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Kalavacherla S, Stone LE, McCann CP, Saripella M, Pham MH. A systematic review of pseudarthrosis and reoperation rates in minimally invasive adult spinal deformity correction. World Neurosurg X 2024; 22:100282. [PMID: 38444873 PMCID: PMC10914570 DOI: 10.1016/j.wnsx.2024.100282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 02/20/2024] [Indexed: 03/07/2024] Open
Abstract
Background/objective The recent development of minimally invasive surgical techniques (MIS) has made possible the correction of adult spinal deformity (ASD) with less blood loss and shorter hospital stays. However, minimally invasive placement of pedicle screws at the proximal level of the construct can increase pseudarthrosis risk, leading to implant failure, kyphosis, and reoperations. We aggregate existing literature to describe pseudarthrosis rates at the proximal thoracic or thoracolumbar junction in MIS and subsequent reoperation rates. Methods After a three-tied search strategy in PubMed, we identified 9 articles for study inclusion, describing outcomes from MIS correction of ASD, pseudarthrosis as complication, and surgery on 4+ levels. Baseline patient characteristics and combined rates of pseudarthrosis and reoperation were calculated. Results A total of 482 patients were studied with an average [range] age of 65.5 [60.4,72], 6.3 [4.4,11] levels fused per patient, follow-up time of 28.3 [12,39] months, and 64.8% females. Pseudarthrosis was reported in 28 of 482 pooled patients (5.8%) of which 15 of 374 pooled patients (4.0%) ultimately underwent a reoperation for pseudarthrosis. Post-operative characteristics included an estimated blood loss (EBL) of 527.1 [241,1466] mL, operating time of 297.9 [183,475] minutes, and length of stay of 7.7 [5,10] days. Among the papers comparing MIS to open surgery, all reported a significantly lower EBL in patients treated with MIS. Conclusion This analysis demonstrate a measurable pseudarthrosis risk when using MIS to treat ASD, overwhelming requiring reoperation. The benefits of MIS must be considered against the drawbacks of pseudarthrosis when determining ASD management.
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Affiliation(s)
| | - Lauren E. Stone
- Department of Neurological Surgery, University of California San Diego, La Jolla, CA, USA
| | - Carson P. McCann
- School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Megana Saripella
- School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Martin H. Pham
- Department of Neurological Surgery, University of California San Diego, La Jolla, CA, USA
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Cheung ATM, Kurland DB, Neifert S, Mandelberg N, Nasir-Moin M, Laufer I, Pacione D, Lau D, Frempong-Boadu AK, Kondziolka D, Golfinos JG, Oermann EK. Developing an Automated Registry (Autoregistry) of Spine Surgery Using Natural Language Processing and Health System Scale Databases. Neurosurgery 2023; 93:1228-1234. [PMID: 37345933 DOI: 10.1227/neu.0000000000002568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 04/25/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Clinical registries are critical for modern surgery and underpin outcomes research, device monitoring, and trial development. However, existing approaches to registry construction are labor-intensive, costly, and prone to manual error. Natural language processing techniques combined with electronic health record (EHR) data sets can theoretically automate the construction and maintenance of registries. Our aim was to automate the generation of a spine surgery registry at an academic medical center using regular expression (regex) classifiers developed by neurosurgeons to combine domain expertise with interpretable algorithms. METHODS We used a Hadoop data lake consisting of all the information generated by an academic medical center. Using this database and structured query language queries, we retrieved every operative note written in the department of neurosurgery since our transition to EHR. Notes were parsed using regex classifiers and compared with a random subset of 100 manually reviewed notes. RESULTS A total of 31 502 operative cases were downloaded and processed using regex classifiers. The codebase required 5 days of development, 3 weeks of validation, and less than 1 hour for the software to generate the autoregistry. Regex classifiers had an average accuracy of 98.86% at identifying both spinal procedures and the relevant vertebral levels, and it correctly identified the entire list of defined surgical procedures in 89% of patients. We were able to identify patients who required additional operations within 30 days to monitor outcomes and quality metrics. CONCLUSION This study demonstrates the feasibility of automatically generating a spine registry using the EHR and an interpretable, customizable natural language processing algorithm which may reduce pitfalls associated with manual registry development and facilitate rapid clinical research.
