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1. Effect of age-adjusted alignment goals and distal inclination angle on the fate of distal junctional kyphosis in cervical deformity surgery

Author

Peter Gust Passias, Samantha R Horn, Virginie Lafage, Renaud Lafage, Justin S Smith, Breton G Line, Themistocles S Protopsaltis, Alex Soroceanu, Cole Bortz, Frank A Segreto, Waleed Ahmad, Sara Naessig, Katherine E Pierce, Avery E Brown, Haddy Alas, Han Jo Kim, Alan H Daniels, Eric O Klineberg, Douglas C Burton, Robert A Hart, Frank J Schwab, Shay Bess, Christopher I Shaffrey, and Christopher P Ames

Subjects
age-adjusted, alignment targets, cervical deformity, distal junctional kyphosis, inclination angle, Diseases of the musculoskeletal system, RC925-935
Abstract

Background: Age-adjusted alignment targets in the context of distal junctional kyphosis (DJK) development have yet to be investigated. Our aim was to assess age-adjusted alignment targets, reciprocal changes, and role of lowest instrumented level orientation in DJK development in cervical deformity (CD) patients. Methods: CD patients were evaluated based on lowest fused level: cervical (C7 or above), upper thoracic (UT: T1–T6), and lower thoracic (LT: T7–T12). Age-adjusted alignment targets were calculated using published formulas for sagittal vertical axis (SVA), pelvic incidence-lumbar lordosis (PI-LL), pelvic tilt (PT), T1 pelvic angle (TPA), and LL-thoracic kyphosis (TK). Outcome measures were cervical and global alignment parameters: Cervical SVA (cSVA), cervical lordosis, C2 slope, C2–T3 angle, C2–T3 SVA, TS-CL, PI-LL, PT, and SVA. Subanalysis matched baseline PI to assess age-adjusted alignment between DJK and non-DJK. Results: Seventy-six CD patients included. By 1Y, 20 patients developed DJK. Non-DJK patients had 27% cervical lowest instrumented vertebra (LIV), 68% UT, and 5% LT. DJK patients had 25% cervical, 50% UT, and 25% LT. There were no baseline or 1Y differences for PI, PI-LL, SVA, TPA, or PT for actual and age-adjusted targets. DJK patients had worse baseline cSVA and more severe 1Y cSVA, C2–T3 SVA, and C2 slope (P < 0.05). The distribution of over/under corrected patients and the offset between actual and ideal alignment for SVA, PT, TPA, PI-LL, and LL-TK were similar between DJK and non-DJK patients. DJK patients requiring reoperation had worse postoperative changes in all cervical parameters and trended toward larger offsets for global parameters. Conclusion: CD patients with severe baseline malalignment went on to develop postoperative DJK. Age-adjusted alignment targets did not capture differences in these populations, suggesting the need for cervical-specific goals.

Published
2021
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2. Risk-benefit assessment of major versus minor osteotomies for flexible and rigid cervical deformity correction

Author

Peter Gust Passias, Lara Passfall, Samantha R Horn, Katherine E Pierce, Virginie Lafage, Renaud Lafage, Justin S Smith, Breton G Line, Gregory M Mundis, Robert Eastlack, Bassel G Diebo, Themistocles S Protopsaltis, Han Jo Kim, Justin Scheer, Douglas C Burton, Robert A Hart, Frank J Schwab, Shay Bess, Christopher P Ames, Christopher I Shaffrey, and On Behalf of the International Spine Study Group

Subjects
fixed deformity, flexible deformity, osteotomy, pedicle subtraction osteotomy, rigid deformity, vertebral column resection, Diseases of the musculoskeletal system, RC925-935
Abstract

Introduction: Osteotomies are commonly performed to correct sagittal malalignment in cervical deformity (CD). However, the risks and benefits of performing a major osteotomy for cervical deformity correction have been understudied. The objective of this retrospective cohort study was to investigate the risks and benefits of performing a major osteotomy for CD correction. Methods: Patients stratified based on major osteotomy (MAJ) or minor (MIN). Independent t-tests and Chi-squared tests were used to assess differences between MAJ and MIN. A sub-analysis compared patients with flexible versus rigid CL. Results: 137 CD patients were included (62 years, 65% F). 19.0% CD patients underwent a MAJ osteotomy. After propensity score matching for cSVA, 52 patients were included. About 19.0% CD patients underwent a MAJ osteotomy. MAJ patients had more minor complications (P = 0.045), despite similar surgical outcomes as MIN. At 3M, MAJ and MIN patients had similar NDI, mJOA, and EQ5D scores, however by 1 year, MAJ patients reached MCID for NDI less than MIN patients (P = 0.003). MAJ patients with rigid deformities had higher rates of complications (79% vs. 29%, P = 0.056) and were less likely to show improvement in NDI at 1 year (0.95 vs. 0.54, P = 0.027). Both groups had similar sagittal realignment at 1 year (all P > 0.05). Conclusions: Cervical deformity patients who underwent a major osteotomy had similar clinical outcomes at 3-months but worse outcomes at 1-year as compared to minor osteotomies, likely due to differences in baseline deformity. Patients with rigid deformities who underwent a major osteotomy had higher complication rates and worse clinical improvement despite similar realignment at 1 year.

Published
2021
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3. Radiographic benefit of incorporating the inflection between the cervical and thoracic curves in fusion constructs for surgical cervical deformity patients

Author

Cole Bortz, Peter G Passias, Katherine Elizabeth Pierce, Haddy Alas, Avery Brown, Sara Naessig, Waleed Ahmad, Renaud Lafage, Christopher P Ames, Bassel G Diebo, Breton G Line, Eric O Klineberg, Douglas C Burton, Robert K Eastlack, Han Jo Kim, Daniel M Sciubba, Alex Soroceanu, Shay Bess, Christopher I Shaffrey, Frank J Schwab, Justin S Smith, and Virginie Lafage

Subjects
cervical deformity, cervicothoracic junction, inflection, outcomes, surgery, Diseases of the musculoskeletal system, RC925-935
Abstract

Purpose: The aim is to assess the relationship between cervicothoracic inflection point and baseline disability, as well as the relationship between clinical outcomes and pre- to postoperative changes in inflection point. Methods: Cervical deformity (CD) patients with baseline and 3-month (3M) postoperative radiographic, clinical, and inflection data were grouped by region of inflection point: C6 or above, C6-C7 to C7-T1, T1, or below. Inflection was defined as: Distal-most level where cervical lordosis (CL) changes to thoracic kyphosis (TK). Differences in alignment and patient factors across pre- and postoperative inflection point groups were assessed, as were outcomes by the inclusion of inflection in the CD-corrective fusion construct. Results: A total of 108 patients were included. Preoperative inflection breakdown: C6 or above (42%), C6-C7 to C7-T1 (44%), T1 or below (15%). Surgery was associated with a caudal migration of inflection by 3M: C6 or above (8%), C6-C7 to C7-T1 (58%), T1 or below (33%). For patients with preoperative inflection T1 or below, the inclusion of inflection in the fusion construct was associated with improvements in horizontal gaze (McGregor's Slope included: −11.3° vs. not included: 1.6°, P = 0.038). The inclusion of preoperative inflection in fusion was associated with the superior cervical sagittal vertical axis (cSVA) changes for C6-C7 to C7-T1 patients (−5.2 mm vs. 3.2 mm, P = 0.018). The location of postoperative inflection was associated with variation in 3M alignment: Inflection C6 or above was associated with less Pelvic Tilt (PT), PT and a trend of larger cSVA. Location of inflection or inclusion in fusion was not associated with reoperation or distal junctional kyphosis. Conclusions: Incorporating the inflection point between CL and TK in the fusion construct was associated with superior restoration of cervical alignment and horizontal gaze for surgical CD patients.

