Outcomes of Fusions From the Cervical Spine to the Pelvis.

Retrospective cohort study. Determine the indications, complications, and clinical outcomes in patients requiring fusions from the cervical spine to the pelvis. Several investigators have examined fusions from the thoracic spine to the sacrum, but no similar study has been performed for cervical-to-pelvis fusions. Patients from 2003 to 2014 with an upper instrumented vertebrae (UIV) in the cervical spine (any level) and a lower instrumented vertebrae (LIV) in the sacrum or pelvis were included in the study. Those with infectious or acute trauma-related deformities were excluded. Patient demographics, medical history, diagnosis, operative procedure, and health-related quality of life measures were analyzed. Student's Fifty-five patients met inclusion criteria for the study. Average follow-up was 2.8 years. Proximal junctional kyphosis was the most common indication for cervical-to-pelvis fusions (36%). The most common UIV was C2 (29%) followed by C7 (24%). There was an average 31° correction in maximum kyphosis and a 3.3 Proximal junctional kyphosis is the most common indication for patients requiring fusion to the cervical spine. Adult patients incur a significant risk of major complications and reoperations. However, significant improvement in SRS-22r outcomes are noted in these patients.

Déclaration de conflit d'intérêts

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr Iyer has received grants from the CSRS outside the submitted work. Dr Kim reports personal fees from Medtronic, personal fees from Biomet, personal fees from K2M, personal fees from Stryker, personal fees from DePuy, grants from CSRS, outside the submitted work. Dr Theologis has nothing to disclose. Dr Nemani has nothing to disclose. Dr Albert reports personal fees and other fees from DePuy, personal fees and other fees from Biomet, other fees from Vertech, other fees from In Vivo Therapeutics, other fees from Paradigm Spine, other fees from Biomerix, other fees from Breakaway Imaging, other fees from Crosstree, other fees from Invuity, other fees from Pioneer, other fees from Gentis, other fees from ASIP, other fees from PMIG, personal fees from Facetlink, other fees from United Healthcare, other fees from CSRS, other fees from SRS, other fees from IMAST, other fees from AOA, outside the submitted work. Dr Lenke reports the following conflicts outside the submitted work: Quality Medical Publishing—Royalties; Setting Scoliosis Straight Foundation—Grant support; AO Spine—Grant support; SRS BOD; OREF BOD; Fox Family Foundation—Grant support; EOS Technology—Grant support; Broadwater—Honorarium; K2M Spine—consultant; Depuy-Synthes Spine—consultant; Medtronic—Royalties and consulting payments. Dr Burch reports personal fees from Medtronic, grants from Lilly Inc, grants from Integra Lifescience Corp, outside the submitted work. Dr Deviren reports grants and personal fees from NuVasive, grants from AOSpine, grants from Globus, outside the submitted work. Dr Protopsaltis reports personal fees from Medicrea, personal fees from Globus, personal fees from Innovasis, grants from Zimmer Spine, outside the submitted work. Dr Smith reports personal fees from Zimmer Biomet, personal fees from Nuvasive, personal fees from K2M, personal fees from Cerapedics, grants from DePuy Synthes, grants from AOSpine, grants from NREF, outside the submitted work. Mr Scheer has nothing to disclose. Dr Mizutani has nothing to disclose. Dr Klineberg reports personal fees from Depuy-Synthes, personal fees from Stryker, personal fees from K2M, grants and personal fees from AOSpine, outside the submitted work. Dr Ames reports personal fees from DePuy, personal fees from Medtronic, personal fees from Stryker, personal fees from Biomet Spine, personal fees from Stryker, outside the submitted work. In addition, Dr Ames has a patent, Fish & Richardson, P.C. issued.