10 Years of Special Care for the Spine

10 Years of Special Care for the Spine
Celebrating a Decade of Success
When Baylor Scoliosis Center (BSC) first opened its doors, the idea was to deliver advanced, skilled care for
spinal deformity in a boutique setting, keeping the patient at the center of everything we do.
BSC was built around the patient – not his or her condition.
By taking this patient-centered approach, over the past 10 years, we have become one of the largest regional
deformity centers in the United States. More than 3,000 patients and their families have relied on us for
hope and healing. Many of our patients were told by other specialists that nothing could be done for their
condition. Then they came to BSC, and their lives were forever changed.
Nearly every day we are contacted by prospective patients, as well as spine surgeons from across the country,
in need of help managing complex spine issues. As our caseloads grow, so does our experience in treating
increasingly difficult spine problems, which only serves to enhance the level of care and service we are able to
provide. It also enables us to create evidence-based care protocols and further both the science and practice
of spine care. Our expertise and reputation for excellence have helped establish BSC as a leading center for
health economics and spinal deformity research.
Richard Hostin, MD
Medical Director
Baylor Scoliosis Center
The tremendous strides we have made would not have been possible without our team approach to care.
From imaging studies to examination by other specialists to procedure scheduling and follow-up, we strive to
provide our patients a level of service and convenience that few other centers in the nation can match. One
of the ways we do this is through expert care coordination.
BSC patients have the same care coordinator throughout the diagnosis and treatment process. These skilled
members of our care team help reduce confusion, delays and duplication, as well as scheduling all the tests
and consultations needed prior to major surgery in a matter of days, not weeks. Our approach is all about
creating the best experience possible for patients and families, many of whom have traveled great distances
to receive care.
Baylor Scoliosis Center has accomplished much over the past decade, for both our patients and the field of
spine medicine. We are grateful for the continued support of those we serve and for all our colleagues, as we
continue to advance care for the patients of tomorrow.
Jerri Garison
President
Baylor Scott & White
Medical Center – Plano
A History of
Compassion
The Baylor Scoliosis Center (BSC), which opened in February 2005, was
the vision of the late Alexis Shelokov, MD, an orthopedic spine surgeon
renowned for his expertise in treating complex spinal deformities. Rather
than creating a scoliosis program focused solely on driving volumes, Dr.
Shelokov sought to create a boutique medical practice for patients with
scoliosis, featuring highly personalized care built around convenience for
patients and their families.
Over its first decade, the BSC has grown from 184 procedures to nearly
400 procedures annually – and from one surgeon on the medical staff
to three. The scope of the center has also become more robust, treating
patients experiencing spinal problems, in addition to increasingly
complex cases of spinal deformity. Additionally, BSC has become a
leading research center for complex spine problems, creating evidencebased protocols for care and uncovering the best approaches to surgical
care for specific conditions.
In 2008, BSC opened an outpatient clinic on the Baylor All Saints Medical
Center at Fort Worth campus as an added convenience for patients, who
now come from all over the world to receive care. A year later, BSC
suffered a tremendous loss with the unexpected passing of Dr. Shelokov.
While BSC has experienced tremendous growth since 2005, adding
additional services and expanding to Baylor Scott & White Medical
Center - McKinney, one thing that has not changed is the commitment
of the entire Baylor Scoliosis Center team to always put the patient at the
center of everything that we do.
Celebrating Ten Years
Surgical Volumes
2005
184
2006
203
2007
243
2008
264
2009
239
2010
289
2011
306
2012
377
2013
401
2014
396
2015
398
0
100
200
300
400
500
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Darlene
Jordan
“I’m pain free. I go. I do, and
nothing slows me down.”
Darlene Jordan was a junior in high school when she was
diagnosed with scoliosis. Within a matter of months, she had
her first surgery to try to correct the condition. At the time, the
procedure she had was considered revolutionary and involved
fusing vertebrae and the insertion of a metal rod along her
spine. But any relief she initially felt was short-lived when the
rod broke.
“It was put in in 1972, and I had it taken out in October of
1976,” Jordan explains. Over the years, she tried numerous
other procedures to deal with pain that only seemed to progress.
“I had had numerous surgeries, but I wasn’t getting any better.”
“Dr. Hostin was able to look at my films and he could tell
immediately what needed to be done to help me,” explains Jordan.
The Baylor Scoliosis Center team performed anterior and
posterior spinal fusion surgery to straighten her back. It was a
major operation, but the results far exceeded her expectations.
She now walks three miles nearly every morning, and she and
her husband are able to travel extensively, including taking a
dream trip to New Zealand.
Jordan’s body was in constant pain. It was difficult just standing.
She could no longer walk normally, but rather was reduced to
shuffling around with baby steps. Whenever she went shopping,
she was forced to use a scooter to get around the store. She saw
an ad for the Baylor Scoliosis Center in a magazine, and decided
to schedule an appointment. It was a life-changing decision.
Celebrating Ten Years
5
Patients From All Over the U.S.
Choose Us for Great Care
From South Florida to the Pacific Northwest, from Hawaii to New England, the Baylor Scoliosis Center
has become a national leader in caring for patients with spinal deformity. More than 3,000 patients from
across the country and beyond have relied on us for care.
BSC has helped
more than
3,000
patients from
more than
45
states
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Celebrating Ten Years
A Singular
Focus on the
Spine
Patients from all over the world have turned to the Baylor
Scoliosis Center to find the specialized care they need for
scoliosis deformities, complex spine surgeries, and revision
surgeries after a procedure at another facility. As a result of
this focus, BSC is able to offer a greater range of options
and personalized care plans for patients of all ages.