Published
2020
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4. The impact of osteotomy grade and location on regional and global alignment following cervical deformity surgery

Author

Peter G Passias, Samantha R Horn, Tina Raman, Avery E Brown, Virginie Lafage, Renaud Lafage, Justin S Smith, Cole A Bortz, Frank A Segreto, Katherine E Pierce, Haddy Alas, Breton G Line, Bassel G Diebo, Alan H Daniels, Han Jo Kim, Alex Soroceanu, Gregory M Mundis, Themistocles S Protopsaltis, Eric O Klineberg, Douglas C Burton, Robert A Hart, Frank J Schwab, Shay Bess, Christopher I Shaffrey, Christopher P Ames, and International Spine Study Group

Subjects
cervical deformity surgery, global alignment, osteotomy, osteotomy location, regional alignment, Diseases of the musculoskeletal system, RC925-935
Abstract

Introduction: Correction of cervical deformity (CD) often involves different types of osteotomies to address sagittal malalignment. This study assessed the relationship between osteotomy grade and vertebral level on alignment and clinical outcomes. Methods: Retrospective review of a multi-center prospectively collected CD database. CD was defined as at least one of the following: C2–C7 Cobb >10°, cervical lordosis (CL) >10°, C2–C7 sagittal vertical axis (cSVA) >4 cm, and chin-brow vertical angle > 25°. Patients were evaluated for level and type of cervical osteotomy. Results: 86 CD patients were included (61.4 ± 10.6 years, 66.3% female, body mass index 29.1 kg/m2). 141 osteotomies were in the cervical spine and 79 were in the thoracic spine. There were 19 major osteotomies performed, with 47% at T1. Patients with an osteotomy in the cervical spine improved in T1 slope minus CL (TS − CL), CL, and C2 slope (all P < 0.05). Patients with upper thoracic osteotomies improved in TS − CL, cSVA, C2–T3, C2–T3 sagittal vertical axis (SVA), and C2 slope (all P < 0.05). Minor osteotomies in the upper thoracic spine showed improvement in cSVA (63 mm to 49 mm, P = 0.022), C2–T3 ( P = 0.007), and SVA (−16 mm to 27 mm, P < 0.001). The greatest amount of C2–T3 angular change occurred for patients with a major osteotomy at T2 (39.1° change), then T3 (15.7°), C7 (16.9°°), and T1 (13.5°°). Patients with a major osteotomy in the upper thoracic spine showed similar radiographic changes from pre- to post-operative as patients with three or more minor osteotomies, although C2–T3 SVA trended toward greater improvement with a major osteotomy (−22.5 mm vs. +5.9 mm, P = 0.058) due to lever arm effect. Conclusions: CD patients undergoing osteotomies in the cervical and upper thoracic spine experienced improvement in TS–−CL and C2 slope. In the upper thoracic spine, multiple minor osteotomies achieved similar alignment changes to major osteotomies at a single level, while a major osteotomy focused at T2 had the greatest overall impact in cervicothoracic and global alignment in CD patients.

Published
2019
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5. Global spinal deformity from the upper cervical perspective. What is 'Abnormal' in the upper cervical spine?

Author

Peter G Passias, Haddy Alas, Renaud Lafage, Bassel G Diebo, Irene Chern, Christopher P Ames, Paul Park, Khoi D Than, Alan H Daniels, D Kojo Hamilton, Douglas C Burton, Robert A Hart, Shay Bess, Breton G Line, Eric O Klineberg, Christopher I Shaffrey, Justin S Smith, Frank J Schwab, and Virginie Lafage

Subjects
cervical spine, global spinal deformity, roussouly classification, schwab classification, Diseases of the musculoskeletal system, RC925-935
Abstract

Hypothesis: Reciprocal changes in the upper cervical spine correlate with adult TL deformity modifiers. Design: This was a retrospective review. Introduction: The upper cervical spine has remarkable adaptability to wide ranges of thoracolumbar (TL) deformity. Methods: Patients >18 years with adult spinal deformity (ASD) and complete radiographic data at baseline (BL) and 1 year were identified. Patients were grouped into component types of the Roussouly classification system (Type 1: Pelvic incidence [PI] 65°). Patients were categorized by increasing severity of Schwab modifiers at BL (0, +, and ++) and further grouped by regional malalignment moving cranially (P: pelvic only; LP: lumbopelvic; TL: thoracic and LP; C: subaxial and TL). Analysis of variance and Pearson's r assessed changes in BL upper cervical parameters (C0-2, C0 slope, McGregor's Slope [MGS], and CBVA) across groups. Results: A total of 343 ASD patients were analyzed. When grouped by BL Schwab and Roussouly, Group P had the lowest BL disability compared to other Groups, while Roussouley Type 1 correlated with higher BL disability compared to Type 2. Moving cranially up the spine, Group P, Group LP, and Group TL did not differ in C0-2 angle, C0 slope, MGS, or CBVA. Group C had a significantly smaller C0-C2, and more negative MGS, C0 slope, and CBVA than noncervical groups. Type 1 trended slightly higher CBVA and MGS than types 2–4, but no differences in cervical lordosis, C0-C2, or C0S were found. MGS (r = −0.131, P = 0.015), CBVA (r = −0.473, P < 0.001), and C0S (r = −0.099, P = 0.042) correlated most strongly with sagittal vertical axis (SVA) compared to other Schwab modifiers. We found SVA > 34 mm predicted a 1 unit (°°) decrease in MGS (odds ratio [OR]: 0.970 [0.948–0.993], P = 0.010), while cervical SVA >51 mm predicted a 1 unit increase in MGS (OR: 1.25 [1.12–1.38], P < 0.001). Conclusions: Our study suggests that upper cervical alignment remains relatively stable through most broad variations of adult TL deformity. Changes in SVA correlated most with upper cervical changes.

Published
2019
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6. Defining modern iatrogenic flatback syndrome: examination of segmental lordosis in short lumbar fusion patients undergoing thoracolumbar deformity correction

Author

Diebo, Bassel G., Singh, Manjot, Balmaceno-Criss, Mariah, Daher, Mohammad, Lenke, Lawrence G., Ames, Christopher P., Burton, Douglas C., Lewis, Stephen M., Klineberg, Eric O., Lafage, Renaud, Eastlack, Robert K., Gupta, Munish C., Mundis, Gregory M., Gum, Jeffrey L., Hamilton, Kojo D., Hostin, Richard, Passias, Peter G., Protopsaltis, Themistocles S., Kebaish, Khaled M., Kim, Han Jo, Shaffrey, Christopher I., Line, Breton G., Mummaneni, Praveen V., Nunley, Pierce D., Smith, Justin S., Turner, Jay, Schwab, Frank J., Uribe, Juan S., Bess, Shay, Lafage, Virginie, and Daniels, Alan H.

