Nicholas A., additional, Williamson, Tyler, additional, Imbo, Bailey, additional, Tretiakov, Peter, additional, Moattari, Kevin, additional, Joujon-Roche, Rachel, additional, Zhong, Jack, additional, Balouch, Eaman, additional, O’Connell, Brooke, additional, Maglaras, Constance, additional, Diebo, Bassel, additional, Lafage, Renaud, additional, Lafage, Virginie, additional, Vira, Shaleen, additional, Hale, Steven, additional, Gerling, Michael, additional, Protopsaltis, Themistocles, additional, Buckland, Aaron, additional, and Passias, Peter G., additional

Published
2023
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22. Failure to Normalize Risk Profile of Spine Fusion Patients With Coronary Artery Disease Previously Treated With Percutaneous Stent Revascularization

Author

Ahmad, Waleed, primary, Bell, Joshua, additional, Krol, Oscar, additional, Passfall, Lara, additional, Kamalapathy, Pramod, additional, Imbo, Bailey, additional, Tretiakov, Peter, additional, Williamson, Tyler, additional, Joujon-Roche, Rachel, additional, Moattari, Kevin, additional, Kummer, Nicholas, additional, Vira, Shaleen, additional, Lafage, Virginie, additional, Paulino, Carl, additional, Schoenfeld, Andrew J., additional, Diebo, Bassel, additional, Hassanzadeh, Hamid, additional, and Passias, Peter, additional

Published
2023
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23. The Effects of Global Alignment and Proportionality Scores on Postoperative Outcomes After Adult Spinal Deformity Correction

Author

Passias, Peter G., primary, Krol, Oscar, additional, Owusu-Sarpong, Stephane, additional, Tretiakov, Peter, additional, Passfall, Lara, additional, Kummer, Nicholas, additional, Ani, Fares, additional, Imbo, Bailey, additional, Joujon-Roche, Rachel, additional, Williamson, Tyler K., additional, Sagoo, Navraj S., additional, Vira, Shaleen, additional, Schoenfeld, Andrew, additional, De la Garza Ramos, Rafael, additional, Janjua, Muhammad Burhan, additional, Sciubba, Daniel, additional, Diebo, Bassel G., additional, Paulino, Carl, additional, Smith, Justin, additional, Lafage, Renaud, additional, and Lafage, Virginie, additional

Published
2023
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24. Highest Achievable Outcomes for Patients Undergoing Cervical Deformity Corrective Surgery by Frailty

Author

Passias, Peter G., primary, Kummer, Nicholas, additional, Williamson, Tyler K., additional, Moattari, Kevin, additional, Lafage, Virginie, additional, Lafage, Renaud, additional, Kim, Han Jo, additional, Daniels, Alan H., additional, Gum, Jeffrey L., additional, Diebo, Bassel G., additional, Protopsaltis, Themistocles S., additional, Mundis, Gregory M., additional, Eastlack, Robert K., additional, Soroceanu, Alexandra, additional, Scheer, Justin K., additional, Hamilton, D. Kojo, additional, Klineberg, Eric O., additional, Line, Breton, additional, Hart, Robert A., additional, Burton, Douglas C., additional, Mummaneni, Praveen, additional, Chou, Dean, additional, Park, Paul, additional, Schwab, Frank J., additional, Shaffrey, Christopher I., additional, Bess, Shay, additional, Ames, Christopher P., additional, and Smith, Justin S., additional

Published
2022
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26. Predicting 30-Day Perioperative Outcomes in Adult Spinal Deformity Patients With Baseline Paralysis or Functional Dependence

Author

Alas, Haddy, primary, Ihejirika, Rivka C., additional, Kummer, Nicholas, additional, Passfall, Lara, additional, Krol, Oscar, additional, Bortz, Cole, additional, Pierce, Katherine E., additional, Brown, Avery, additional, Vasquez-Montes, Dennis, additional, Diebo, Bassel G., additional, Paulino, Carl B., additional, Garza-Ramos, Rafael De La, additional, Janjua, Muhammad B., additional, Gerling, Michael C., additional, and Passias, Peter G., additional