While the center is proud to feature skilled surgeons on our
medical staff and advanced operating room technologies,
surgery is never the first option, and there are a number
of other therapies and treatments we can recommend. If
surgery is recommended to correct a spinal deformity, we
can match the patient with a former patient who had a
similar type of deformity, so they can learn more about
the process from the perspective of someone who has
been in their position.
Dr. Hostin, medical director, and
Dr. O’Brien, medical director
of research at BSC and on the
medical staff of Baylor Scott &
White Medical Center - Plano
Although we pride ourselves on being a leader in the field
of spinal diseases, including pediatric and adult spinal
deformity, we treat all conditions of the spine, as well as
spinal injury, tumors and infections. Our multi-specialty
medical team includes fellowship-trained scoliosis
surgeons, cardiac anesthesiologists, implant specialists,
a spinal cord monitoring team, and physiatrists on the
medical staff – all of whom specialize in complex spinal
deformities and other conditions of the spine.
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Getting the
Back on Track
Scoliosis Deformity
Scoliosis/spinal deformity is a sideways curve of the spine that shows
up as an “S” or “C” shape rather than a straight line down the back. It
can occur in children, adolescents and adults. Many people have some
degree of curvature of the spine, or scoliosis, yet experience little or
no discomfort. Those with more severe scoliosis may experience back
pain, disfigurement and nerve compression that can cause numbness,
weakness and leg pain, especially upon standing or walking.
BSC treats a number of different forms of the disease in both adults and
adolescents, including:
• Type 1/ progressive scoliosis – A type of scoliosis that starts out
mild or asymptomatic in young adults but worsens with age due to
degenerative changes in the spine.
• Type II/ adult scoliosis – Scoliosis that begins in adulthood in
response to degenerative disease of the spinal column. This type
of scoliosis can progress at a much more rapid pace than in Type I
Adult Scoliosis.
• Adolescent idiopathic scoliosis – The most common diagnosis in
children, representing nearly 90 percent of cases.
• Congenital scoliosis – Involves spinal bones that did not form
properly during fetal development.
• Neuromuscular scoliosis – Caused by abnormalities in
neuromuscular function.
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SCOLISCORE
The SCOLISCORE Test is the
first genetic test designed to help
provide physicians and parents with
insight into the possible progression
of adolescent idiopathic scoliosis.
Using DNA and current curvature
angle, the SCOLISCORE Test will
allocate a number between 1 and
200 to the probability of curve
progression.
The SCOLISCORE Test is
appropriate for:
• Children between the ages of 9
and 13
• Those with a diagnosis of
adolescent idiopathic scoliosis
(AIS)
• Caucasian males and females,
including North American, South
American, European, Eastern
European and Middle Eastern
• Children with a mild curve of 10°
to 25°
Spondylolisthesis
Spondylolisthesis is when one vertebra
of the spine, usually in the lower back,
slips out of place onto the vertebra
below it – potentially pressing on a
nerve, causing pain. There are a number
of different treatment approaches
BSC can take to help patients with
the condition – depending on the
severity and type of spondylolisthesis –
including medication, physical therapy,
bracing, and surgical options such as
decompressive laminectomy and spinal
fusion.
These options can be used to treat:
• Congenital spondylolisthesis – a result
of abnormal bone formation, putting
vertebrae at greater risk for slipping
• Traumatic spondylolisthesis –
caused when an injury leads to a
spinal fracture or slippage
• Isthmic spondylolisthesis – small
stress fractures in the vertebrae that
weaken the bone so much that it slips
out of place
• Pathological spondylolisthesis –
occurs when the spine is weakened
by disease such as osteoporosis,
infection or tumor
• Degenerative spondylolisthesis – the most common form of the disorder,
caused by aging discs becoming less
spongy and flexible
• Post-surgical spondylolisthesis –
slippage that occurs or becomes
worse after spinal surgery
Spinal Stenosis
Disc Herniation
As people age, a natural narrowing of the spinal canal is often
normal, changing the size and shape of the spinal canal. This
narrowing, called spinal stenosis, can lead to spine problems
that need to be addressed in some cases. Lumbar spinal stenosis
happens when bone and/or tissue grow into the openings within
the spinal bones, thus squeezing and irritating nerves that
branch out from the spinal cord. With cervical spinal stenosis,
the spinal canal narrows in the neck and can compress the nerve
roots where they leave the spinal cord, or it may compress or
damage the spinal cord itself.
Small spongy discs in between the vertebrae act as shock
absorbers and help keep the spine flexible. However, these discs
can become damaged due to injury or wear and tear. When a disc
begins to bulge, break open or slip out of place, it can cause pain,
numbness and weakness in the area of the body where the nerve
travels. A herniated disc in the lower back is called a lumbar
herniation, and can cause pain and numbness in the buttock
and down the leg. A herniated disc in the neck or upper spine
is called a cervical herniation, and can cause pain, numbness, or
weakness in the neck, shoulders, chest, arms and hands.
Mild to moderate symptoms associated with lumbar spinal
stenosis often can be controlled with over-the-counter pain
medicines, exercise and physical therapy. For severe symptoms,
BSC can perform decompressive surgery. Since cervical spinal
stenosis can potentially cause more serious problems with the
nervous system, decompressive surgical intervention may be
necessary sooner to avoid complications from stenosis.
BSC can typically diagnose herniated discs based on a physical
exam and symptom history. Most hernias heal without the
need for surgery. BSC can recommend a number of options
for healing, including lifestyle changes, medication and physical
therapy. Should surgery be necessary, the spine surgeons on the
BSC medical staff are skilled in the repair of herniated discs.