Published
2024
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7. Intraoperative fluid management in adult spinal deformity surgery: variation analysis and association with outcomes

Author

Cetik, Riza M., Gum, Jeffrey L., Lafage, Renaud, Smith, Justin S., Bess, Shay, Mullin, Jeffrey P., Kelly, Michael P., Diebo, Bassel G., Buell, Thomas J., Scheer, Justin K., Line, Breton G., Lafage, Virginie, Klineberg, Eric O., Kim, Han Jo, Passias, Peter G., Kebaish, Khaled M., Eastlack, Robert K., Daniels, Alan H., Soroceanu, Alex, Mundis, Gregory M., Hostin, Richard A., Protopsaltis, Themistocles S., Hamilton, D. Kojo, Hart, Robert A., Gupta, Munish C., Lewis, Stephen J., Schwab, Frank J., Lenke, Lawrence G., Shaffrey, Christopher I., Ames, Christopher P., and Burton, Douglas C.

Published
2024
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8. Thoracolumbar fusions for adult lumbar deformity show superior QALY gain and lower costs compared with upper thoracic fusions

Author

Kim, Andrew H., Hostin, Richard A., Yeramaneni, Samrat, Gum, Jeffrey L., Nayak, Pratibha, Line, Breton G., Bess, Shay, Passias, Peter G., Hamilton, D. Kojo, Gupta, Munish C., Smith, Justin S., Lafage, Renaud, Diebo, Bassel G., Lafage, Virginie, Klineberg, Eric O., Daniels, Alan H., Protopsaltis, Themistocles S., Schwab, Frank J., Shaffrey, Christopher I., Ames, Christopher P., Burton, Douglas C., and Kebaish, Khaled M.

Published
2024
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9. Microscopic view on the polarization-resolved S-SHG intensity of the vapor/liquid interface of pure water.

Author

Le Breton, G., Loison, C., Vynck, K., Benichou, E., and Bonhomme, O.

Abstract

Second harmonic generation (SHG) is a nonlinear optical phenomenon where two photons at the frequency ω combine to form a single photon at the second-harmonic frequency 2ω. Since that second-order process is very weak in bulk isotropic media, optical SHG responses of interfaces provide a powerful and versatile technique to probe the molecular structure and dynamics of liquid interfaces. Both local dipole contributions and non-local quadrupole contributions can be interesting to investigate different properties of the interface, such as the molecular orientation or the charge density. However, a major difficulty is to comprehend the link between the S-SHG intensity and molecular details. This article reports a numerical approach to model the polarization-resolved SHG intensities of a model vapor/liquid interface of pure water. The influence of the interfacial local environment on the hyperpolarizability is taken into account using quantum mechanical/molecular mechanics calculations. The numerical predictions are in very good agreement with experiments. We detail the hypotheses made during the modeling steps and discuss the impact of various factors on the modeled SHG intensities, including the description of the exciting field in the interfacial layer, the effect of neighboring molecules on the second-harmonic polarization, and the presence of an additional static electric field at the interface. [ABSTRACT FROM AUTHOR]

Published
2024
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10. Restoring L4-S1 Lordosis Shape in Severe Sagittal Deformity: Impact of Correction Techniques on Alignment and Complication Profile

Author

Singh, Manjot, Balmaceno-Criss, Mariah, Daher, Mohammad, Lafage, Renaud, Hamilton, D. Kojo, Smith, Justin S., Eastlack, Robert K., Fessler, Richard G., Gum, Jeffrey L., Gupta, Munish C., Hostin, Richard, Kebaish, Khaled M., Klineberg, Eric O., Lewis, Stephen J., Line, Breton G., Nunley, Pierce D., Mundis, Gregory M., Passias, Peter G., Protopsaltis, Themistocles S., Buell, Thomas, Ames, Christopher P., Mullin, Jeffrey P., Soroceanu, Alex, Scheer, Justin K., Lenke, Lawrence G., Bess, Shay, Shaffrey, Christopher I., Schwab, Frank J., Lafage, Virginie, Burton, Douglas C., Diebo, Bassel G., and Daniels, Alan H.

Published
2024
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11. Impact of Hip and Knee Osteoarthritis on Full Body Sagittal Alignment and Compensation for Sagittal Spinal Deformity

Author

Balmaceno-Criss, Mariah, Lafage, Renaud, Alsoof, Daniel, Daher, Mohammad, Hamilton, David Kojo, Smith, Justin S., Eastlack, Robert K., Fessler, Richard G., Gum, Jeffrey L., Gupta, Munish C., Hostin, Richard, Kebaish, Khaled M., Klineberg, Eric O., Lewis, Stephen J., Line, Breton G., Nunley, Pierce D., Mundis, Gregory M., Passias, Peter G., Protopsaltis, Themistocles S., Buell, Thomas, Scheer, Justin K., Mullin, Jeffrey P., Soroceanu, Alex, Ames, Christopher P., Lenke, Lawrence G., Bess, Shay, Shaffrey, Christopher I., Schwab, Frank J., Lafage, Virginie, Burton, Douglas C., Diebo, Bassel G., and Daniels, Alan H.

Published
2024
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12. Hip Osteoarthritis in Patients Undergoing Surgery for Severe Adult Spinal Deformity: Prevalence and Impact on Spine Surgery Outcomes

Author

Diebo, Bassel G., Alsoof, Daniel, Balmaceno-Criss, Mariah, Daher, Mohammad, Lafage, Renaud, Passias, Peter G., Ames, Christopher P., Shaffrey, Christopher I., Burton, Douglas C., Deviren, Vedat, Line, Breton G., Soroceanu, Alex, Hamilton, D. Kojo, Klineberg, Eric O., Mundis, Gregory M., Kim, Han Jo, Gum, Jeffrey L., Smith, Justin S., Uribe, Juan S., Kebaish, Khaled M., Gupta, Munish C., Nunley, Pierce D., Eastlack, Robert K., Hostin, Richard, Protopsaltis, Themistocles S., Lenke, Lawrence G., Hart, Robert A., Schwab, Frank J., Bess, Shay, Lafage, Virginie, Daniels, Alan H., and International Spine Study Group

Published
2024
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13. Postoperative Discharge to Acute Rehabilitation or Skilled Nursing Facility Compared to Home Does Not Reduce Hospital Readmissions, Return to Surgery or Improve Outcomes Following Adult Spine Deformity Surgery

Author

Bess, Shay, Line, Breton G., Nunley, Pierce, Ames, Christopher, Burton, Douglas, Mundis, Gregory, Eastlack, Robert, Hart, Robert, Gupta, Munish, Klineberg, Eric, Kim, Han Jo, Kelly, Michael, Hostin, Richard, Kebaish, Khaled, Lafage, Virgine, Lafage, Renaud, Schwab, Frank, Shaffrey, Christopher, and Smith, Justin S.

