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To establish the relationship in the five critical X-ray time points during multilevel posterior column osteotomies (MPCO) spinal deformity realignment in patients with adult spinal deformity and to follow the participants longitudinally to examine any follow-up X-rays and clinical data to compare to the post-operative standing scan and pre-operative data.
Studies in adult spinal deformity (ASD) have found that the presence of sagittal imbalance directly correlates with worsening quality of life. Multilevel posterior column osteotomies (MPCOs) is a technique that can provide correction to adult spinal deformity. MPCOs can be utilized for revision surgery as an alternative to 3-column osteotomies and have the ability to aggregate large amount of lordosis segmentally. The success of the MPCO technique largely depends on radiographs taken during these surgeries to aid the surgeon in establishing the best screw and rod placement and making intraoperative adjustments. Imaging plays a vital role in evaluating hardware positioning and assessing hardware integrity as well as evaluating potential complication. The investigator plans to evaluate and establish the relationship in the five critical X-ray time points (preoperative standing and supine, intraoperative pre- and post-correction, and postoperative standing films) during MPCO spinal deformity realignment and measure pre- to post-operative outcome longitudinally. The investigator will investigate lumbar lordosis and sagittal and coronal alignment at those 5 time points and examine the relationship between pre-op, intra-op, and post-op images to understand impact of the MPCO technique and examine expected outcome to final outcome. Additionally, if the O-Arm 2D long film scanner is utilized during the surgery, the investigator will analyze that film and compare it to the other X-rays taken.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Spine Surgery Participants | Spine surgical candidates that will be receiving posterior only surgery for spinal deformity |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Imaging-Observational | Other | Preoperative standing and supine, intraoperative pre- and post-correction, and postoperative standing imaging as well as imaging collected during follow-up exams for a year following surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Evaluate the Change from Baseline Sagittal Cobb angles to Post-Surgical Sagittal Cobb angles | Data analysis will involve analysis of the change of segmentally measured Sagittal Cobbs angles in the presurgical baseline, intra-operative and post-surgical X-rays | Baseline through end of Hospital Stay, an average of 6 weeks |
| Evaluate the Change from Baseline Total Lumbar Lordosis to Post-Surgical Total Lumbar Lordosis | Data analysis will involve analysis of the change of measured total lumbar lordosis in the presurgical baseline, intra-operative and post-surgical X-rays | Baseline through end of Hospital Stay, an average of 6 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Evaluation of the change of Sagittal Cobb angles in post-operative X-rays taken at follow-up appointments for the first year post surgery | Data analysis will involve analysis of the post-surgical X-rays utilizing the Sagittal Cobb angles measured segmentally | Through study completion, an average of 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| PROMIS-29 (Patient-Reported Outcomes Measurement Information System-29 question) questionnaire | The PROMIS-29 will be given to assess change over time in global physical, mental and social health. | Through study completion, an average of 1 year |
| Oswestry Disability Index |
Inclusion Criteria:
Exclusion Criteria:
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The cohort will be select from the UCSD Neurological Surgery Spine clinic who are candidates for Posterior Spinal Surgery involving more then 3 levels of posterior column osteotomies
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Pete Chase, MS | Contact | (858) 657-7651 | pchase@health.ucsd.edu |
| Name | Affiliation | Role |
|---|---|---|
| Joseph Osorio, MD, PhD | University of California, San Diego | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of California, San Diego | Recruiting | San Diego | California | 92037 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31214712 | Background | Chan AK, Lau D, Osorio JA, Yue JK, Berven SH, Burch S, Hu SS, Mummaneni PV, Deviren V, Ames CP. Asymmetric Pedicle Subtraction Osteotomy for Adult Spinal Deformity with Coronal Imbalance: Complications, Radiographic and Surgical Outcomes. Oper Neurosurg. 2020 Feb 1;18(2):209-216. doi: 10.1093/ons/opz106. | |
| 30122396 | Background |
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Sharing of IPD depends on future relevant collaborations that require IPD to be shared
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| Evaluation of the change of total lumbar lordosis in post-operative X-rays taken at follow-up appointments for the first year post surgery |
Data analysis will involve analysis of the post-surgical X-rays utilizing the angle for lumbar lordosis |
| Through study completion, an average of 1 year |
The Oswestry Disability Index will be given to assess change over time in functional disability |
| Through Study Completion, an average of 1 year |
| SRS-22r (Scoliosis Research Society Patient Outcome Questionnaire) | The SRS-22r (Scoliosis Research Society Patient Outcome Questionnaire) will be given to assess change in the health related quality of life specific to spinal deformity | Through Study Completion, an average of 1 year |
| Visual Analog Scale (VAS) Low Back and/or Leg | The Visual Analog Scale (VAS) for Low Back and/or Leg will be given to assess changes in pain level. | Through Study Completion, an average of 1 year |
| Scheer JK, Osorio JA, Smith JS, Schwab F, Hart RA, Hostin R, Lafage V, Jain A, Burton DC, Bess S, Ailon T, Protopsaltis TS, Klineberg EO, Shaffrey CI, Ames CP; International Spine Study Group. Development of a Preoperative Predictive Model for Reaching the Oswestry Disability Index Minimal Clinically Important Difference for Adult Spinal Deformity Patients. Spine Deform. 2018 Sep-Oct;6(5):593-599. doi: 10.1016/j.jspd.2018.02.010. |
| 29624129 | Background | Lau D, Osorio JA, Deviren V, Ames CP. The relationship of older age and perioperative outcomes following thoracolumbar three-column osteotomy for adult spinal deformity: an analysis of 300 consecutive cases. J Neurosurg Spine. 2018 Jun;28(6):593-606. doi: 10.3171/2017.10.SPINE17374. Epub 2018 Apr 6. |