Araştırma Çıktıları

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Author: search.filters.author.Yilgor, CaglarSubject: search.filters.subject.Adult spinal deformity

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    Toward the Development of a Comprehensive Clinically Oriented Patient Profile: A Systematic Review of the Purpose, Characteristic, and Methodological Quality of Classification Systems of Adult Spinal Deformity
    (OXFORD UNIV PRESS INC, 2021-01-01) Kwan, Kenny Yat Hong; Naresh-Babu, J.; Jacobs, Wilco; de Kleuver, Marinus; Polly, David W.; Yilgor, Caglar; Wu, Yabin; Park, Jong-Beom; Ito, Manabu; van Hooff, Miranda L.; Deformity, A.O. Spine Knowledge Forum
    BACKGROUND: Existing adult spinal deformity (ASD) classification systems are based on radiological parameters but management of ASD patients requires a holistic approach. A comprehensive clinically oriented patient profile and classification of ASD that can guide decision-making and correlate with patient outcomes is lacking. OBJECTIVE: To perform a systematic review to determine the purpose, characteristic, and methodological quality of classification systems currently used in ASD. METHODS: A systematic literature search was conducted in MEDLINE, EMBASE, CINAHL, and Web of Science for literature published between January 2000 and October 2018. From the included studies, list of classification systems, their methodological measurement properties, and correlation with treatment outcomes were analyzed. RESULTS: Out of 4470 screened references, 163 were included, and 54 different classification systems for ASD were identified. The most commonly used was the Scoliosis Research Society-Schwab classification system. A total of 35 classifications were based on radiological parameters, and no correlation was found between any classification system levels with patient-related outcomes. Limited evidence of limited quality was available on methodological quality of the classification systems. For studies that reported the data, intraobserver and interobserver reliability were good (kappa = 0.8). CONCLUSION:This systematic literature search revealed that current classification systems in clinical use neither include a comprehensive set of dimensions relevant to decision-making nor did they correlate with outcomes. A classification system comprising a core set of patient-related, radiological, and etiological characteristics relevant to the management of ASD is needed.
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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