Published
2023
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14. Risk-benefit assessment of major versus minor osteotomies for flexible and rigid cervical deformity correction

Author

Passias, Peter Gust, Passfall, Lara, Horn, Samantha R, Pierce, Katherine E, Lafage, Virginie, Lafage, Renaud, Smith, Justin S, Line, Breton G, Mundis, Gregory M, Eastlack, Robert, Diebo, Bassel G, Protopsaltis, Themistocles S, Kim, Han Jo, Scheer, Justin, Burton, Douglas C, Hart, Robert A, Schwab, Frank J, Bess, Shay, Ames, Christopher P, and Shaffrey, Christopher I

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Patient Safety, Fixed deformity, flexible deformity, osteotomy, pedicle subtraction osteotomy, rigid deformity, vertebral column resection, International Spine Study Group, Neurosciences, Clinical sciences
Abstract

IntroductionOsteotomies are commonly performed to correct sagittal malalignment in cervical deformity (CD). However, the risks and benefits of performing a major osteotomy for cervical deformity correction have been understudied. The objective of this retrospective cohort study was to investigate the risks and benefits of performing a major osteotomy for CD correction.MethodsPatients stratified based on major osteotomy (MAJ) or minor (MIN). Independent t-tests and Chi-squared tests were used to assess differences between MAJ and MIN. A sub-analysis compared patients with flexible versus rigid CL.Results137 CD patients were included (62 years, 65% F). 19.0% CD patients underwent a MAJ osteotomy. After propensity score matching for cSVA, 52 patients were included. About 19.0% CD patients underwent a MAJ osteotomy. MAJ patients had more minor complications (P = 0.045), despite similar surgical outcomes as MIN. At 3M, MAJ and MIN patients had similar NDI, mJOA, and EQ5D scores, however by 1 year, MAJ patients reached MCID for NDI less than MIN patients (P = 0.003). MAJ patients with rigid deformities had higher rates of complications (79% vs. 29%, P = 0.056) and were less likely to show improvement in NDI at 1 year (0.95 vs. 0.54, P = 0.027). Both groups had similar sagittal realignment at 1 year (all P > 0.05).ConclusionsCervical deformity patients who underwent a major osteotomy had similar clinical outcomes at 3-months but worse outcomes at 1-year as compared to minor osteotomies, likely due to differences in baseline deformity. Patients with rigid deformities who underwent a major osteotomy had higher complication rates and worse clinical improvement despite similar realignment at 1 year.

Published
2021

15. Height Gain Following Correction of Adult Spinal Deformity

Author

Diebo, Bassel G., Tataryn, Zachary, Alsoof, Daniel, Lafage, Renaud, Hart, Robert A., Passias, Peter G., Ames, Christopher P., Scheer, Justin K., Lewis, Stephen J., Shaffrey, Christopher I., Burton, Douglas C., Deviren, Vedat, Line, Breton G., Soroceanu, Alex, Hamilton, D. Kojo, Klineberg, Eric O., Mundis, Gregory M., Kim, Han Jo, Gum, Jeffrey L., Smith, Justin S., Uribe, Juan S., Kelly, Michael P., Kebaish, Khaled M., Gupta, Munish C., Nunley, Pierce D., Eastlack, Robert K., Hostin, Richard, Protopsaltis, Themistocles S., Lenke, Lawrence G., Schwab, Frank J., Bess, Shay, Lafage, Virginie, and Daniels, Alan H.

Published
2023
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19. Lumbar Lordosis Redistribution and Segmental Correction in Adult Spinal Deformity: Does it Matter?

Author

Diebo, Bassel G., Balmaceno-Criss, Mariah, Lafage, Renaud, Daher, Mohammad, Singh, Manjot, Hamilton, D. Kojo, Smith, Justin S., Eastlack, Robert K., Fessler, Richard, Gum, Jeffrey L., Gupta, Munish C., Hostin, Richard, Kebaish, Khaled M., Lewis, Stephen, Line, Breton G., Nunley, Pierce D., Mundis, Gregory M., Passias, Peter G., Protopsaltis, Themistocles S., and Turner, Jay

Published
2024
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20. Impact of Self-Reported Loss of Balance and Gait Disturbance on Outcomes following Adult Spinal Deformity Surgery

Author

Diebo, Bassel G., primary, Alsoof, Daniel, additional, Lafage, Renaud, additional, Daher, Mohammad, additional, Balmaceno-Criss, Mariah, additional, Passias, Peter G., additional, Ames, Christopher P., additional, Shaffrey, Christopher I., additional, Burton, Douglas C., additional, Deviren, Vedat, additional, Line, Breton G., additional, Soroceanu, Alex, additional, Hamilton, David Kojo, additional, Klineberg, Eric O., additional, Mundis, Gregory M., additional, Kim, Han Jo, additional, Gum, Jeffrey L., additional, Smith, Justin S., additional, Uribe, Juan S., additional, Kebaish, Khaled M., additional, Gupta, Munish C., additional, Nunley, Pierce D., additional, Eastlack, Robert K., additional, Hostin, Richard, additional, Protopsaltis, Themistocles S., additional, Lenke, Lawrence G., additional, Hart, Robert A., additional, Schwab, Frank J., additional, Bess, Shay, additional, Lafage, Virginie, additional, and Daniels, Alan H., additional

Published
2024
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21. 371 The Impact of Thoracolumbar Inflection Point on Outcomes and Complications in Adult Spinal Deformity

Author

Mir, Jamshaid M., primary, Passias, Peter G., additional, Lewis, Stephen, additional, Tretiakov, Peter S., additional, Dave, Pooja, additional, Lafage, Renaud, additional, Smith, Justin S., additional, Line, Breton G., additional, Diebo, Bassel G., additional, Daniels, Alan H., additional, Gum, Jeffrey Lynn, additional, and Protopsalt, Themistocles, additional

Published
2024
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22. 326 Factors Associated With the Maintenance of Cost-Effectiveness at 5 Years in Adult Spinal Deformity Corrective Surgery

Author

Passias, Peter G., primary, Mir, Jamshaid M., additional, Dave, Pooja, additional, Tretiakov, Peter S., additional, Smith, Justin S., additional, Lafage, Renaud, additional, Gum, Jeffrey Lynn, additional, Line, Breton G., additional, Diebo, Bassel G., additional, Daniels, Alan H., additional, Protopsaltis, Themistocles, additional, and Hamilton, D. Kojo, additional

Published
2024
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23. Predictors of serious, preventable, and costly medical complications in a population of adult spinal deformity patients

Author

Alas, Haddy, Passias, Peter G., Brown, Avery E., Pierce, Katherine E., Bortz, Cole, Bess, Shay, Lafage, Renaud, Lafage, Virginie, Ames, Christopher P., Burton, Douglas C., Hamilton, D. Kojo, Kelly, Michael P., Hostin, Richard, Neuman, Brian J., Line, Breton G., Shaffrey, Christopher I., Smith, Justin S., Schwab, Frank J., and Klineberg, Eric O.

Published
2021
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24. Postoperative Discharge to Acute Rehabilitation or Skilled Nursing Facility Compared With Home Does Not Reduce Hospital Readmissions, Return to Surgery, or Improve Outcomes Following Adult Spine Deformity Surgery.

Author

Bess, Shay, Line, Breton G., Nunley, Pierce, Ames, Christopher, Burton, Douglas, Mundis, Gregory, Eastlack, Robert, Hart, Robert, Gupta, Munish, Klineberg, Eric, Han Jo Kim, Kelly, Michael, Hostin, Richard, Kebaish, Khaled, Lafage, Virgine, Lafage, Renaud, Schwab, Frank, Shaffrey, Christopher, and Smith, Justin S.

