Spine
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Review article of medical complications related to adult spinal deformity surgery. ⋯ Awareness of the presentation, treatment, and prevention of medical complications of deformity surgery may allow minimization of their occurrence and optimize treatment should they occur.
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Author experience and literature review. ⋯ Segmental pedicle screw fixation coupled with one of four posterior osteotomy/resection techniques can be used to address most sagittal plain deformities. Careful application of these techniques is important. Smith-Petersen and Ponte osteotomies are most appropriate for long sweeping deformities with mobile anterior columns. Pedicle subtraction osteotomies and vertebral column resections are most appropriate for fixed, sharply angulated spinal deformities. The successful application of these techniques is dependent on accurate preoperative evaluation of the structural properties of the kyphosis and meticulous execution of the surgical technique.
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Review article. ⋯ An appreciation of both the coronal and sagittal plane components of spinal deformity is mandatory to achieve optimal results with surgical stabilization of adult scoliosis.
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Author experience and literature review. ⋯ As the magnitude of resection increases, the ability to correct deformity improves, but also the risk of complication increases. Therein, an understanding of potential applications and complications is helpful.
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Descriptive study of the Scoliosis Research Society (SRS) Classification for Adult Spinal Deformity using interobserver reliability measures for validation of the system. ⋯ A uniform system for classification of adult spinal deformity has significant utility in improving the ability of surgeons and authors to compare and combine similar cases, and in improving the accuracy of reports on the outcomes of care for adults with spinal deformity. The SRS Classification System for Adult Spinal Deformity has good interobserver reliability and is predictive of surgical strategies. Further validation of the SRS Classification System will include measures of intraobserver reliability, and inclusion of clinical characteristics of patient presentation and comorbidities.