Browsing by Author "Pizones, Javier"

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    Adult Congenital Spine Deformity: Clinical Features and Motivations for Surgical Treatment
    (INT SOC ADVANCEMENT SPINE SURGERY-ISASS, 2021-01-01) Pizones, Javier; Moreno-Manzanaro, Lucia; Vila-Casademunt, Alba; Fernandez-Baillo, Nicomedes; Sanchez-Marquez, Jose; Talavera, Gloria; Obeid, Ibrahim; Alanay, Ahmet; Kleinstuck, Frank; Pellise, Ferran; Sanchez Perez-Grueso, Francisco Javier; ESSG
    Background: There is scarce information available about adult congenital spine deformity (ACSD) in the literature, especially its impact after the pediatric age. The aim was to define ACSD characteristics and to establish the drivers for surgical intervention. Methods: Cross-sectional study of data collected in an adult deformity multicenter database. Only ACSD patients were included. Demographic and radiographic data, as well as patient-reported outcome measures, were assessed. Conservatively (C) vs surgically (S) treated patients were compared using Student t test, chi(2), and Mann-Whitney U test. Results: Fifty-two patients were included. They were young adults (x = 37.7 years), mostly female (71\%). Among them. 60\% had single hemivertebrae (HV), 35\% had multiple HV, and 5\% had segmentation defects. Also. 75\% had mainly corona' deformity (Cobb 625 degrees +/- 29.6) and 25\% had sagittal deformity. Mean Oswestry Disability Index (ODI) was 29.6\% +/- 17 and mean Scoliosis Research Society 22-item survey (SRS-22) total score was 3.2 +/- 0.8. Of note, mean SRS-22 self-image score was 2.8 +/- 0.9 and 36-item Short Form Health Survey (SF-36) physical function score was 40.9 +/- 11. Thirty patients were treated conservatively (C), whereas 22 patients underwent surgery (S). No differences were found regarding age, type or location of the deformity, comorbidities, or radiographic parameters. Operated patients had worse Core Outcome Measurement Index (COMI) back scores (C: 3.8 +/- 2.4 vs S: 6.7 +/- 2.4
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    Association between sagittal alignment and loads at the adjacent segment in the fused spine: a combined clinical and musculoskeletal modeling study of 205 patients with adult spinal deformity
    (SPRINGER, 2022-01-01) Ignasiak, Dominika; Behm, Pascal; Mannion, Anne F.; Galbusera, Fabio; Kleinstuck, Frank; Fekete, Tamas F.; Haschtmann, Daniel; Jeszenszky, Dezso; Zimmermann, Laura; Richner-Wunderlin, Sarah; Vila-Casademunt, Alba; Pellise, Ferran; Obeid, Ibrahim; Pizones, Javier; Sanchez Perez-Grueso, Francisco J.; Karaman, Muhammed Ilkay; Alanay, Ahmet; Yilgor, Caglar; Ferguson, Stephen J.; Loibl, Markus
    PurposeSagittal malalignment is a risk factor for mechanical complications after surgery for adult spinal deformity (ASD). Spinal loads, modulated by sagittal alignment, may explain this relationship. The aims of this study were to investigate the relationships between: (1) postoperative changes in loads at the proximal segment and realignment, and (2) absolute postoperative loads and postoperative alignment measures. MethodsA previously validated musculoskeletal model of the whole spine was applied to study a clinical sample of 205 patients with ASD. Based on clinical and radiographic data, pre-and postoperative patient-specific alignments were simulated to predict loads at the proximal segment adjacent to the spinal fusion. ResultsWeak-to-moderate associations were found between pre-to-postop changes in lumbar lordosis, LL (r = - 0.23, r = - 0.43
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    Obeid-Coronal Malalignment Classification Is Age Related and Independently Associated to Personal Reported Outcome Measurement Scores in the Nonfused Spine
    (KOREAN SPINAL NEUROSURGERY SOC, 2021-01-01) Kieser, David Christopher; Boissiere, Louis; Bourghli, Anouar; Hayashi, Kazunori; Cawley, Derek; Yilgor, Caglar; Alanay, Ahmet; Acaroglu, Emre; Kleinstueck, Frank; Pizones, Javier; Pellise, Ferran; Perez-Grueso, Francisco Javier Sanchez; Obeid, Ibrahim; Grp, European Spine Study
    Objective: To evaluate Obeid-coronal malalignment (O-CM) modifiers according to age, sagittal alignment, and patient-reported outcome measures (PROMs), in the mobile spine. Methods: Retrospective review of a prospective multicenter adult spinal deformity (ASD) database with 1,243 (402 nonoperative, 841 operative) patients with no prior fusion surgery. Patients were included if they were aged over 18 years and were affected by spinal deformity defined by one of: Cobb angle >\_ 20 degrees, pelvic tilt >\_ 25 degrees, sagittal vertical axis >\_ 5 cm, thoracic kyphosis >\_ 60 degrees. Patients were classified according to the O-CM classification and compared to coronally aligned patients. Multivariate analysis was performed on the relationship between PROMs and age, global tilt (GT) and coronal malalignment (CM). Results: Four hundred forty-three patients had CM of more than 2 cm compared to 800 who did not. The distribution of these modifiers was correlated to age. After multivariate analysis, using age and GT as confounding factors, we found that before the age of 50 years, 2A1 patients had worse sex life and greater satisfaction than patients without CM. After 50 years of age, patients with CM (1A1, 1A2) had worse self-image and those with 2A2, 2B had worse self-image, satisfaction, and 36-item Short Form Health Survey physical function. Self-image was the consistent determinant of patients opting for surgery for all ages. Conclusion: CM distribution according to O-CM modifiers is age dependent. A clear correlation between the coronal malalignment and PROMs exists when using the O-CM classification and in the mobile spine, this typically affects self-image and satisfaction. Thus, CM classified according to O-CM modifiers is correlated to PROMs and should be considered in ASD.