Subjects
*SPINAL surgery, *NURSING care facilities, *PATIENT readmissions, *SPINE abnormalities, *REHABILITATION nursing, *PROPENSITY score matching
Abstract

Study Design. Retrospective review of a prospective multicenter adult spinal deformity (ASD) study. Objective. The aim of this study was to evaluate 30-day readmissions, 90-day return to surgery, postoperative complications, and patient-reported outcomes (PROs) for matched ASD patients receiving nonhome discharge (NON), including acute rehabilitation (REHAB), and skilled nursing facility (SNF), or home (HOME) discharge following ASD surgery. Summary of Background Data. Postoperative disposition following ASD surgery frequently involves nonhome discharge. Little data exists for longer term outcomes for ASD patients receiving nonhome discharge versus patients discharged to home. Materials and Methods. Surgically treated ASD patients prospectively enrolled into a multicenter study were assessed for NON or HOME disposition following hospital discharge. NON was further divided into REHAB or SNF. Propensity score matching was used to match for patient age, frailty, spine deformity, levels fused, and osteotomies performed at surgery. Thirty-day hospital readmissions, 90-day return to surgery, postoperative complications, and 1-year and minimum 2-year postoperative PROs were evaluated. Results. A total of 241 of 374 patients were eligible for the study. NON patients were identified and matched to HOME patients. Following matching, 158 patients remained for evaluation; NON and HOME had similar preoperative age, frailty, spine deformity magnitude, surgery performed, and duration of hospital stay (P>0.05). Thirty-day readmissions, 90-day return to surgery, and postoperative complications were similar for NON versus HOME and similar for REHAB (N =64) versus SNF (N = 42) versus HOME (P>0.05). At 1-year and minimum 2-year follow-up, HOME demonstrated similar to better PRO scores including Oswestry Disability Index, Short-Form 36v2 questionnaire Mental Component Score and Physical Component Score, and Scoliosis Research Society scores versus NON, REHAB, and SNF (P< 0.05). Conclusions. Acute needs must be considered following ASD surgery, however, matched analysis comparing 30-day hospital readmissions, 90-day return to surgery, postoperative complications, and PROs demonstrated minimal benefit for NON, REHAB, or SNF versus HOME at 1- and 2-year follow-up, questioning the risk and cost/benefits of routine use of nonhome discharge. [ABSTRACT FROM AUTHOR]

Published
2024
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25. Probability of severe frailty development among operative and nonoperative adult spinal deformity patients: an actuarial survivorship analysis over a 3-year period

Author

Passias, Peter G., Segreto, Frank A., Bortz, Cole A., Horn, Samantha R., Pierce, Katherine E., Naessig, Sara, Brown, Avery E., Jackson-Fowl, Brendan, Ahmad, Waleed, Oh, Cheongeun, Lafage, Virginie, Lafage, Renaud, Smith, Justin S., Daniels, Alan H., Line, Breton G., Kim, Han Jo, Uribe, Juan S., Eastlack, Robert K., Hamilton, D. Kojo, Klineberg, Eric O., Burton, Douglas C., Hart, Robert A.A., Schwab, Frank J., Shaffrey, Christopher I., Ames, Christopher P., and Bess, Shay

Published
2020
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26. Hospital-acquired conditions occur more frequently in elective spine surgery than for other common elective surgical procedures

Author

Horn, Samantha R., Segreto, Frank A., Alas, Haddy, Bortz, Cole, Jackson-Fowl, Brendan, Brown, Avery E., Pierce, Katherine E., Vasquez-Montes, Dennis, Egers, Max I., Line, Breton G., Oh, Cheongeun, Moon, John, De la Garza Ramos, Rafael, Vira, Shaleen, Diebo, Bassel G., Frangella, Nicholas J., Stekas, Nicholas, Shepard, Nicholas A., Horowitz, Jason A., Hassanzadeh, Hamid, Bendo, John A., Lafage, Renaud, Lafage, Virginie, and Passias, Peter G.

Published
2020
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27. 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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29. An Arabidopsis gene regulatory network for secondary cell wall synthesis

Author

Taylor-Teeples, M, Lin, L, de Lucas, M, Turco, G, Toal, TW, Gaudinier, A, Young, NF, Trabucco, GM, Veling, MT, Lamothe, R, Handakumbura, PP, Xiong, G, Wang, C, Corwin, J, Tsoukalas, A, Zhang, L, Ware, D, Pauly, M, Kliebenstein, DJ, Dehesh, K, Tagkopoulos, I, Breton, G, Pruneda-Paz, JL, Ahnert, SE, Kay, SA, Hazen, SP, and Brady, SM

Subjects
Plant Biology, Biochemistry and Cell Biology, Bioinformatics and Computational Biology, Biological Sciences, Genetics, Biotechnology, Underpinning research, 1.1 Normal biological development and functioning, Generic health relevance, Arabidopsis, Arabidopsis Proteins, Cell Wall, DNA, Plant, E2F Transcription Factors, Feedback, Gene Expression Regulation, Developmental, Gene Expression Regulation, Plant, Gene Regulatory Networks, Iron Deficiencies, Organ Specificity, Promoter Regions, Genetic, Reproducibility of Results, Salinity, Time Factors, Transcription Factors, Xylem, General Science & Technology
Abstract

The plant cell wall is an important factor for determining cell shape, function and response to the environment. Secondary cell walls, such as those found in xylem, are composed of cellulose, hemicelluloses and lignin and account for the bulk of plant biomass. The coordination between transcriptional regulation of synthesis for each polymer is complex and vital to cell function. A regulatory hierarchy of developmental switches has been proposed, although the full complement of regulators remains unknown. Here we present a protein-DNA network between Arabidopsis thaliana transcription factors and secondary cell wall metabolic genes with gene expression regulated by a series of feed-forward loops. This model allowed us to develop and validate new hypotheses about secondary wall gene regulation under abiotic stress. Distinct stresses are able to perturb targeted genes to potentially promote functional adaptation. These interactions will serve as a foundation for understanding the regulation of a complex, integral plant component.

Published
2015

31. 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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32. Predictors of pelvic tilt normalization: a multicenter study on the impact of regional and lower-extremity compensation on pelvic alignment after complex adult spinal deformity surgery.

Author

Dave, Pooja, Lafage, Renaud, Smith, Justin S., Line, Breton G., Tretiakov, Peter S., Mir, Jamshaid, Diebo, Bassel, Daniels, Alan H., Gum, Jeffrey L., Hamilton, D. Kojo, Buell, Thomas, Than, Khoi D., Kai-Ming Fu, Scheer, Justin K., Eastlack, Robert, Mullin, Jeffrey P., Mundis Jr., Gregory, Naobumi Hosogane, Mitsuru Yagi, and Nunley, Pierce

Published
2024
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33. The Case for Operative Efficiency in Adult Spinal Deformity Surgery: Impact of Operative Time on Complications, Length of Stay, Alignment, Fusion Rates, and Patient-Reported Outcomes.