Published
2022
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27. Cervical Deformity Correction Fails to Achieve Age-Adjusted Spinopelvic Alignment Targets

Author

Passias, Peter G., primary, Pierce, Katherine E., additional, Horn, Samantha R., additional, Segar, Anand, additional, Passfall, Lara, additional, Kummer, Nicholas, additional, Krol, Oscar, additional, Bortz, Cole, additional, Brown, Avery E., additional, Alas, Haddy, additional, Segreto, Frank A., additional, Ahmad, Waleed, additional, Naessig, Sara, additional, Buckland, Aaron J., additional, Protopsaltis, Themistocles S., additional, Gerling, Michael, additional, Lafage, Renaud, additional, Schwab, Frank J., additional, and Lafage, Virginie, additional

Published
2022
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28. Predicting development of severe clinically relevant distal junctional kyphosis following adult cervical deformity surgery, with further distinction from mild asymptomatic episodes

Author

Passias, Peter G., primary, Naessig, Sara, additional, Kummer, Nicholas, additional, Passfall, Lara, additional, Lafage, Renaud, additional, Lafage, Virginie, additional, Line, Breton, additional, Diebo, Bassel G., additional, Protopsaltis, Themistocles, additional, Kim, Han Jo, additional, Eastlack, Robert, additional, Soroceanu, Alex, additional, Klineberg, Eric O., additional, Hart, Robert A., additional, Burton, Douglas, additional, Bess, Shay, additional, Schwab, Frank, additional, Shaffrey, Christopher I., additional, Smith, Justin S., additional, and Ames, Christopher P., additional

Published
2022
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29. The Inherent Value of Preoperative Optimization—Absolute and Incremental Reduction in Components of Metabolic Syndrome Can Enhance Recovery and Minimize Perioperative Burden

Author

Naessig, Sara, primary, Para, Ashok, additional, Moattari, Kevin, additional, Imbo, Bailey, additional, Williamson, Tyler K., additional, Joujon-Roche, Rachel, additional, Tretiakov, Peter, additional, Passfall, Lara, additional, Krol, Oscar, additional, Kummer, Nicholas, additional, Ahmad, Waleed, additional, Pierce, Katherine, additional, Ayres, Ethan, additional, Vira, Shaleen, additional, Diebo, Bassel, additional, and Passias, Peter G., additional

Published
2022
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30. Assessment of Postoperative Outcomes of Spine Fusion Patients With History of Cardiac Disease

Author

Ahmad, Waleed, primary, Fernandez, Laviel, additional, Bell, Joshua, additional, Krol, Oscar, additional, Kummer, Nicholas, additional, Passfall, Lara, additional, Naessig, Sara, additional, Pierce, Katherine, additional, Tretiakov, Peter, additional, Moattari, Kevin, additional, Joujon-Roche, Rachel, additional, Williamson, Tyler K., additional, Imbo, Bailey, additional, Vira, Shaleen, additional, Lafage, Virginie, additional, Paulino, Carl, additional, Schoenfeld, Andrew J., additional, Diebo, Bassel, additional, Hassanzadeh, Hamid, additional, and Passias, Peter, additional

Published
2022
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33. Improvements in Outcomes and Cost After Adult Spinal Deformity Corrective Surgery Between 2008 and 2019.

Author

Passias, Peter G., Kummer, Nicholas, Imbo, Bailey, Lafage, Virginie, Lafage, Renaud, Smith, Justin S., Line, Breton, Vira, Shaleen, Schoenfeld, Andrew J., Gum, Jeffrey L., Daniels, Alan H., Klineberg, Eric O., Gupta, Munish C., Kebaish, Khaled M., Jain, Amit, Neuman, Brian J., Chou, Dean, Carreon, Leah Y., Hart, Robert A., and Burton, Douglas C.