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Affiliation(s)
| | - David B Kurland
- Department of Neurosurgery, NYU Langone Health, New York , New York , USA
| | - Sean Neifert
- Department of Neurosurgery, NYU Langone Health, New York , New York , USA
| | | | - Mustafa Nasir-Moin
- Department of Neurosurgery, NYU Langone Health, New York , New York , USA
| | - Ilya Laufer
- Department of Neurosurgery, NYU Langone Health, New York , New York , USA
| | - Donato Pacione
- Department of Neurosurgery, NYU Langone Health, New York , New York , USA
| | - Darryl Lau
- Department of Neurosurgery, NYU Langone Health, New York , New York , USA
| | | | - Douglas Kondziolka
- Department of Neurosurgery, NYU Langone Health, New York , New York , USA
| | - John G Golfinos
- Department of Neurosurgery, NYU Langone Health, New York , New York , USA
| | - Eric Karl Oermann
- Department of Neurosurgery, NYU Langone Health, New York , New York , USA
- Department of Radiology, NYU Langone Health, New York , New York , USA
- Center for Data Science, New York University, New York , New York , USA
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Lovecchio F, Shahi P, Patel A, Qureshi S. Single-position Minimally Invasive Surgery for Correction of Adult Spinal Deformity. J Am Acad Orthop Surg 2023; 31:e590-e600. [PMID: 37162446 DOI: 10.5435/jaaos-d-22-01037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 03/27/2023] [Indexed: 05/11/2023] Open
Abstract
Minimally invasive adult spinal deformity (MIS ASD) surgery may offer benefits over conventional techniques in select circumstances. The success of the procedure is based on proper patient selection, restoring adequate alignment, and optimizing fusion. In the past, MIS techniques were limited because of the need to reposition the patient-a source of increased surgical time and potentially patient risk. New developments now allow for single-position, MIS correction of adult deformity. Additional research will be needed to determine the ideal patient for minimally invasive adult spinal deformity surgery and whether prone or lateral single-position confers the best outcomes.
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Affiliation(s)
- Francis Lovecchio
- From the Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY (Lovecchio, Shahi, and Qureshi) and the Department of Orthopaedic Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL (Patel)
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Tanaka M, Mehta R, Yamauchi T, Arataki S, Fujiwara Y, Shinohara K, Yamane K. Triangular fixation to prevent proximal screw pullout for adult spinal deformity Surgery: A technical note. INTERDISCIPLINARY NEUROSURGERY 2022. [DOI: 10.1016/j.inat.2022.101514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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5
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Pullen MW, Valero-Moreno F, Rajendran S, Shah VU, Bruneau BR, Martinez JL, Ramos-Fresnedo A, Quinones-Hinojosa A, Fox WC. Creation of a Proof-of-Concept 3D-Printed Spinal Lateral Access Simulator. Cureus 2022; 14:e25448. [PMID: 35663684 PMCID: PMC9150718 DOI: 10.7759/cureus.25448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2022] [Indexed: 12/27/2022] Open
Abstract
Background Minimally invasive lateral lumbar interbody fusion (LLIF) offers advantages over traditional approaches, providing indirect decompression of neural elements and deformity correction while avoiding many challenges and risks of anterior and posterior approaches. Mastering this technique requires a specialized team, advanced equipment, and sufficient case exposure. Current training is limited to the classic educational model, and alternative training methods such as cadaver labs can be inconvenient, inaccessible, expensive, and incompatible with intraoperative neuromonitoring (IONM) systems. Objective The aim of this study was to create a proof-of-concept, low-cost, fully synthetic lateral lumbar surgical simulator and to increase awareness of the lack of current training alternatives. Methods Standard engineering design and expert interviews of attending neurosurgeons, nurses, engineers, and medical device representatives (n=20) were utilized to determine key elements for the simulator, physical characteristics of the components, and translational strategy. Physical and radiographic testing was performed on multiple thermoplastics to determine appropriateness for inclusion in the simulator. For evaluation of the concept, a descriptive slide deck and questionnaire were sent to 15 U.S. and 15 international surgeons who perform LLIF. Results The lateral access training model (LATM) features the following three components: torso casing, spine module, and IONM feature. This model utilizes operable ABS (acrylonitrile butadiene styrene) 3D-printed lumbar vertebrae, verified for anatomical accuracy and compatibility with fluoroscopy. Additionally, a novel neuromonitoring simulation algorithm was developed to train junior residents on neurological complications. To further highlight the need for lateral training models, 30/30 polled surgeons felt that this simulator has value for the field, 29/30 noted that they would have used the LATM if they had access during training, and 30/30 responded that they would encourage trainees to practice on the LATM. Conclusion The LATM is a first step to provide reliable and inexpensive basic lateral lumbar spine training. While this model is lacking some anatomical features, our simulator offers novel training elements for lateral lumbar transpsoas approaches, which lay the foundation for future models to be built. The need for this training exists, and current gaps in the approach to learning these complex techniques need to be filled due to the inconvenience, cost, and impracticability of standard cadaveric models.