Author

Daniels, Alan H., Daher, Mohammad, Singh, Manjot, Balmaceno-Criss, Mariah, Lafage, Renaud, Diebo, Bassel G., Hamilton, David K., Smith, Justin S., Eastlack, Robert K., Fessler, Richard G., Gum, Jeffrey L., Gupta, Munish C., Hostin, Richard, Kebaish, Khaled M., Klineberg, Eric O., Lewis, Stephen J., Line, Breton G., Nunley, Pierce D., Mundis, Gregory M., and Passias, Peter G.

Published
2024
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34. Economic burden of nonoperative treatment of adult spinal deformity

Author

Passias, Peter G., primary, Ahmad, Waleed, additional, Dave, Pooja, additional, Lafage, Renaud, additional, Lafage, Virginie, additional, Mir, Jamshaid, additional, Klineberg, Eric O., additional, Kabeish, Khaled M., additional, Gum, Jeffrey L., additional, Line, Breton G., additional, Hart, Robert, additional, Burton, Douglas, additional, Smith, Justin S., additional, Ames, Christopher P., additional, Shaffrey, Christopher I., additional, Schwab, Frank, additional, Hostin, Richard, additional, Buell, Thomas, additional, Hamilton, D. Kojo, additional, and Bess, Shay, additional

Published
2023
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35. Incremental benefits of circumferential minimally invasive surgery for increasingly frail patients with adult spinal deformity

Author

Peter G. Passias, Peter S. Tretiakov, Pierce D. Nunley, Michael Y. Wang, Paul Park, Adam S. Kanter, David O. Okonkwo, Robert K. Eastlack, Gregory M. Mundis, Dean Chou, Nitin Agarwal, Richard G. Fessler, Juan S. Uribe, Neel Anand, Khoi D. Than, Gregory Brusko, Kai-Ming Fu, Jay D. Turner, Vivian P. Le, Breton G. Line, Christopher P. Ames, Justin S. Smith, Christopher I. Shaffrey, Robert A. Hart, Douglas Burton, Renaud Lafage, Virginie Lafage, Frank Schwab, Shay Bess, and Praveen V. Mummaneni

Subjects
General Medicine
Abstract

OBJECTIVE Circumferential minimally invasive surgery (cMIS) may provide incremental benefits compared with open surgery for patients with increasing frailty status by decreasing peri- and postoperative complications. METHODS Operative patients with adult spinal deformity (ASD) ≥ 18 years old with baseline and 2-year postoperative data were assessed. With propensity score matching, patients who underwent cMIS (cMIS group) were matched with similar patients who underwent open surgery (open group) based on baseline BMI, C7–S1 sagittal vertical axis, pelvic incidence to lumbar lordosis mismatch, and S1 pelvic tilt. The Passias modified ASD frailty index (mASD-FI) was used to determine patient frailty stratification as not frail, frail, or severely frail. Baseline and postoperative factors were assessed using two-way analysis of covariance (ANCOVA) and multivariate ANCOVA while controlling for baseline age, Charlson Comorbidity Index (CCI) score, and number of levels fused. RESULTS After propensity score matching, 170 ASD patients (mean age 62.71 ± 13.64 years, 75.0% female, mean BMI 29.25 ± 6.60 kg/m2) were included, split evenly between the cMIS and open groups. Surgically, patients in the open group had higher numbers of posterior levels fused (p = 0.021) and were more likely to undergo three-column osteotomies (p > 0.05). Perioperatively, cMIS patients had lower intraoperative blood loss and decreased use of cell saver across frailty groups (with adjustment for baseline age, CCI score, and levels fused), as well as fewer perioperative complications (p < 0.001). Adjusted analysis also revealed that compared to open patients, increasingly frail patients in the cMIS group were also more likely to demonstrate greater improvement in 1- and 2-year postoperative scores for the Oswestry Disability Index, SRS-36 (total), EQ-5D and SF-36 (all p < 0.05). With regard to postoperative complications, increasingly frail patients in the cMIS group were also noted to experience significantly fewer complications overall (p = 0.036) and fewer major intraoperative complications (p = 0.039). The cMIS patients were also less likely to need a reoperation than their open group counterparts (p = 0.043). CONCLUSIONS Surgery performed with a cMIS technique may offer acceptable outcomes, with diminishment of perioperative complications and mitigation of catastrophic outcomes, in increasingly frail patients who may not be candidates for surgery using traditional open techniques. However, further studies should be performed to investigate the long-term impact of less optimal alignment in this population.

Published
2023

36. Patient and procedural risk factors for decline in lower-extremity motor scores following adult spinal deformity surgery

Author

Sarthak Mohanty, Fthimnir M. Hassan, Lawrence G. Lenke, Douglas Burton, Alan H. Daniels, Munish C. Gupta, Khaled M. Kebaish, Michael Kelly, Han Jo Kim, Eric O. Klineberg, Peter G. Passias, Themistocles Protopsaltis, Frank Schwab, Christopher I. Shaffrey, Justin S. Smith, Breton G. Line, Renaud Lafage, Virginie Lafage, and Shay Bess

Subjects
General Medicine
Abstract

OBJECTIVE The purpose of this study was to discern factors that differentiate patients who experience postoperative lower-extremity motor function decline in the early postoperative period. METHODS Adult spinal deformity (ASD) patients who were enrolled in a multicenter, observational, and prospectively collected study from 2018 to 2021 at 18 spinal deformity centers in North America were queried. Eligible participants met at least one of the following radiographic and/or procedural inclusion criteria: pelvic incidence minus lumbar lordosis (PI-LL) ≥ 25°, T1 pelvic angle (T1PA) ≥ 30°, sagittal vertical axis (SVA) ≥ 15 cm, thoracic scoliosis ≥ 70°, thoracolumbar scoliosis ≥ 50°, global coronal malalignment ≥ 7 cm, 3-column osteotomy, spinal fusion ≥ 12 levels, and/or age ≥ 65 years with ≥ 7 levels of instrumentation. Patients with an inflammatory or autoimmune disease and those who were incarcerated or pregnant were excluded, as were non-English speakers. Only patients with baseline and 6-week postoperative lower-extremity motor score (LEMS) were analyzed. Patient information, including demographic data, operative data, patient-reported outcomes, and radiographic parameters, were collected. Univariate and multivariable logistic regression models were built to quantify the degree to which a patient’s postoperative LEMS decline was related to demographic and clinical characteristics. RESULTS In total, 205 patients (mean age 61.5 years, mean total instrumented levels 12.6, 67.3% female, 54.2% primary cases, 79.5% with pelvic fixation) were evaluated. Of these 205 patients, 32 (15.5%) experienced LEMS decline in the perioperative period. These patients were older (p = 0.0014) and had greater BMI (p = 0.0176), higher frailty scores (p = 0.047), longer operating room times (p = 0.033), and greater estimated blood loss (p < 0.0001), and they were more frequently observed to have intraoperative neurophysiological monitoring (IONM) changes (p = 0.018). The deteriorated cohort had greater C7SVA at baseline (p = 0.0028) but were comparable in terms of all other radiographic parameters. No radiographic differences were seen between the groups at the 6-week visit; however, the deteriorated cohort experienced greater change in PI-LL (p < 0.0001), lumbar lordosis (p = 0.0461), C7SVA (p = 0.0004), and T1PA (p < 0.0001). Multivariate logistic regression demonstrated that the presence of IONM changes and each degree of negative change in T1PA conferred 3.71 (95% CI 1.01–13.42) and 1.09 (1.01–1.19) greater odds of postoperative LEMS deterioration, respectively. CONCLUSIONS In this study, 15.6% of ASD patients incurred LEMS decline in the perioperative period. The magnitude of change in global sagittal alignment, specifically T1PA, was the strongest independent predictor of LEMS decline, which has implications for surgical planning, patient counseling, and clinical research.

