Circumferential MIS Correction of ASD PDF
Preview Circumferential MIS Correction of ASD
Circumferential MIS Correction of ASD – 2017 update NEEL ANAND, MD Clinical Professor of Surgery Director, Spine Trauma Minimally Invasive Spine Surgery Spine Center, Cedars Sinai Medical Center Los Angeles, CA Disclosures • Consultant – Medtronics, Globus, GYS Tech • Speaker – DePuy Synthes, Stryker • Royalties –, Medtronics, Globus, Elsevier • SAB – Globus, GYS Tech, Theracell • Editor – Gray’s Anatomy • Stocks/Stock Options – Medtronics, Globus, Atlas Spine, Paradigm Spine, Theracell, AF cell, Bonovo, GYS Tech Case C.B.: • 64 yr old Female Retired Nurse • Severe back Pain 4 years • Bilateral claudication 3 years L>R • Back 60 %, Leg 40 % • Neuro intact • Tried PT, Epidurals, Chiropractor, Acupuncture, Acupressure, • On Norco past 9 months 68 yr old Female Retired Nurse Pain Diagram Functional Scores 4 ODI - 60 3.5 TIS - 63 3 2.5 Pre-op SF 36 2 – PCS: 22.2 1.5 1 – MCS: 43 0.5 0 Functional Pain Self Image Mental health Satisfaction SRS 22 Domains Classic Rx • Routine Lateral bending films - Flexibility • Open Surgical Correction • Posterior instrumentation predominantly • Cobalt Chrome rods • T2 to Pelvis with posterior column Osteotomies • L4-5, L5-S1 ALIF • Post op ICU x 24-48 hrs WHY CHANGE ? Complications RELATIONSHIP TO COMPLICATIONS Patient Variables P- value, OR (95% CI) Comorbidities p=0.71 # levels Fused p=0.36 revision p=0.45 Duration of surgery p=0.21 Age p=0.006, 1.23 (1.06,1.42) Age >69 years p=0.01, 9.45 (1.67,53) PSO p=0.02, 6.96 (1.10,79) Daubs, Lenke, et al. Spine 2007;32:2238-44 CAN MINIMALLY INVASIVE STRATEGIES CHANGE THE PARADIGM
Description:The list of books you might like