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Doodkorte RJP, Roth AK, Jacobs E, Arts JJC, Willems PC. Biomechanical Evaluation of Semi-rigid Junctional Fixation Using a Novel Cable Anchor System to Prevent Proximal Junctional Failure in Adult Spinal Deformity Surgery. Spine (Phila Pa 1976) 2022; 47:E415-E422. [PMID: 34559764 DOI: 10.1097/brs.0000000000004228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A porcine cadaveric biomechanical study. OBJECTIVE To biomechanically evaluate a novel Cable Anchor System as semi-rigid junctional fixation technique for the prevention of proximal junctional failure after adult spinal deformity surgery and to make a comparison to alternative promising prophylactic techniques. SUMMARY OF BACKGROUND DATA The abrupt change of stiffness at the proximal end of a pedicle screw construct is a major risk factor for the development of proximal junctional failure after adult spinal deformity surgery. A number of techniques that aim to provide a gradual transition zone in range of motion (ROM) at the proximal junction have previously been studied. In this study, the design of a novel Cable Anchor System, which comprises a polyethylene cable for rod fixation, is assessed. METHODS Ten T6-T13 porcine spine segments were subjected to cyclic 4 Nm pure-moment loading. The following conditions were tested: uninstrumented, 3 level pedicle screw fixation (PSF), and PSF with supplementary Cable Anchors applied proximally at 1-level (Anchor1) or 2-levels (Anchor2), transverse process hooks (TPH), and 2-level sublaminar tapes (Tape2). The normalized segmental range of motion in the junctional zone was compared using one-way analysis of variance and linear regression. RESULTS Statistical comparison at the level proximal to PSF showed significantly lower ROMs for all techniques compared to PSF fixation alone in all movement directions. Linear regression demonstrated a higher linearity for Anchor1 (0.820) and Anchor2 (0.923) in the junctional zone in comparison to PSF (1-level: 0.529 and 2-level: 0.421). This linearity was similar to the compared techniques (TPH and Tape2). CONCLUSION The Cable Anchor System presented in this study demonstrated a gradual ROM transition zone at the proximal end of a rigid pedicle screw construct similar to TPH and 2-level sublaminar tape semi-rigid junctional fixation constructs, while providing the benefit of preserving the posterior ligament complex.Level of Evidence: 5.
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Affiliation(s)
- Remco J P Doodkorte
- Department of Orthopaedic Surgery, Research School CAPHRI, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands
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Ishihara M, Taniguchi S, Kawashima K, Adachi T, Paku M, Tani Y, Ando M, Saito T. Bone Fusion Morphology after Circumferential Minimally Invasive Spine Surgery Using Lateral Lumbar Interbody Fusion and Percutaneous Pedicle Screws without Bone Grafting in the Thoracic Spine: A Retrospective Study. Medicina (B Aires) 2022; 58:medicina58040496. [PMID: 35454335 PMCID: PMC9031519 DOI: 10.3390/medicina58040496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 11/25/2022] Open
Abstract
Background and Objectives: This study aimed to investigate the process and morphology of thoracic and lumbosacral bone fusion in patients with adult spinal deformity (ASD) who underwent circumferential minimally invasive spine surgery (CMIS) by lateral lumbar interbody fusion (LLIF) and percutaneous pedicle screws (PPSs) without bone grafting in the thoracic spine and who have risk factors for bone fusion failure in the thoracic spine. Materials and Methods: This retrospective study included 61 patients with spinal deformities (46 women and 15 men) who underwent CMIS with LLIF and PPSs at our hospital after 2016 and completed a 3-year postoperative follow-up. The rate and morphology of bone fusion and rod fracture rate in the thoracic and lumbosacral vertebrae were evaluated. Patients were divided into the thoracic spine spontaneous bone fusion group and the bone fusion failure group. The data of various spinopelvic parameters and the incidence of complications were compared. The vertebral body conditions in the thoracic spine were classified as less degenerative (type N), osteophyte (type O), and diffuse idiopathic skeletal hyperostosis (DISH) (type D). Results: After three postoperative years, the bone fusion rates were 54%, 95%, and 89% for the thoracic, lumbar, and lumbosacral spine, respectively. Screw loosening in the thoracic vertebrae was significantly higher in the bone fusion failure group, while no significant differences were observed in the spinopelvic parameters, Oswestry Disability Index (ODI), and rate of proximal junctional kyphosis and rod fractures. Type N vertebral body condition and screw loosening were identified as risk factors for spontaneous bone fusion failure in the thoracic spine. Conclusion: This study indicated that spontaneous bone fusion is likely to be obtained without screw loosening, and even if bone fusion is not obtained, there is no effect on clinical results with the mid-term (3-year) results of CMIS without bone grafting in the thoracic spine.