Published
2023

37. Patient profiling can identify patients with adult spinal deformity (ASD) at risk for conversion from nonoperative to surgical treatment: initial steps to reduce ineffective ASD management

Author

Passias, Peter G., Jalai, Cyrus M., Line, Breton G., Poorman, Gregory W., Scheer, Justin K., Smith, Justin S., Shaffrey, Christopher I., Burton, Douglas C., Fu, Kai-Ming G., Klineberg, Eric O., Hart, Robert A., Schwab, Frank, Lafage, Virginie, and Bess, Shay

Published
2018
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39. Effective Prevention of Proximal Junctional Failure in Adult Spinal Deformity Surgery Requires a Combination of Surgical Implant Prophylaxis and Avoidance of Sagittal Alignment Overcorrection

Author

Line, Breton G., Bess, Shay, Lafage, Renaud, Lafage, Virgine, Schwab, Frank, Ames, Christopher, Kim, Han Jo, Kelly, Michael, Gupta, Munish, Burton, Douglas, Hart, Robert, Klineberg, Eric, Kebaish, Khaled, Hostin, Richard, Mundis, Gregory, Eastlack, Robert, Shaffrey, Christopher, and Smith, Justin S.

Published
2020
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40. Patient and procedural risk factors for decline in lower-extremity motor scores following adult spinal deformity surgery

Author

Mohanty, Sarthak, primary, Hassan, Fthimnir M., additional, Lenke, Lawrence G., additional, Burton, Douglas, additional, Daniels, Alan H., additional, Gupta, Munish C., additional, Kebaish, Khaled M., additional, Kelly, Michael, additional, Kim, Han Jo, additional, Klineberg, Eric O., additional, Passias, Peter G., additional, Protopsaltis, Themistocles, additional, Schwab, Frank, additional, Shaffrey, Christopher I., additional, Smith, Justin S., additional, Line, Breton G., additional, Lafage, Renaud, additional, Lafage, Virginie, additional, and Bess, Shay, additional

Published
2023
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41. Incremental benefits of circumferential minimally invasive surgery for increasingly frail patients with adult spinal deformity

Author

Passias, Peter G., primary, Tretiakov, Peter S., additional, Nunley, Pierce D., additional, Wang, Michael Y., additional, Park, Paul, additional, Kanter, Adam S., additional, Okonkwo, David O., additional, Eastlack, Robert K., additional, Mundis, Gregory M., additional, Chou, Dean, additional, Agarwal, Nitin, additional, Fessler, Richard G., additional, Uribe, Juan S., additional, Anand, Neel, additional, Than, Khoi D., additional, Brusko, Gregory, additional, Fu, Kai-Ming, additional, Turner, Jay D., additional, Le, Vivian P., additional, Line, Breton G., additional, Ames, Christopher P., additional, Smith, Justin S., additional, Shaffrey, Christopher I., additional, Hart, Robert A., additional, Burton, Douglas, additional, Lafage, Renaud, additional, Lafage, Virginie, additional, Schwab, Frank, additional, Bess, Shay, additional, and Mummaneni, Praveen V., additional

Published
2023
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42. 432 Enhanced Surgical Recovery for Thoracolumbar Spine Surgery is Associated With Decreased Opioid Consumption, Length of Hospital Stay, and Hospital Readmissions: Evaluation of 51,236 Cases

Author

Good, Christopher, primary, Bess, Shay, additional, Orosz, Lindsay, additional, Scibelli, Stephen Scott, additional, Line, Breton G., additional, Remington, Gina, additional, Roman, Cecile, additional, Luckett, Daniel, additional, and Jazini, Ehsan, additional

Published
2023
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43. UK investment analyst reaction to window dressing of financial statements : a laboratory experiment

Author

Breton, G.

Subjects
658, HG Finance
Abstract

This thesis is primarily concerned with the reaction of UK investment analysts when confronted with window dressed financial statements and its implications for stock market information processing and efficiency. Three associated empirical examinations are undertaken. 1) A detailed investigation of the prevalence of window dressing in UK company accounts and the nature of such exercises is conducted using a random sample of 100 sets of accounts for large UK corporates. A substantial degree of window dressing is identified. The analysis is developedfurther to explore the relationship between extent of window dressing and financial position of the firm although the results are ambiguous. 2) To explore the importance of accounting information generally to the investment analysis community, relative to alternative sources, and the manner in which it is used to drive investment recommendations a detailed content analysis of a large sample of stockbroker circulars is conducted. The results suggest the importance of accounting information for market participants may be conventionally overstated. Nonetheless the statistical findings, although significant, are not very strong which may partially reflect the heterogeneity found in the methods used by different stockbroking firms in appraising shares. Further work is required. 3) The main part of the thesis reports on a laboratory experiment with 63 experienced stockbroking analysts drawn from five of the top City houses. The analysts were required to process company accounts and adjust for window dressed items. We were forced to conclude that, at least at the time, the research took place in early 1990, investment analysts were neither very concerned by nor able or inclined to correct for creative accounting. These findings are discussed in detail and implications for different market theories drawn. The theories conclude that there may well be valid concerns about the conventional role attributed to investment analysts as information intermediaries in maintaining market efficiency, particularly in the processing of and disseminating complex accounting information.

Published
1993

44. Grading of Complications After Cervical Deformity-corrective Surgery: Are Existing Classification Systems Applicable?

Author

Bortz, Cole A., Passias, Peter G., Segreto, Frank A., Horn, Samantha R., Lafage, Renaud, Smith, Justin S., Line, Breton G., Mundis, Gregory M., Jr, Kelly, Michael P., Park, Paul, Sciubba, Daniel M., Hamilton, D. Kojo, Gum, Jeffrey L., Burton, Douglas C., Hart, Robert A., Schwab, Frank J., Bess, Shay, Shaffrey, Christopher, and Klineberg, Eric O.