Celebrating Ten Years
9
Hope Is Not Lost
Revision Surgery
Complex Surgery
For many patients, to be told that “nothing can be done” to
correct a painful spinal deformity is hard enough to hear. But
having a procedure that was supposed to fix the problem, only to
have it fail and then be told “nothing more can be done,” can be
even more devastating. Baylor Scoliosis Center offers renewed
hope for many of these patients through surgical revisions.
Going the Extra Mile
Many spine centers won’t attempt to correct a failed first
procedure. That’s because surgical revisions can pose challenges
that were not present with the initial procedures, since the
normal spine anatomy is altered from the original surgery. For
instance, the blood supply to the spine and surrounding tissue
may have been compromised, or scar tissue may be present at
the surgical site, which can impact functionality even if another
procedure does achieve the surgical objective.
At Baylor Scoliosis Center, though, these complex revision
procedures are virtually routine. Revision surgeries are
considered for almost any patient who is healthy, regardless of
their age or the reason for the failure of the previous surgery.
The center can even help patients who are not candidates for
revision surgery, by assessing their circumstance with fresh eyes
and presenting options that could help improve their quality
of life.
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Baylor Scoliosis Center prides itself in caring for patients with
complex spinal deformities that are both painful and disabling,
and whose conditions were once considered untreatable. Many
of these patients can barely walk, yet can’t find a physician able to
help due to either the condition itself – such as an inflammatory
condition that can cause some of the vertebrae in the spine to
fuse together – or because they have another existing condition
that complicates their care, such as diabetes or morbid obesity.
Baylor Scoliosis Center’s experience and capabilities have been
highly developed to take care of these difficult cases. The staff
collaborates as a team to devise a care plan to help each patient
have a quality result. It takes lots of planning, though. Part of
the planning process involves a pre-operative evaluation, which
can help determine whether a patient is a candidate for surgery.
This pre-operative evaluation identifies any barriers to a safe,
quality surgery outcome. For example, if a patient is diabetic,
Baylor Scoliosis Center works with the patient to get the
patient’s hemoglobin A1c in control, or if a patient is morbidly
obese, a weight loss surgery evaluation may be recommended.
So while many centers see these patients’ complicating factors
and simply turn them away, Baylor Scoliosis Center looks as
each one as an opportunity to help improve their overall health,
and then do whatever is necessary to help improve their complex
spine condition as well.
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Allie
Johnson
The procedure was successful in taking Allie’s
81-degree curve to about 10 degrees. After
recovery and rehabilitation, she is living pain-free.
Growing up in the sun paradise of Hawaii,
kids live in swimsuits and beachwear – but not
Allie Johnson. At age seven, she was diagnosed
with adolescent idiopathic scoliosis.
– his specific words were ‘you’ll always be
deformed,’ and that was really heartbreaking,”
says Johnson, who was a teen at the time.
She didn’t think anyone would be able to
correct it. But after speaking with a care
coordinator at the Baylor Scoliosis Center, she
decided to make the several-thousand-mile
journey to Plano for another opinion.
“I had to wear a hard brace that went from
my collarbone all the way down to my pelvic
area,” explains Johnson. “It was a plastic brace
that I had to wear for 23 hours a day, which is
really hard considering I live in Hawaii and it’s
90 degrees half the time.”
As she grew, her scoliosis progressed and
became more noticeable, since it caused her
rib cage to stick out. In elementary and middle school, she was
often teased about it. Not only was there emotional pain from
the teasing, but as her scoliosis worsened, she was in a lot of
physical pain as well.
“My first visit with Dr. O’Brien, he looked at
it and said, ‘oh, I can fix this,’ very casually,”
says Johnson. “I got really excited, and I know
my parents were thrilled to hear good news
after all the bad news we were used to getting.”
On a business trip through DFW, Johnson’s father happened
to see an ad for the Baylor Scoliosis Center. It stuck with him.
The procedure was successful in taking Johnson’s 81-degree
curve to about 10 degrees. After recovery and rehabilitation,
Johnson is so grateful to be living pain-free. While she jokes
about now being taller, the biggest change is in her confidence.
Prior to surgery, she always wore baggy clothes.
“Before coming to the Baylor Scoliosis Center, I had visited other
doctors and one said he could get it about 50 percent corrected
“I can wear what I want to wear without feeling people are
staring at me or my back,” she says.
Celebrating Ten Years
13
A Guide by Your Side
The prospect of major surgery can be daunting for anyone. Add to that all the
pre-operative appointments, testing, and then post-operative follow-up care
and rehabilitation, and the entire process can seem overwhelming. The Baylor
Scoliosis Center features care coordinators who strive to take all the added
stress out of the treatment process for patients and their families by acting as
each patient’s guide through every step of the care plan.
Since many Baylor Scoliosis Center patients come from outside of Texas,
care coordinators are especially important in helping to ensure that all tests
and evaluations by specialists are done in a timely manner. After surgery, care
coordinators can locate appropriate rehabilitation facilities near the patient’s
home and schedule their first rehab session.
Care coordinators also serve as advocates for their patients, providing critical
information on what to expect at every stage of the care process and getting
answers to any questions they may have along the way. The care coordination
team takes responsibility for the patient’s experience in the clinic, in the
hospital, and back at home.
A major role coordinators play
is being a patient’s personal
scheduler. This includes:
• initial consultation
• all pre-operative work-ups
and clearances: cardiac
stress test, pulmonary
function test, clearance
from internal medicine
specialists, imaging studies
and lab work
• the date and time of the
surgical procedure
• follow-up appointments
and care
CARE COORDINATORS
Frieda Bone
14
Megan Covert
Toni Dunlap
Natasha Morton
Charlotte Taylor
Nurse Navigators
The nurse navigator is a single point of contact who
guides patients through the continuum of care,
helping each patient understand his or her diagnosis
and treatment options. The nurse navigator also
educates the patient about the resources available
to them, including community resources,
technologies, hospital services and support services.