Subjects
*SPINE abnormalities, *QUALITY of life, *PATIENT reported outcome measures, *MEDICARE reimbursement, *COST effectiveness
Abstract

Study Design.: A retrospective cohort study. Objective.: To assess whether patient outcomes and cost-effectiveness of adult spinal deformity (ASD) surgery have improved over the past decade. Background.: Surgery for ASD is an effective intervention, but one that is also associated with large initial healthcare expenditures. Changes in the cost profile for ASD surgery over the last decade has not been evaluated previously. Materials and Methods.: ASD patients who received surgery between 2008 and 2019 were included. Analysis of covariance was used to establish estimated marginal means for outcome measures [complication rates, reoperations, health-related quality of life, total cost, utility gained, quality adjusted life years (QALYs), cost-efficiency (cost per QALY)] by year of initial surgery. Cost was calculated using the PearlDiver database and represented national averages of Medicare reimbursement for services within a 30-day window including length of stay and death differentiated by complication/comorbidity, revision, and surgical approach. Internal cost data was based on individual patient diagnosis-related group codes, limiting revisions to those within two years (2Y) of the initial surgery. Cost per QALY over the course of 2008–2019 were then calculated. Results.: There were 1236 patients included. There was an overall decrease in rates of any complication (0.78 vs. 0.61), any reoperation (0.25 vs. 0.10), and minor complication (0.54 vs. 0.37) between 2009 and 2018 (all P <0.05). National average 2Y cost decreased at an annual rate of $3194 (R 2=0.6602), 2Y utility gained increased at an annual rate of 0.0041 (R 2=0.57), 2Y QALYs gained increased annually by 0.008 (R 2=0.57), and 2Y cost per QALY decreased per year by $39,953 (R 2=0.6778). Conclusion.: Between 2008 and 2019, rates of complications have decreased concurrently with improvements in patient reported outcomes, resulting in improved cost effectiveness according to national Medicare average and individual patient cost data. The value of ASD surgery has improved substantially over the course of the last decade. [ABSTRACT FROM AUTHOR]

Published
2023
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34. Examination of the Economic Burden of Frailty in Patients With Adult Spinal Deformity Undergoing Surgical Intervention

Author

Passias, Peter G., primary, Ahmad, Waleed, additional, Kummer, Nicholas, additional, Lafage, Renaud, additional, Lafage, Virginie, additional, Kebaish, Khaled, additional, Daniels, Alan, additional, Klineberg, Eric, additional, Soroceanu, Alex, additional, Gum, Jeffrey, additional, Line, Breton, additional, Hart, Robert, additional, Burton, Douglas, additional, Eastlack, Robert, additional, Jain, Amit, additional, Smith, Justin S., additional, Ames, Christopher P., additional, Shaffrey, Christopher, additional, Schwab, Frank, additional, Hostin, Richard, additional, and Bess, Shay, additional

Published
2021
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36. 193. Should our corrective realignments be tailored to different frailty states?

Author

Passias, Peter G., primary, Krol, Oscar, additional, Passfall, Lara, additional, Kummer, Nicholas, additional, Pierce, Katherine E., additional, Ahmad, Waleed, additional, Naessig, Sara, additional, Vira, Shaleen N., additional, OConnell, Brooke, additional, Maglaras, Constance, additional, Paulino, Carl B., additional, Sciubba, Daniel M., additional, Lafage, Renaud, additional, Protopsaltis, Themistocles S., additional, Diebo, Bassel G., additional, Lafage, Virginie, additional, Fernandez, Laviel, additional, Patel, Karan S., additional, and Ihejirika-Lomedico, Rivka C., additional

Published
2021
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37. P98. Complication rates following Chiari Malformation Surgical Management based on sub type and surgical variables

Author

Naessig, Sara, primary, Ahmad, Waleed, additional, Pierce, Katherine E., additional, Kummer, Nicholas, additional, Krol, Oscar, additional, Passfall, Lara, additional, Janjua, Muhammad B., additional, Vira, Shaleen N., additional, Diebo, Bassel G., additional, Sciubba, Daniel M., additional, Passias, Peter G., additional, Fernandez, Laviel, additional, Patel, Karan S., additional, and Ihejirika-Lomedico, Rivka C., additional

Published
2021
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38. P105. When does the construct need to extend to the thoracic spine in patients undergoing correction for cervical deformity?