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Conditions for Achieving Postoperative Pelvic Incidence-Lumbar Lordosis < 10° in Circumferential Minimally Invasive Surgery for Adult Spinal Deformity. J Clin Med 2022; 11:jcm11061586. [PMID: 35329912 PMCID: PMC8951564 DOI: 10.3390/jcm11061586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/27/2022] [Accepted: 03/11/2022] [Indexed: 12/10/2022] Open
Abstract
This retrospective study aimed to evaluate the clinical outcomes of circumferential minimally invasive surgery (CMIS) using lateral lumbar interbody fusion (LLIF) and percutaneous pedicle screw (PPS) in adult spinal deformity (ASD) patients, and to clarify the conditions for achieving postoperative pelvic incidence-lumbar lordosis (PI-LL) < 10°. Demographics and other parameters of ASD patients who underwent CMIS and who were divided into groups G (achieved postoperative PI-LL < 10°) and P (PI-LL ≥ 10°) were compared. Of the 145 included ASD patients who underwent CMIS, the average fused level, bleeding volume, operative time, and number of intervertebral discs that underwent LLIF were 10.3 ± 0.5 segments, 723 ± 375 mL, 366 ± 70 min, and 4.0 segments, respectively. The rod material was titanium alloy in all the cases. The PI-LL significantly improved from 37.3 ± 17.9° to 1.2 ± 12.2° postoperatively. Pre- and postoperative PI, postoperative LL, preoperative PI-LL, PI-LL after LLIF, and postoperative PI-LL were significantly larger in group P. PI-LL after LLIF was identified as a significant risk factor of postoperative PI-LL < 10° by logistic regression, and the cut-off value on receiver operating characteristic curve analysis was 20°. Sufficient correction was achieved by CMIS. If PI-LL after LLIF was ≤20°, it was corrected to the ideal alignment by the PPS procedure.
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Cronin PK, Poelstra K, Protopsaltis TS. Role of Robotics in Adult Spinal Deformity. Int J Spine Surg 2021; 15:S56-S64. [PMID: 34675030 DOI: 10.14444/8140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Robotic-assisted adult deformity surgery has played a rapidly expanding role since its introduction. As robotic spine technologies improve, the potential to limit complications and morbidity is vast. The improvements in instrumentation accuracy combined with the ability to maintain that accuracy in multiple positions allow creative surgical approaches and techniques that can limit operative time, blood loss, and improve outcomes. In the years to come, robotic-assisted spine surgery and navigation will likely play an expanding role that continues to be defined. LEVEL OF EVIDENCE: 5, expert opinion.
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Affiliation(s)
- Patrick K Cronin
- Division of Spine Surgery, Department of Orthopaedic Surgery, NYU Langone Medical Center, New York, New York
| | | | - Themistocles S Protopsaltis
- Division of Spine Surgery, Department of Orthopaedic Surgery, NYU Langone Medical Center, New York, New York
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Camino Willhuber G, Bendersky M, De Cicco FL, Kido G, Duarte MP, Estefan M, Petracchi M, Gruenberg M, Sola C. Development of a New Therapy-Oriented Classification of Intervertebral Vacuum Phenomenon With Evaluation of Intra- and Interobserver Reliabilities. Global Spine J 2021; 11:480-487. [PMID: 32875883 PMCID: PMC8119922 DOI: 10.1177/2192568220913006] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
STUDY DESIGN Diagnostic study, level of evidence III. OBJECTIVES Low back pain is a common cause of disability among elderly patients. Percutaneous discoplasty has been developed as a tool to treat degenerative disease when conservative management is not successful. Indications for this procedure include low back pain and the presence of vacuum phenomenon. The objective of this study was to describe a new classification of vacuum phenomenon based on computed tomography scan in order to improve the indications for percutaneous discoplasty. METHODS We developed a classification of vacuum phenomenon based on computed tomography scan images. We describe 3 types of vacuum based on the relationship between vacuum and the superior/inferior endplates and 2 subtypes based on the presence of significant subchondral sclerosis. A validation study was conducted selecting 10 orthopedic residents with spine surgery training to analyze 25 vacuum scenarios. Inter- and intraobserver reliabilities were assessed through the Fleiss's and Cohen's kappa statistics, respectively. RESULTS The overall Fleiss's κ value for interobserver reliability was 0.85 (95% CI 0.82-0.86) in the first reading and 0.93 (95% CI 0.92-0.95) in the second reading. Cohen's κ for intraobserver reliability was 0.88 (95% CI 0.77-0.99). CONCLUSION The new classification has shown almost perfect inter- and intraobserver reliabilities for grading the vacuum phenomenon and could be an important tool to improve the indications for percutaneous cement discoplasty.