A nurse navigator serves as an essential link between
the patient and his or her health care provider.
Care Coordinators
Care coordinators help coordinate all aspects of
pre- and post-operative surgical care. They provide
patients and their families with education and
counseling regarding the scoliosis procedure, and – if
needed – assist with housing and travel arrangements.
Karen Davenport,
nurse navigator
Sue Saunders, ACNP-BC
Our clinical research coordinator and acute
nurse practitioner, Sue Saunders, ACNPBC, conducts research in accordance with
federal, state and institutional guidelines.
She supports spine surgery clinical research
by extensive chart review, data collection,
database management, statistics and analysis.
15
Jasmeet Gill, Chessie Robinson, Elaheh Naseri and Jennifer Fox
Research
Like everything at the Baylor Scoliosis Center,
the approach to research is patient-centered. The
primary goal behind most research studies is to help
provide patients with spinal deformity the right
care for their condition. Consequently, BSC is a
recognized leader when it comes to cost-effectiveness
as it relates to treatment techniques and outcomes
for complex conditions affecting the spine.
“Spine surgery is difficult and costly,” explains
Michael O’Brien, MD, medical director of research
at BSC. “We are helping set standards in regard
to cost and technique to make sure people will
continue to be able to get the help they need.”
BSC belongs to several national and international
study groups on spinal deformity. In collaboration
with these groups, the center researches and explores
16
topics to further the field of spine medicine and
promote quality care for the patients of today and
tomorrow. That’s why research and data measurement
are fully integrated with the overall patient care
experience.
“The research helps us develop our clinical practice
by validating and verifying the things that we do
and providing insight into areas for improvement,”
says Dr. O’Brien.
Since BSC conducts hundreds of complex spine
procedures annually, it has a unique platform
to provide data, which can be analyzed both inhouse and by other groups in order to inform best
practices in spinal deformity treatment. Annually,
the center produces 10 to 15 abstracts and presents
at 8 to 10 national conferences.
Michael O’Brien, MD
Medical Director of Research
Baylor Scoliosis Center
Publications
Analysis of Health Related Quality of Life
Improvements among Patients with Adult
Spinal Deformity. Michael O’Brien, MD,
Richard Hostin, MD, Ian McCarthy, PhD,
Neil Fleming, PhD, Gerald Ogola, MS, Rustam
Kudyakov, MD, MPH, Kathleen Richter, MS,
Rajiv Saigal, MD, PhD, Sigurd Berven, MD,
Vedat Deviren, MD, Christopher P. Ames, MD.
Spine J. 2012 Sep;12(9):S133
Analysis of the Direct Cost of Surgery for Four
Diagnostic Categories of Adult Spinal Deformity.
McCarthy IM, Hostin RA, O’Brien MF, Fleming
NS, Ogola G, Kudyakov R, Richter KM, Saigal R,
Berven SH, Ames CP; International Spine Study
Group. Spine J. 2013 Dec;13(12):1843-8.
Cost-Effectiveness of Surgical Treatment for
Adult Spinal Deformity: A Comparison of
Dollars per Quality of Life Improvement across
Health Domains. Ian McCarthy, PhD, Richard
Hostin, MD, Michael O’Brien, MD, Neil Fleming,
PhD, Gerald Ogola, PhD, Rustam Kudyakov, MD,
MPH, Kathleen Richter, MS, MFA, Rajiv Saigal,
MD, Sigurd Berven, MD, Vedat Deviren, MD,
Christopher Ames, MD; International Spine Study
Group. Spine Deformity. 2013 Jul; 1(4):293-298.
Detection of Pseudarthrosis in Adult Spinal
Deformity: The use of health-related qualityof-life outcomes to predict pseudarthrosis.
Klineberg E, Gupta M, McCarthy I, Hostin R. J Spinal Disord Tech. 2013 Dec 11.
Health Economic Analysis of Adult Deformity
Surgery. McCarthy I, Hostin R, O’Brien M, Saigal R, Ames CP. Neurosurg Clin N Am. 2013 Apr;24(2):293-304.
Identification of Decision Criteria for Revision
Surgery among Patients with Proximal
Junctional Failure following Surgical Treatment
for Spinal Deformity. Hart R, McCarthy I,
O’Brien M, Bess S, Line B, Adjei OB, Burton D,
Gupta M, Ames C, Deviren V, Kebaish K, Shaffrey
C, Wood K, Hostin R; International Spine Study
Group. Spine (Phila Pa 1976). 2013 Jun 17.
Incidence, Mode, and Location of Acute
Proximal Junctional Failures Following Surgical
Treatment for Adult Spinal Deformity. Hostin
R, McCarthy I, O’Brien M, Bess S, Line B,
Boachie-Adjei O, Burton D, Gupta M, Ames C,
Deviren V, Kebaish K, Shaffrey C, Wood K, Hart
R; International Spine Study Group. Spine (Phila
Pa 1976). 2012 Sep 13.
Incremental Cost-Effectiveness of Adult Spinal
Deformity Surgery: Observed QALYs with Surgery
Compared to Predicted QALYs without Surgery.
McCarthy I, O’Brien M, Ames C, Robinson C,
Errico T, Polly DW Jr, Hostin R; International
Spine Study Group. JNS Focus. 2014 May.
Proximal junctional kyphosis and proximal
junctional failure. Hart RA, McCarthy I, Ames
CP, Shaffrey CI, Hamilton DK, Hostin R.