Author

Passias, Peter G., primary, Passfall, Lara, additional, Kummer, Nicholas, additional, Krol, Oscar, additional, Ahmad, Waleed, additional, Naessig, Sara, additional, Pierce, Katherine E., additional, Abola, Matthew V., additional, Vira, Shaleen N., additional, Kapadia, Bhaveen H., additional, O'Connell, Brooke K., additional, Maglaras, Constance, additional, Lafage, Renaud, additional, Schoenfeld, Andrew J., additional, Diebo, Bassel G., additional, Lafage, Virginie, additional, Fernandez, Laviel, additional, Patel, Karan S., additional, and Ihejirika-Lomedico, Rivka C., additional

Published
2021
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39. 184. Psychological distress in patients undergoing cervical spine surgery: two-year outcomes of a randomized controlled trial

Author

Passfall, Lara, primary, Krol, Oscar, additional, Kummer, Nicholas, additional, Naessig, Sara, additional, Pierce, Katherine E., additional, Ahmad, Waleed, additional, Saleh, Hesham, additional, Vira, Shaleen N., additional, Kapadia, Bhaveen H., additional, Diebo, Bassel G., additional, Passias, Peter G., additional, Fernandez, Laviel, additional, Patel, Karan S., additional, and Ihejirika-Lomedico, Rivka C., additional

Published
2021
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40. 129. Is it possible to recover from distal junctional kyphosis occurrence and reoperation?

Author

Passias, Peter G., primary, Naessig, Sara, additional, Ahmad, Waleed, additional, Pierce, Katherine E., additional, Kummer, Nicholas, additional, Krol, Oscar, additional, Passfall, Lara, additional, Diebo, Bassel G., additional, Vira, Shaleen N., additional, Fernandez, Laviel, additional, Patel, Karan S., additional, and Ihejirika-Lomedico, Rivka C., additional

Published
2021
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42. 192. The effects of global alignment and proportionality scores on postoperative outcomes following adult spinal deformity correction

Author

Passias, Peter G., primary, Krol, Oscar, additional, Kummer, Nicholas, additional, Pierce, Katherine E., additional, Ahmad, Waleed, additional, Naessig, Sara, additional, OConnell, Brooke, additional, Vira, Shaleen N., additional, Kapadia, Bhaveen H., additional, Maglaras, Constance, additional, Janjua, Muhammad B., additional, Paulino, Carl B., additional, Sciubba, Daniel M., additional, De la Garza Ramos, Rafael, additional, Lafage, Renaud, additional, Schoenfeld, Andrew J., additional, Protopsaltis, Themistocles S., additional, Diebo, Bassel G., additional, Lafage, Virginie, additional, Fernandez, Laviel, additional, Patel, Karan S., additional, and Ihejirika-Lomedico, Rivka C., additional

Published
2021
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43. P106. Normalization of pelvic tilt following corrective adult spinal deformity surgery: Analysis of prevalence, timing, and factors determining occurrence

Author

Passias, Peter G., primary, Passfall, Lara, additional, Krol, Oscar, additional, Kummer, Nicholas, additional, Pierce, Katherine E., additional, Naessig, Sara, additional, Ahmad, Waleed, additional, Ihejirika-Lomedico, Rivka C., additional, Kapadia, Bhaveen H., additional, O'Connell, Brooke K., additional, Maglaras, Constance, additional, Paulino, Carl B., additional, De la Garza Ramos, Rafael, additional, Lafage, Renaud, additional, Schoenfeld, Andrew J., additional, Buckland, Aaron J., additional, Protopsaltis, Themistocles S., additional, Diebo, Bassel G., additional, Lafage, Virginie, additional, Vira, Shaleen N., additional, Fernandez, Laviel, additional, and Patel, Karan S., additional

