Spinal Deformity Complexity Checklist for Minimally Invasive Surgery: Expert Consensus from the Minimally Invasive International Spine Study Group.

Adult Humans Consensus Checklist Treatment Outcome Spinal Fusion / methods Minimally Invasive Surgical Procedures / methods Retrospective Studies
Adult spinal deformity Checklist Minimally invasive surgery Spinal surgery Surgical approach

Journal

World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275

Informations de publication

Date de publication:
May 2023
Historique:
received: 06 01 2023
revised: 17 02 2023
accepted: 18 02 2023
medline: 17 5 2023
pubmed: 26 2 2023
entrez: 25 2 2023
Statut: ppublish

Résumé

We developed a spinal deformity complexity checklist (SDCC) to assess the difficulty in performing a circumferential minimally invasive surgery (MIS) for adult spinal deformity. A modified Delphi method of panel experts was used to construct an SDCC checklist of radiographic and patient-related characteristics that could affect the complexity of surgery via MIS approaches. Ten surgeons with expertise in MIS deformity surgery were queried to develop and refine the SDCC with 3 radiographic categories (x-ray, magnetic resonance imaging, computed tomography) and 1 patient-related category. Within each category, characteristics affecting MIS complexity were identified by initial roundtable discussion. Second-round discussion determined which characteristics substantially impacted complexity the most. Thirteen characteristics within the x-ray category were determined. Spinopelvic characteristics, endpoints of instrumentation, and prior hardware/fusion were associated with increased complexity. Vertebral body rotation-as reflected by the Nash-Moe grade-added significant complexity. Psoas anatomy and spinal stenosis added the most complexity for the 5 magnetic resonance imaging characteristics. There were 3 characteristics in the CT category with pre-exisiting fusion, being the variable most highly selected. Of the 5 patient-related characteristics, osteoporosis and BMI were found to most affect complexity. The SDCC is a comprehensive list of pertinent radiographic and patient-related characteristics affecting complexity level for MIS deformity surgery. The value of the SDCC is that it allows rapid assessment of key factors when determining whether MIS surgery can be performed effectively and safely. Patients with scores of 4 in any characteristic should be considered challenging to treat with MIS; open surgery may be a better alternative.

Sections du résumé

BACKGROUND BACKGROUND
We developed a spinal deformity complexity checklist (SDCC) to assess the difficulty in performing a circumferential minimally invasive surgery (MIS) for adult spinal deformity.
METHODS METHODS
A modified Delphi method of panel experts was used to construct an SDCC checklist of radiographic and patient-related characteristics that could affect the complexity of surgery via MIS approaches. Ten surgeons with expertise in MIS deformity surgery were queried to develop and refine the SDCC with 3 radiographic categories (x-ray, magnetic resonance imaging, computed tomography) and 1 patient-related category. Within each category, characteristics affecting MIS complexity were identified by initial roundtable discussion. Second-round discussion determined which characteristics substantially impacted complexity the most.
RESULTS RESULTS
Thirteen characteristics within the x-ray category were determined. Spinopelvic characteristics, endpoints of instrumentation, and prior hardware/fusion were associated with increased complexity. Vertebral body rotation-as reflected by the Nash-Moe grade-added significant complexity. Psoas anatomy and spinal stenosis added the most complexity for the 5 magnetic resonance imaging characteristics. There were 3 characteristics in the CT category with pre-exisiting fusion, being the variable most highly selected. Of the 5 patient-related characteristics, osteoporosis and BMI were found to most affect complexity.
CONCLUSIONS CONCLUSIONS
The SDCC is a comprehensive list of pertinent radiographic and patient-related characteristics affecting complexity level for MIS deformity surgery. The value of the SDCC is that it allows rapid assessment of key factors when determining whether MIS surgery can be performed effectively and safely. Patients with scores of 4 in any characteristic should be considered challenging to treat with MIS; open surgery may be a better alternative.

Identifiants

DOI: 10.1016/j.wneu.2023.02.082 PMID: 36841536
pubmed: 36841536
pii: S1878-8750(23)00235-8
doi: 10.1016/j.wneu.2023.02.082
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e472-e477

Informations de copyright

Copyright © 2023 Elsevier Inc. All rights reserved.

Auteurs

Neel Anand (N)

Department of Orthopaedics, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Praveen V Mummaneni (PV)

Department of Neurosurgery, University of California-San Francisco, San Francisco, California, USA.

Juan S Uribe (JS)

Barrow Neurologic Institute, Phoenix, Arizona, USA.

Jay Turner (J)

Barrow Neurologic Institute, Phoenix, Arizona, USA.

Khoi D Than (KD)

Departments of Orthopaedic Surgery and Neurosurgery, Duke University, Durham, North Carolina, USA.

Dean Chou (D)

Department of Neurosurgery, University of California-San Francisco, San Francisco, California, USA.

Pierce D Nunley (PD)

Spine Institute of Louisiana, Shreveport, Louisiana, USA.

Michael Y Wang (MY)

Department of Neurosurgery, University of Miami, Miami, Florida, USA.

Richard G Fessler (RG)

Department of Neurological Surgery, Rush University Medical Center, Chicago, Illinois, USA.

Vivian Le (V)

Department of Neurosurgery, University of California-San Francisco, San Francisco, California, USA.

Jerry Robinson (J)

Department of Orthopaedics, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Corey Walker (C)

Department of Orthopaedics, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Sheila Kahwaty (S)

Department of Orthopaedics, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Babak Khanderhoo (B)

Department of Orthopaedics, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Robert K Eastlack (RK)

Department of Orthopaedic Surgery, Scripps Clinic, La Jolla, California, USA.

David O Okonkwo (DO)

Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Adam S Kanter (AS)

Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Kai-Ming G Fu (KG)

Department of Neurosurgery, Cornell Medical Center, New York, New York, USA.

Gregory M Mundis (GM)

Department of Orthopaedic Surgery, Scripps Clinic, La Jolla, California, USA.

Peter Passias (P)

Division of Spinal Surgery, Department of Orthopaedic and Neurological Surgery, NYU School of Medicine, New York Spine Institute, New York, New York, USA.

Paul Park (P)

Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee, USA; Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis, Tennessee, USA. Electronic address: ppark@semmes-murphey.com.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Spinal Deformity Complexity Checklist for...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Spinal Deformity Complexity Checklist for...
questionsmedicales.fr › Phénomènes psychologiques › Processus mentaux › Pensée (activité mentale) › Prise de décision › Consensus › Spinal Deformity Complexity Checklist for...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Liste de contrôle › Spinal Deformity Complexity Checklist for...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Spinal Deformity Complexity Checklist for...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures orthopédiques › Arthrodèse › Arthrodèse vertébrale › Spinal Deformity Complexity Checklist for...
questionsmedicales.fr › Procédures de chirurgie opératoire › Interventions chirurgicales mini-invasives › Spinal Deformity Complexity Checklist for...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Spinal Deformity Complexity Checklist for...