Neurosurg Clin N Am. 2013 Apr;24(2):213.
Retrospective Study of Anterior Interbody
Fusion Rates and Patient Outcomes of Using
Mineralized Collagen and Bone Marrow Aspirate
in Multilevel Adult Spinal Deformity Surgery.
Hostin R, O’Brien M, McCarthy I, Bess S, Gupta
M, Klineberg E; International Spine Study Group,
Denver, CO. J Spinal Disord Tech. 2013 Nov 6.
Risk Factors for Major Peri-Operative
Complications in Adult Spinal Deformity
Surgery. Schwab FJ, Hawkinson N, Lafage V,
Smith JS, Hart R, Mundis G, Burton DC, Line
B, Akbarnia B, Boachie-Adjei O, Hostin R,
Shaffrey CI, Arlet V, Wood K, Gupta M, Bess S,
Mummaneni PV; International Spine Study Group.
Eur Spine J. 2012 Dec;21(12):2603- 10.
Total Costs of Multilevel Fusion Surgery Including
Outpatient Care. Ian McCarthy, PhD, Chessie
Robinson, MA, Michael O’Brien, MD, Richard
Hostin, MD. SpineLine. 2014 May/June 15(3).
Total Hospital Costs of Surgical Treatment for
Adult Spinal Deformity: An Extended Follow-up
Study. McCarthy IM, Hostin RA, Ames CP, Kim
HJ, Smith JS, Boachie-Adjei O, Schwab FJ, Klineberg EO, Shaffrey CI, Gupta MC, Polly DW; International Spine Study Group. Spine J. 2014 Jan 24.
NON-BAYLOR
A standardized nomenclature for cervical spine
soft-tissue release and osteotomy for deformity
correction. Ames CP, Smith JS, Scheer JK, Shaffrey
CI, Lafage V, Deviren V, Moal B, Protopsaltis
T, Mummaneni PV, Mundis GM Jr, Hostin R,
Klineberg E, Burton DC, Hart R, Bess S, Schwab
FJ; International Spine Study Group. J Neurosurg
Spine. 2013 Jul 5. [Epub ahead of print].
Acute Reciprocal Changes Distant from the
Site of Spinal Osteotomies Affect Global
Postoperative Alignment. Klineberg E, Schwab F,
Ames C, Hostin R, Bess S, Smith JS, Gupta MC,
Boachie-Adjei O, Hart RA, Akbarnia BA, Burton
DC, Lafage V. Adv Orthop. 2011; 2011:415946.
Change in Classification Grade by the SRSSchwab Adult Spinal Deformity Classification
Predicts Impact on Health-Related Quality of
Life Measures: Prospective Analysis of Operative
and Non-operative Treatment. Smith JS,
Klineberg E, Schwab F, Shaffrey CI, Moal B, Ames
CP, Hostin R, Fu KM, Burton D, Akbarnia B,
Gupta M, Hart R, Bess S, Lafage V; International
Spine Study Group. Spine (Phila Pa 1976). 2013
Jun 11. [Epub ahead of print]
Changes in Thoracic Kyphosis Negatively
Impact Sagittal Alignment After Lumbar Pedicle
Subtraction Osteotomy: A Comprehensive
Radiographic Analysis. Lafage V, Ames C, Schwab
F, Klineberg E, Akbarnia B, Smith J, Boachie-Adjei
O, Burton D, Hart R, Hostin R, Shaffrey C, Wood
K, Bess S; International Spine Study Group. Spine
2012. Feb 1;37(3):E180-7.
Chapter 22: Complications in Surgery for Spinal
Deformity. Newton Peter O, O’Brien Michael F,
eds. Idiopathic Scoliosis: The Harms Study Group
Treatment Guide. Thieme. 2010
Clinical improvement through nonoperative
treatment of adult spinal deformity: who is
likely to benefit? Slobodyanyuk K, Poorman
CE, Smith JS, Protopsaltis TS, Hostin R, Bess S,
Mundis GM Jr, Schwab FJ, Lafage V; International
Spine Study Group. Neurosurg Focus. 2014
May;36(5):E2. doi: 10.3171/2014.3.FOCUS1426.
Comparison of Patient and Surgeon Perceptions
of Adverse Events Following Adult Spinal
Deformity Surgery. Hart RA, Cabalo A, Bess
S, Akbarnia BA, Boachie-Adjei O, Burton D,
Cunningham ME, Gupta M, Hostin R, Kebaish
K, Klineberg E, Mundis G, Shaffrey C, Smith JS,
Wood K; International Spine Study Group. Spine
(Phila Pa 1976). 2012 Nov 2. [Epub ahead of print]
Complications and intercenter variability of
three-column osteotomies for spinal deformity
surgery: a retrospective review of 423 patients.
Bianco K, Norton R, Schwab F, Smith JS, Klineberg
E, Obeid I, Mundis G Jr, Shaffrey CI, Kebaish K,
Hostin R, Hart R, Gupta MC, Burton D, Ames C,
Boachie-Adjei O, Protopsaltis TS, Lafage V; International Spine Study Group. Neurosurg Focus. 2014
May;36(5):E18. doi: 10.3171/2014.2.FOCUS1422.
Does vertebral level of Pedicle Subtraction
Osteotomy correlate with degree of spino-pelvic
parameter correction? Lafage V, Schwab F, Vira
S, Hart R, Burton D, Smith JS, Boachie-Adjei
O, Shelokov A, Hostin R, Shaffrey CI, Gupta M,
Akbarnia BA, Bess S, Farcy JP. J Neurosurg Spine.