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Affiliation(s)
- Gaston Camino Willhuber
- Institute of Orthopedics “Carlos E. Ottolenghi” Hospital Italiano de Buenos
Aires, Buenos Aires, Argentina
| | - Mariana Bendersky
- Institute of Orthopedics “Carlos E. Ottolenghi” Hospital Italiano de Buenos
Aires, Buenos Aires, Argentina
- III Normal Anatomy Department, School of Medicine, University of
Buenos Aires, Argentina
| | - Franco L. De Cicco
- Institute of Orthopedics “Carlos E. Ottolenghi” Hospital Italiano de Buenos
Aires, Buenos Aires, Argentina
| | - Gonzalo Kido
- Institute of Orthopedics “Carlos E. Ottolenghi” Hospital Italiano de Buenos
Aires, Buenos Aires, Argentina
| | - Matias Pereira Duarte
- Institute of Orthopedics “Carlos E. Ottolenghi” Hospital Italiano de Buenos
Aires, Buenos Aires, Argentina
| | - Martin Estefan
- Institute of Orthopedics “Carlos E. Ottolenghi” Hospital Italiano de Buenos
Aires, Buenos Aires, Argentina
| | - Matias Petracchi
- Institute of Orthopedics “Carlos E. Ottolenghi” Hospital Italiano de Buenos
Aires, Buenos Aires, Argentina
| | - Marcelo Gruenberg
- Institute of Orthopedics “Carlos E. Ottolenghi” Hospital Italiano de Buenos
Aires, Buenos Aires, Argentina
| | - Carlos Sola
- Institute of Orthopedics “Carlos E. Ottolenghi” Hospital Italiano de Buenos
Aires, Buenos Aires, Argentina
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Hussain I, Fu KM, Uribe JS, Chou D, Mummaneni PV. State of the art advances in minimally invasive surgery for adult spinal deformity. Spine Deform 2020; 8:1143-1158. [PMID: 32761477 DOI: 10.1007/s43390-020-00180-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 07/27/2020] [Indexed: 12/21/2022]
Abstract
Adult spinal deformity (ASD) can be associated with substantial suffering due to pain and disability. Surgical intervention for achieving neural decompression and restoring physiological spinal alignment has shown to result in significant improvement in pain and disability through patient-reported outcomes. Traditional open approaches involving posterior osteotomy techniques and instrumentation are effective based on clinical outcomes but associated with high complication rates, even in the hands of the most experienced surgeons. Minimally invasive techniques may offer benefit while decreasing associated morbidity. Minimally invasive surgery (MIS) for ASD has evolved over the past 20 years, driven by improved understanding of open procedures along with novel technique development and technologic advancements. Early efforts were hindered due to suboptimal outcomes resulting from high pseudarthrosis, inadequate correction, and fixation failure rates. To address this, multi-center collaborative groups have been established to study large numbers of ASD patients which have been vital to understanding optimal patient selection and individualized management strategies. Different MIS decision-making algorithms have been described to better define appropriate candidates and interbody selection approaches in ASD. The purpose of this state of the review is to describe the evolution of MIS surgery for adult deformity with emphasis on landmark papers, and to discuss specific MIS technology for ASD, including percutaneous pedicle screw instrumentation, hyperlordotic grafts, three-dimensional navigation, and robotics.
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Affiliation(s)
- Ibrahim Hussain
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Kai-Ming Fu
- Department of Neurological Surgery, Weill Cornell Medical College, New York-Presbyterian Hospital, 525 East 68th Street, Box 99, New York, NY, USA.
| | - Juan S Uribe
- Department of Neurological Surgery, Barrow Neurologic Institute, Phoenix, AZ, USA
| | - Dean Chou
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
| | - Praveen V Mummaneni
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
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Gizatullin SK, Bitner SA, Khristosturov AS, Volkov IV, Kurnosenko VY, Dubinin IP. Minimally invasive endoscopic foraminal decompression for adult degenerative scoliosis: clinical case study and literature review. HIRURGIÂ POZVONOČNIKA (SPINE SURGERY) 2019. [DOI: 10.14531/ss2019.4.54-62] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
| | | | | | - I. V. Volkov
- Russian Scientific Research Institute of Traumatology and Orthopedics n.a. R.R. Vreden
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