Published
2019
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47. Operative treatment outcomes for adult cervical deformity: a prospective multicenter assessment with mean 3-year follow-up

Author

Elias, Elias, primary, Bess, Shay, additional, Line, Breton G., additional, Lafage, Virginie, additional, Lafage, Renaud, additional, Klineberg, Eric, additional, Kim, Han Jo, additional, Passias, Peter, additional, Nasser, Zeina, additional, Gum, Jeffrey L., additional, Kebaish, Khaled, additional, Eastlack, Robert, additional, Daniels, Alan H., additional, Mundis, Gregory, additional, Hostin, Richard, additional, Protopsaltis, Themistocles S., additional, Soroceanu, Alex, additional, Hamilton, D. Kojo, additional, Kelly, Michael P., additional, Gupta, Munish, additional, Hart, Robert, additional, Schwab, Frank J., additional, Burton, Douglas, additional, Ames, Christopher P., additional, Shaffrey, Christopher I., additional, Smith, Justin S., additional, and _, _, additional

Published
2022
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50. Tenofovir DF/emtricitabine and efavirenz combination therapy for HIV infection in patients treated for tuberculosis: the ANRS 129 BKVIR trial

Author

Lortholary, Olivier, Roussillon, Caroline, Boucherie, Céline, Padoin, Christophe, Chaix, Marie-Laure, Breton, Guillaume, Rami, Agathe, Veziris, Nicolas, Patey, Olivier, Caumes, Eric, May, Thierry, Molina, Jean-Michel, Robert, Jérome, Tod, Michel, Fagard, Catherine, Chêne, Geneviève, Aumaître, H., Borsato, F., Malet, M., Médus, M., Moreau, L., Neuville, S., Saada, M., Abgrall, S., Ahoudji, D., Balmard, L., Bentata, M., Bouchaud, O., Boudribila, A., Cailhol, J., Dhote, R., Djebbar, R., Gros, H., Honoré, P., Huynh, T., Krivitzky, A., Mansouri, R., Pizzocolo, C., Rouges, F., Viot, E., Amar, B., Bantsimba, J., Dellion, S., Patey, O., Richier, L., Dupon, M., Dutronc, H., Neau, D., Ragnaud, J. M., Raymond, I., Boucly, S., Gailhoustet, L., Lortholary, O., Maignan, A., Touam, F., Viard, J. P., Bergmann, J. F., Boulanger, E., Delcey, V., Diemer, M., Durel, A., Jouade, F., Parrinello, M., Rami, A., Sellier, P., Brazille, P., Leclerc, C., Welker, Y., Bernard, L., Berthé, H., Perronne, C., Salomon, J., de Truchis, P., Bolliot, C., Couzigou, C., Derradji, O., Escaut, L., Teicher, E., Vittecoq, D., Chakvetadze, C., Fontaine, C., LʼYavanc, T., Maresca, A., Pialoux, G., Slama, L., Tuna, L., Bornarel, D., Boué, F., Chassaing, A., Chaiba-Berroukeche, L., Chambrin, V., Delavalle, A. M., Galanaud, P., Levy, A., Pignon, C., Bonnet, D., Ecobichon, J. L., Fournier, I., Fraquiero, G., Gerbe, J., Gervais, A., Guiyedi, V., Iordache, L., Joly, V., Klutse, P., Laurichesse, J. J., Leport, C., Onanga, M., Pahlaval, G., Phung, B. C., Ralaimazava, P., Yeni, P., Almasi, F., Basler, M., Benammar, N., Brunes, A., Guérin, C., Guillevin, L., Meddour, R., Salmon, D., Spiridon, G., Tahi, T., Bloch, M., Ferreira, C., Mahe, I., Manceron, V., Minozzi, C., Mortier, E., Simonpoli, A. M., Vinceneux, P., Zeng Ai, F., Chesnel, C., Dominguez, S., Jouve, P., Lascaux-Cametz, A. S., Lelièvre, J. D., Levy, Y., Melica, G., Sobel, A., Bentaleb, N., Blondin-Diop, A., Bonmarchand, M., Bossi, P., Brancon, C., Breton, G., Bricaire, F., Caby, F., Canestri, A., Clavel, C., Edeb, N., Herson, S., Iguertsira, M., Katlama, C., Kouadio, H., Lagarde, P., Lopez, J. L., Marguet, F., Martinez, V., Remidi, H., Simon, A., Souchon, J. F., Valantin, M. A., Bollens, D., Girard, P. M., Lagneau, J. L., Lefebvre, B., Mouchotte, R., Ouazene, Z., Sebire, M., Theveny-Christiany, A., Valin, N., Bourgarit, A., de Castro, N., Delgado, J., Ferret, S., Lascoux-Combe, C., Molina, J. M., Parlier, S., Pavie, J., Pintado, C., Ponscarme, D., Rachline, A., Sereni, D., Taulera, O., de Verdiere, C., Vincent, F., Bernard, N., Bonarek, M., Bonnet, F., Delaune, J., Lacoste, D., Louis, I., Malvy, D., Mercier, P., Morlat, P., Pertusa, M. C., Schottey, M., Chanteloube, N., Eden, A., Le Moing, V., Makilson, A., de Boever, C. Merle, Reynes, J., Turrière, C., Tramoni, C., Vidal, M., Anavena, C., Billaud, E., Biron, C., Bonnet, B., Bouchez, J., Boutoille, D., Brosseau, D., Brunct, C., Colas, M., Feuillebois, N., Hüe, H., Launay, E., le Houssine, P. Morineau, Raffi, F., Reliquet, V., Cua, E., Dellamonica, P., Durant, J., Rahelinirina, V., Arvieux, C., Chapplain, J. M., Fily, F., Labbay, E., Michelet, C., Morin, F., Peaucelle, C., Revest, M., Ratajczak, M., Souala, F., Tattevin, P., Thomas, R., Alvarez, M., Balsarin, F., Bonnet, E., Busato, F., Cuzin, L., Marche, D., Marchou, B., Massip, P., Obadia, M., Porte, L., Aissi, E., Ajana, F., Alcaraz, I., Baclet, V., Dubus, S., Gérard, Y., Guerroumi, H., Huleux, T., Lahouste, A., Marien, M. C., Melliez, H., Mouton, Y., Pennel, M. P., Valette, M., Viget, N., Yazdanpanah, Y., Bevilacqua, S., Boyer, L., Lecompte, T., Letranchant, L., May, T., Rabaud, C., Thomas, L., Vancon, R., Wassoumbou, S., Abboud, P., Borsa-Lebas, F., Caron, F., Debab, Y., Etienne, M., Faucon, M., Gueit, I., Brouqui, P., Mokhtari, S., Moreau, J., Schlojsers, M., Vandergheynst, E., Chousterman, M., Delacroix-Szmania, I., El Harrar, B., Garrait, V., Joannes, S., Luquet-Besson, I., Mouchet, M., Richier, L., Stevens, A. Blase, Dupont, C., Maresca, A. Freire, Greffe, S., Hanslik, T., Landi, B., Leporrier, J., Rouveix, E., Toth, K., El Mansouf, L., Khuong-Josses, M. A., Méchali, D., Le Besnerais, J. Phalip, Taverne, B., Barclay, F., Fain, O., Flexor, G., Stirnemann, J., Tassi, S., Levast, M., Rogeaux, O., Raffenot, D., Tous, J., Lortholary, O., Bouchaud, O., Chaix, M. L., Chêne, G., Couffin-Cadiergues, S., Dupon, M., Fagard, C., Joly, V., Launay, O., Molina, J. M., Robert, J., Roussillon, C., Rouzioux, C., Tod, M., Yazdanpanah, Y., Lortholary, O., Breton, G., Caumes, E., May, T., Roussillon, C., Veziris, N., Badets, M., Boucherie, C., Fagard, C., Chêne, G., Roussillon, C., Terras, N., Guérin, C., Altare, F., Bourgarit, A., Carcelain, G., Trylesinski, A., Aubron-Olivier, C., Nguyen, T., and Bennai, Y.

Published
2016
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