2011 Feb;14(2):184-91. Epub 2010 Dec 24.
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Does recombinant human bone morphogenetic
protein-2 use in adult spinal deformity increase
complications and are complications associated
with location of rhBMP-2 use? A prospective,
multicenter study of 279 consecutive patients.
Bess S, Line BG, Lafage V, Schwab F, Shaffrey CI,
Hart RA, Boachie-Adjei O, Akbarnia BA, Ames
CP, Burton DC, Deverin V, Fu KM, Gupta M,
Hostin R, Kebaish K, Klineberg E, Mundis G,
O’Brien M, Shelokov A, Smith JS; International
Spine Study Group ISSG. Spine (Phila Pa
1976). 2014 Feb 1;39(3):233-42. doi: 10.1097/
BRS.0000000000000104.
instrumented vertebra. Scheer JK, Lafage V, Smith
JS, Deviren V, Hostin R, McCarthy IM, Mundis
GM, Burton DC, Klineberg E, Gupta M, Kebaish
K, Shaffrey CI, Bess S, Schwab F, Ames CP;
International Spine Study Group (ISSG). Eur Spine
J. 2014 Jun 1. [Epub ahead of print]
Multicenter validation of a formula predicting
postoperative spinopelvic alignment. Lafage
V, Bharucha NJ, Schwab F, Hart RA, Burton D,
Boachie-Adjei O, Smith JS, Hostin R, Shaffrey C,
Gupta M, Akbarnia BA, Bess S. J Neurosurg Spine.
2012 Jan;16(1):15-21. Epub 2011 Sep 23
Radiographic Spino-pelvic Parameters and
Disability in the Setting of Adult Spinal
Deformity: A Prospective Multicenter Analysis.
Schwab FJ, Blondel B, Bess S, Hostin R, Shaffrey
CI, Smith JS, Boachie-Adjei O, Burton DC,
Akbarnia BA, Mundis GM, Ames CP, Kebaish K,
Hart RA, Farcy JP, Lafage V; International Spine
Study Group (ISSG). Spine (Phila Pa 1976). 2013
Mar 25. [Epub ahead of print]
Dynamic changes of the pelvis and spine are key
to predicting postoperative sagittal alignment
after pedicle subtraction osteotomy: a critical
analysis of preoperative planning techniques.
Smith JS, Bess S, Shaffrey CI, Burton DC, Hart
RA, Hostin R, Klineberg E; International Spine
Study Group. Spine (Phila Pa 1976). 2012 May
1;37(10):845-53
Outcomes and Complications of Extension of
Previous Long Fusion to the Sacro-Pelvis: Does
Surgical Approach Make a Difference? Fu KM,
Smith JS, Burton DC, Shaffrey CI, Boachie-Adjei
O, Carlson B, Schwab FJ, Lafage V, Hostin R, Bess
S, Akbarnia BA, Mundis G, Klineberg E, Gupta M;
International Spine Study Group. World Neurosurg.
2013 Jan;79(1):177-81.
Reoperation Rates and Impact on Outcome in
a Large Prospective Multicenter Adult Spinal
Deformity Database. Scheer JK, Tang JA, Smith
JS, Klineberg E, Hart RA, Mundis GM Jr, Burton
DC, Hostin R, O’Brien MF, Bess S, Kebaish KM,
Deviren V, Lafage V, Schwab F, Shaffrey CI, Ames
CP; International Spine Study Group. J Neurosurg
Spine. 2013 Aug 23. [Epub ahead of print]
Efficacy of Hemivertebra Resection for
Congenital Scoliosis: a multicenter retrospective
comparison of three surgical techniques. Yaszay,
Burt MD; O’Brien, Michael MD; Shufflebarger,
Harry L MD; Betz, Randal R MD; Lonner,
Baron MD; Shah, Suken A. MD; Boachie-Adjei,
Oheneba MD; Crawford, Alvin MD; Letko, Lynn
MD; Harms, Jurgen MD; Gupta, Munish C
MD; Sponseller, Paul D MD; Abel, Mark F MD;
Flynn, John MD; Macagno, Angel MD; Newton,
Peter O MD. Spine (Phila Pa 1976). 2011 Nov
15;36(24):2052-60.
Patients with adult spinal deformity treated
operatively report greater baseline pain and
disability than patients treated nonoperatively;
however, deformities differ between age groups.
Fu KM, Bess S, Shaffrey CI, Smith JS, Lafage V,
Schwab F, Burton DC, Akbarnia BA, Ames CP,
Boachie-Adjei O, Deverin V, Hart RA, Hostin R,
Klineberg E, Gupta M, Kebaish K, Mundis G,
Mummaneni PV; International Spine Study Group.
Spine (Phila Pa 1976). 2014 Aug 1;39(17):1401-7.
doi: 10.1097/BRS.0000000000000414.
Revision extension to the pelvis versus
primary spinopelvic instrumentation in adult
deformity: comparison of clinical outcomes and
complications. Fu KM, Smith JS, Burton DC,
Kebaish KM, Shaffrey CI, Schwab F, Lafage V, Arlet
V, Hostin R, Boachie-Adjei O, Akbarnia B, Bess S;
International Spine Study Group. World Neurosurg.
2014 Sep-Oct;82(3-4):e547-52. doi: 10.1016/j.
wneu.2013.02.059. Epub 2013 Feb 21. Review.
Impact of age on the likelihood of reaching a
minimum clinically important difference in 374
three-column spinal osteotomies: clinical article.
Scheer JK, Lafage V, Smith JS, Deviren V, Hostin
R, McCarthy IM, Mundis GM, Burton DC,
Klineberg E, Gupta MC, Kebaish KM, Shaffrey
CI, Bess S, Schwab F, Ames CP; International
Spine Study Group. J Neurosurg Spine. 2014
Mar;20(3):306-12. doi: 10.3171/2013.12.
SPINE13680. Epub 2014 Jan 3.
Likelihood of reaching minimal clinically
important difference in adult spinal deformity:
a comparison of operative and nonoperative
treatment. Liu S, Schwab F, Smith JS, Klineberg E,
Ames CP, Mundis G, Hostin R, Kebaish K, Deviren
V, Gupta M, Boachie-Adjei O, Hart RA, Bess S,
Lafage V. Ochsner J. 2014 Spring;14(1):67-77.
Maintenance of radiographic correction at 2
years following lumbar pedicle subtraction
osteotomy is superior with upper thoracic
compared with thoracolumbar junction upper
18
Prevalence and type of cervical deformity among
470 adults with thoracolumbar deformity. Smith
JS, Lafage V, Schwab FJ, Shaffrey CI, Protopsaltis T,
Klineberg E, Gupta M, Scheer JK, Fu KM, Mundis
G, Hostin R, Deviren V, Hart R, Burton DC, Bess
S, Ames CP; International Spine Study Group.
Spine (Phila Pa 1976). 2014 Aug 1;39(17):E10019. doi: 10.1097/BRS.0000000000000432.
Pain and disability determine treatment modality
for older patients with adult scoliosis, while
deformity guides treatment for younger patients.
Bess S, Boachie-Adjei O, Burton D, Cunningham
M, Shaffrey C, Shelokov A, Hostin R, Schwab
F, Wood K, Akbarnia B; International Spine
Study Group. Spine (Phila Pa 1976). 2009 Sep
15;34(20):2186-90
Prospective multicenter assessment of risk factors
for rod fracture following surgery for adult spinal
deformity. Smith JS, Shaffrey E, Klineberg E, Shaffrey CI, Lafage V, Schwab FJ, Protopsaltis T, Scheer
JK, Mundis GM Jr, Fu KM, Gupta MC, Hostin R,
Deviren V, Kebaish K, Hart R, Burton DC, Line B,
Bess S, Ames CP; International Spine Study Group.
J Neurosurg Spine. 2014 Dec;21(6):994-1003. doi:
10.3171/2014.9.SPINE131176. Epub 2014 Oct 17.
Revision Surgery After Three-Column Osteotomy
in 335 Adult Spinal Deformity Patients: InterCenter Variability and Risk Factors. Maier S,
Smith JS, Schwab F, Obeid I, Mundis G, Klineberg
E, Hostin R, Hart R, Burton D, Boachie-Adjei
O, Gupta M, Ames C, Protopsaltis T, Lafage V;
International Spine Study Group. Spine (Phila Pa
1976). 2014 Feb 27. [Epub ahead of print]
Sagittal realignment failures following pedicle
subtraction osteotomy surgery: are we doing
enough? Schwab FJ, Patel A, Shaffrey CI, Smith
JS, Farcy JP, Boachie-Adjei O, Hostin RA, Hart
RA, Akbarnia BA, Burton DC, Bess S, Lafage V.
J Neurosurg Spine. 2012 Jun;16(6):539-46. Epub
2012 Mar 30.
Sagittal spino-pelvic alignment failures following
three column thoracic osteotomy for adult spinal
deformity. Lafage V, Smith JS, Bess S, Schwab FJ,
Ames CP, Klineberg E, Arlet V, Hostin R, Burton DC,
Shaffrey CI; International Spine Study Group. Eur
Spine J. 2012 Apr;21(4):698-704. Epub 2011 Aug 12.
Spondylolisthesis, Pelvic Incidence, and
Spinopelvic Balance. Labelle, Hubert MD;
Roussouly, Pierre MD; Berthonnaud, Éric PhD;
Transfeldt, Ensor MD; O’Brien, Michael MD;
Chopin, Daniel MD; Hresko, Timothy MD;
Dimnet, Joannes PhD. Spine (Phila Pa 1976). 2004
Sep 15;29(18):2049-54.
Surgical treatment of pathological loss of
lumbar lordosis (flatback) in patients with
normal sagittal vertical axis achieves similar
clinical improvement as surgical treatment of
elevated sagittal vertical axis: clinical article.
Smith JS, Singh M, Klineberg E, Shaffrey CI,
Lafage V, Schwab FJ, Protopsaltis T, Ibrahimi D,
Scheer JK, Mundis G Jr, Gupta MC, Hostin R,
Deviren V, Kebaish K, Hart R, Burton DC, Bess
S, Ames CP; International Spine Study Group.
J Neurosurg Spine. 2014 Aug;21(2):160-70. doi:
10.3171/2014.3.SPINE13580. Epub 2014 Apr 25.
Correlations Based on a Prospective Operative
and Nonoperative Cohort. Terran J, Schwab
F, Shaffrey CI, Smith JS, Devos P, Ames CP, Fu
KM, Burton D, Hostin R, Klineberg E, Gupta M,
Deviren V, Mundis G, Hart R, Bess S, Lafage V;
International Spine Study Group. Neurosurgery.
2013 Jun 14. [Epub ahead of print]
Upper thoracic versus lower thoracic upper
instrumented vertebrae endpoints have similar
outcomes and complications in adult scoliosis.
Kim HJ, Boachie-Adjei O, Shaffrey CI, Schwab F,
Lafage V, Bess S, Gupta MC, Smith JS, Deviren V,
Akbarnia B, Mundis GM, O’Brien M, Hostin R,
Ames C; International Spine Study Group. Spine
(Phila Pa 1976). 2014 Jun 1;39(13):E795-9. doi:
10.1097/BRS.0000000000000339.
Quantifying the Role of Baseline Quality-of-Life
and Readmissions on the Incremental CostEffectiveness of Surgical Treatment for Adult
Spinal Deformity (ASD), 2013
Total Hospital Costs of Surgical Treatment for
Adult Spinal Deformity: An Extended Follow-up
Study, 2013
The Cost of Implants in Surgical Treatment of
Adult Spinal Deformity, 2013
Calculating and Defining Minimally Important
Clinical Difference (MCID) and Substantial
Clinical Benefit (SCB) Values for Adult Spinal
Deformity (ASD): A Robust Methodology for
Consistent Data Reporting, 2013
Surgical Treatment of Lenke 1 Main Thoracic
Idiopathic Scoliosis? Results of a Prospective,
Multi-Center Study. Newton PO, Marks MC,
Bastrom TP, Betz R, Clements D, Lonner B,
Crawford A, Shufflebarger H, O’Brien M, Yaszay B;
Harms Study Group. Spine (Phila Pa 1976). 2013
Feb 15;38(4):328-38.
A Preliminary Analysis of Outcomes, and Direct
Cost for Four Diagnostic Categories of Adult
Spinal Deformity (ASD), 2011
North American Spine Society 28th Annual
Meeting 10/09-10/12 New Orleans. LANASS
Value Abstract Award
Spontaneous improvement of cervical alignment
after correction of global sagittal balance
following pedicle subtraction osteotomy. Smith JS,
Shaffrey CI, Lafage V, Blondel B, Schwab F, Hostin
R, Hart R, O’Shaughnessy B, Bess S, Hu SS, Deviren
V, Ames CP; International Spine Study Group.
J Neurosurg Spine. 2012 Oct;17(4):300-7. doi:
10.3171/2012.6.SPINE1250. Epub 2012 Aug 3.
Mineralized Collagen and Bone Marrow Aspirate
in Anterior Interbody Carbon Fiber Cages
Achieves High Fusion Rates in Multilevel Adult
Spinal Deformity Surgery, 2011
Comparison of QALYs Predicted from the
ODI and QALYs Calculated from the SF-6D
Following Surgical Treatment for Adult Spinal
Deformity (ASD), 2013
Identification of Decision Criteria for Revision
Surgery among Patients with Acute Proximal
Junctional Failure following Surgical Treatment
for Spinal Deformity, 2012
Expectations and Health Outcomes in the
Surgical Treatment of Adult Spinal Deformity
(ASD), 2013
T1 pelvic angle (TPA) effectively evaluates
sagittal deformity and assesses radiographical
surgical outcomes longitudinally. Ryan DJ,
Protopsaltis TS, Ames CP, Hostin R, Klineberg
E, Mundis GM, Obeid I, Kebaish K, Smith
JS, Boachie-Adjei O, Burton DC, Hart RA,
Gupta M, Schwab FJ, Lafage V; International
Spine Study Group. Spine (Phila Pa 1976).
2014 Jul 1;39(15):1203-10. doi: 10.1097/
BRS.0000000000000382.
The T1 pelvic angle, a novel radiographic
measure of global sagittal deformity, accounts
for both spinal inclination and pelvic tilt and
correlates with health-related quality of life.
Protopsaltis T, Schwab F, Bronsard N, Smith JS,
Klineberg E, Mundis G, Ryan DJ, Hostin R, Hart
R, Burton D, Ames C, Shaffrey C, Bess S, Errico T,
Lafage V; International Spine Study Group. J Bone
Joint Surg Am. 2014 Oct 1;96(19):1631-40. doi:
10.2106/JBJS.M.01459.
The SRS-Schwab Adult Spinal Deformity
Classification: Assessment and Clinical
ABSTRACT PRESENTATIONS
48th Annual Meeting & Course 09/18-09/21 Lyon,
France. SRS Louis A. Goldstein Award for Best
Clinical Poster Presentation
Analysis of Health Related Quality of Life
Improvements among Patients with Adult Spinal
Deformity, 2012
North American Spine Society 27th Annual
Meeting 10/24-10/27 Dallas, TX. NASS Best
Poster Award
The Effect of Complications on Health
Outcomes among Patients Undergoing ThreeColumn Osteotomy Surgery, 2012
The Impact of Restored Global Sagittal
Alignment on Outcomes of Three-Column
Osteotomy, 2012
Analysis of the Cost-Effectiveness of Surgical
Treatment for Adult Spinal Deformity, 2012
Cost-Utility Analysis of Surgical Treatment for
Adult Spinal Deformity, 2013
Incremental Cost-Effectiveness of Adult Spinal
Deformity Surgery: Observed QALYs with
Surgery Compared to Predicted QALYs without
Surgery, 2013
Incremental Cost-Effectiveness of Adult
Spinal Deformity Surgery by Classification of
Deformity, 2014
21st International Meeting on Advanced Spine
Techniques 07/16-07/19 Valencia, Spain. IMAST
Whitecloud Basic Science Award Nominee & Top
Scoring Abstract
Efficiency in Adult Spinal Deformity Surgery:
A Multi-Center Comparison of Resource Use,
2014 North American Spine Society 29th Annual
Meeting 11/12-11/15 San Francisco, CA. NASS
Value Award Nominee
Role of Implant Costs in the Long Term CostEffectiveness of Surgical Treatment of Adult
Spinal Deformity, 2014, 21st International
Meeting on Advanced Spine Techniques 07/1607/19 Valencia, Spain.
IMAST Whitecloud Basic Science Award
Nominee & Top Scoring Abstract, Long Term
Cost-Effectiveness of Adult Spinal Deformity,
2014
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