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

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    Development and Validation of a Multidomain Surgical Complication Classification System for Adult Spinal Deformity
    (LIPPINCOTT WILLIAMS \& WILKINS, 2021-01-01) Klineberg, Eric O.; Wick, Joseph B.; Lafage, Renaud; Lafage, Virginie; Pellise, Ferran; Haddad, Sleiman; Yilgor, Caglar; Nunez-Pereira, Susana; Gupta, Munish; Smith, Justin S.; Shaffrey, Christopher; Schwab, Frank; Ames, Christopher; Bess, Shay; Lewis, Stephen; Lenke, Lawrence G.; Berven, Sigurd; Grp, Int Spine Study
    Study Design. Prospective analysis of example cases Objective. The aim of this study was to analyze the accuracy and repeatability of a new comprehensive classification system for capturing complications data in adult spinal deformity. Summary of Background Data. Complications are common in adult spinal deformity surgery. However, no consensus exists on the definition or classification of complications in adult spinal deformity surgery. The lack of consensus significantly limits understanding of complications' effects on outcomes in surgery for adult spinal deformity. Methods. Using a Delphi method, members of the International Spine Study Group, AO Spine, and the European Spine Study Group collaborated to develop an adult spinal deformity classification system. The multidomain classification system accounts for medical complications (cancer, cardiopulmonary, central nervous system, gastrointestinal, infectious, musculoskeletal, renal) and surgical complications (implant complications, radiographic complications, neurologic events, intraoperative events, and wound complications). Seventeen individuals ({''}event readers{''}), including spine surgeons, trainees, and research coordinators, used the new classification system two separate times to analyze complications in ten example cases. The accuracy and repeatability of the classification system were subsequently calculated based on the providers' responses for the example cases. Results. The 10 example cases included 22 complications. Nearly 95\% of complications were captured by >95\% of the event readers. The system demonstrated good repeatability of 86.9\% between the first and second set of responses provided by event readers. Conclusion. The ISSG-AO Multi-Domain Spinal Deformity Complication Classification System for Adult Spinal Deformity demonstrated good accuracy and repeatability among both surgeons and research coordinators in capturing complications in adult spinal deformity surgery. The ISSG-AO system may be applied to help better understand the impact of complications on outcomes and costs in adult spinal deformity surgery.
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    AO Spine Adult Spinal Deformity Patient Profile: A Paradigm Shift in Comprehensive Patient Evaluation in Order to Optimize Treatment and Improve Patient Care
    (SAGE PUBLICATIONS LTD, 2022-01-01) Naresh-Babu, J.; Kwan, Kenny Yat Hong; Wu, Yabin; Yilgor, Caglar; Alanay, Ahmet; Cheung, Kenneth M. C.; Polly Jr., David W.; Park, Jong-Beom; Ito, Manabu; Lenke, Lawrence G.; van Hooff, Miranda L.; de Kleuver, Marinus; Deformity, A.O. Spine Knowledge Forum
    Study Design: Modified Delphi study. Objective: Adult spinal deformity (ASD) is an increasingly recognized condition, comprising a spectrum of pathologies considerably impacting patients' health and functional status. Patients present with a combination of pain, disability, comorbidities and radiological deformity. The study aims to propose a systematic approach of gathering information on the factors that drive decision-making by developing a patient profile. Methods: The present study comprises of 3 parts. Part 1: Development of prototype of patient profile: The data from the Core Outcome Study on SCOlisis (COSSCO) by Scoliosis Research Society (SRS) was categorized into a conceptual framework. Part 2: Modified Delphi study: Items reaching >70\% agreement were included in a 4 round iterative process with 51 panellists across the globe. Part 3: Pilot testing-feasibility: Content validity and usability were evaluated quantitatively. Results: The profile consisted of 4 domains. 1. General health with demographics and comorbidities, 2.Spine-specific health with spine related health and neurological status, 3. Imaging with radiographic and MRI parameters and 4. Deformity type. Each domain consisted of 1 or 2 components with various factors and their measuring instruments. Profile was found to have an excellent content validity (1-CVIr 0.78-1.00
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    Relative lumbar lordosis and lordosis distribution index: individualized pelvic incidence-based proportional parameters that quantify lumbar lordosis more precisely than the concept of pelvic incidence minus lumbar lordosis
    (AMER ASSOC NEUROLOGICAL SURGEONS, 2017-01-01) Yilgor, Caglar; Sogunmez, Nuray; Yavuz, Yasemin; Abul, Kadir; Boissiere, Louis; Haddad, Sleiman; Obeid, Ibrahim; Kleinstuck, Frank; Sanchez Perez-Grueso, Francisco Javier; Acaroglu, Emre; Mannion, Anne F.; Pellise, Ferran; Alanay, Ahmet; Grp, European Spine Study
    OBJECTIVE The subtraction of lumbar lordosis (LL) from the pelvic incidence (PI) offers an estimate of the LL required for a given PI value. Relative LL (RLL) and the lordosis distribution index (LDI) are PI-based individualized measures. RLL quantifies the magnitude of lordosis relative to the ideal lordosis as defined by the magnitude of PI. LDI defines the magnitude of lower arc lordosis in proportion to total lordosis. The aim of this study was to compare RLL and PI - LL for their ability to predict postoperative complications and their correlations with health-related quality of life (HRQOL) scores. METHODS Inclusion criteria were >= 4 levels of fusion and >= 2 years of follow-up. Mechanical complications were proximal junctional kyphosis/proximal junctional failure, distal junctional kyphosis/distal junctional failure, rod breakage, and implant-related complications. Correlations between PI - LL, RLL, PI, and HRQOL were analyzed using the Pearson correlation coefficient. Mechanical complication rates in PI - LL, RLL, LDI, RLL, and LDI interpreted together, and RLL subgroups for each PI - LL category were compared using chi-square tests and the exact test. Predictive models for mechanical complications with RLL and PI - LL were analyzed using binomial logistic regressions. RESULTS Two hundred twenty-two patients (168 women, 54 men) were included. The mean age was 52.2 +/- 19.3 years (range 18-84 years). The mean follow-up was 28.8 +/- 8.2 months (range 24-62 months). There was a significant correlation between PI - LL and PI (r = 0.441, p < 0.001), threatening the use of PI -LL to quantify spinopelvic mismatch for different PI values. RLL was not correlated with PI (r = -0.093, p > 0.05)