Published
2021
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44. P104. Identifying C2 slope and T1 slope thresholds for optimal functional and clinical outcomes in cervical deformity correction

Author

Passfall, Lara, primary, Kummer, Nicholas, additional, Krol, Oscar, additional, Pierce, Katherine E., additional, Ahmad, Waleed, additional, Naessig, Sara, additional, Saleh, Hesham, additional, Vira, Shaleen N., additional, Kapadia, Bhaveen H., additional, Lafage, Renaud, additional, Diebo, Bassel G., additional, Lafage, Virginie, additional, Passias, Peter G., additional, Fernandez, Laviel, additional, Patel, Karan S., additional, and Ihejirika-Lomedico, Rivka C., additional

Published
2021
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45. 30. Outcomes analysis of staged vs same day surgery patients undergoing identical cervical deformity corrective surgery

Author

Krol, Oscar, primary, Kummer, Nicholas, additional, Passfall, Lara, additional, Ahmad, Waleed, additional, Pierce, Katherine E., additional, Naessig, Sara, additional, Vira, Shaleen N., additional, Kapadia, Bhaveen H., additional, Zavodovsky, Volmir, additional, Lafage, Renaud, additional, Lafage, Virginie, additional, Diebo, Bassel G., additional, and Passias, Peter G., additional

Published
2021
Full Text
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46. 223. The psychological burden of disease among patients undergoing cervical spine surgery: are we underestimating our patients’ inherent disability?

Author

Passias, Peter G., primary, Naessig, Sara, additional, Ahmad, Waleed, additional, Pierce, Katherine E., additional, Passfall, Lara, additional, Kummer, Nicholas, additional, Krol, Oscar, additional, Diebo, Bassel G., additional, Vira, Shaleen N., additional, Fernandez, Laviel, additional, Patel, Karan S., additional, and Ihejirika-Lomedico, Rivka C., additional

Published
2021
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47. 180. Do robotic procedures have improved perioperative outcomes after a learning curve period?

Author

Krol, Oscar, primary, Passfall, Lara, additional, Kummer, Nicholas, additional, Vira, Shaleen N., additional, Dinizo, Michael, additional, Abola, Matthew V., additional, Diebo, Bassel G., additional, Zavodovsky, Volmir, additional, Sagoo, Navraj, additional, Passias, Peter G., additional, Fernandez, Laviel, additional, Patel, Karan S., additional, and Ihejirika-Lomedico, Rivka C., additional

Published
2021
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48. P102. Determining the impact of proximal junctional kyphosis on cost utility in adult spinal deformity patients

Author

Passias, Peter G., primary, Krol, Oscar, additional, Passfall, Lara, additional, Kummer, Nicholas, additional, Pierce, Katherine E., additional, Ahmad, Waleed, additional, Naessig, Sara, additional, Vira, Shaleen N., additional, Kapadia, Bhaveen H., additional, OConnell, Brooke, additional, Maglaras, Constance, additional, Paulino, Carl B., additional, Ramos, Rafael De la Garza, additional, Lafage, Renaud, additional, Schoenfeld, Andrew J., additional, Buckland, Aaron J., additional, Protopsaltis, Themistocles S., additional, Diebo, Bassel G., additional, Lafage, Virginie, additional, Fernandez, Laviel, additional, Patel, Karan S., additional, and Ihejirika-Lomedico, Rivka C., additional

Published
2021
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49. 83. External validation of the NSQIP calculator utilizing a single institutional experience for adult spinal deformity corrective surgery

Author

Naessig, Sara, primary, Ahmad, Waleed, additional, Pierce, Katherine E., additional, Passfall, Lara, additional, Krol, Oscar, additional, Kummer, Nicholas, additional, Protopsaltis, Themistocles S., additional, Maglaras, Constance, additional, O'Connell, Brooke K., additional, Buckland, Aaron J., additional, Passias, Peter G., additional, Vira, Shaleen N., additional, Fernandez, Laviel, additional, Patel, Karan S., additional, and Ihejirika-Lomedico, Rivka C., additional

Published
2021
Full Text
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