دورية أكاديمية
Patient-specific Cervical Deformity Corrections With Consideration of Associated Risk: Establishment of Risk Benefit Thresholds for Invasiveness Based on Deformity and Frailty Severity.
| العنوان: | Patient-specific Cervical Deformity Corrections With Consideration of Associated Risk: Establishment of Risk Benefit Thresholds for Invasiveness Based on Deformity and Frailty Severity. |
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| المؤلفون: | Passias, Peter G, Pierce, Katherine E, Williamson, Tyler K, Lebovic, Jordan, Schoenfeld, Andrew J, Lafage, Renaud, Lafage, Virginie, Gum, Jeffrey L, Eastlack, Robert, Kim, Han Jo, Klineberg, Eric O, Daniels, Alan H, Protopsaltis, Themistocles S, Mundis, Gregory M, Scheer, Justin K, Park, Paul, Chou, Dean, Line, Breton, Hart, Robert A, Burton, Douglas C, Bess, Shay, Schwab, Frank J, Shaffrey, Christopher I, Smith, Justin S, Ames, Christopher P |
| المصدر: | Articles, Abstracts, and Reports |
| بيانات النشر: | Providence Digital Commons |
| سنة النشر: | 2023 |
| المجموعة: | Providence St. Joseph Health Digital Commons |
| مصطلحات موضوعية: | washington, swedish neuro, Orthopedics, Surgery |
| الوصف: | STUDY DESIGN/SETTING: This was a retrospective cohort study. BACKGROUND: Little is known of the intersection between surgical invasiveness, cervical deformity (CD) severity, and frailty. OBJECTIVE: The aim of this study was to investigate the outcomes of CD surgery by invasiveness, frailty status, and baseline magnitude of deformity. METHODS: This study included CD patients with 1-year follow-up. Patients stratified in high deformity if severe in the following criteria: T1 slope minus cervical lordosis, McGregor's slope, C2-C7, C2-T3, and C2 slope. Frailty scores categorized patients into not frail and frail. Patients are categorized by frailty and deformity (not frail/low deformity; not frail/high deformity; frail/low deformity; frail/high deformity). Logistic regression assessed increasing invasiveness and outcomes [distal junctional failure (DJF), reoperation]. Within frailty/deformity groups, decision tree analysis assessed thresholds for an invasiveness cutoff above which experiencing a reoperation, DJF or not achieving Good Clinical Outcome was more likely. RESULTS: A total of 115 patients were included. Frailty/deformity groups: 27% not frail/low deformity, 27% not frail/high deformity, 23.5% frail/low deformity, and 22.5% frail/high deformity. Logistic regression analysis found increasing invasiveness and occurrence of DJF [odds ratio (OR): 1.03, 95% CI: 1.01-1.05, P=0.002], and invasiveness increased with deformity severity (P CONCLUSIONS: Our study correlated increased invasiveness in CD surgery to the risk of DJF, reoperation, and poor clinical success. The thresholds derived for deformity severity and frailty may enable surgeons to individualize the invasiveness of their procedures during surgical planning to account for the heightened risk of adverse events and minimize unfavorable outcomes. |
| نوع الوثيقة: | text |
| اللغة: | unknown |
| العلاقة: | https://digitalcommons.providence.org/publications/7944Test; https://www.ncbi.nlm.nih.gov/pubmed/37798829Test |
| الإتاحة: | https://digitalcommons.providence.org/publications/7944Test https://www.ncbi.nlm.nih.gov/pubmed/37798829Test |
| رقم الانضمام: | edsbas.ABDD4E88 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |