Analysis of Personalized Interbody Implants in the Surgical Treatment of Adult Spinal Deformity.

Autor:	Smith JS; Department of Neurosurgery, University of Virginia, Charlottesville, VA, USA., Mundis GM; Department of Orthopedic Surgery, Scripps Clinic, San Diego, CA, USA., Osorio JA; Department of Neurological Surgery, University of California, San Diego, San Diego, CA, USA., Nicolau RJ; Carlsmed, Carlsbad, CA, USA., Temple-Wong M; Carlsmed, Carlsbad, CA, USA., Lafage R; Department of Orthopedic Surgery, Lennox Hill Hospital, New York City, NY, USA., Bess S; Presbyterian St Lukes Medical Center, Denver, CO, USA., Ames CP; Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA.
Jazyk:	angličtina
Zdroj:	Global spine journal [Global Spine J] 2023 Nov 21, pp. 21925682231216926. Date of Electronic Publication: 2023 Nov 21.
DOI:	10.1177/21925682231216926
Abstrakt:	Study Design: Multicenter cohort. Objectives: A report from the International Spine Study Group (ISSG) noted that surgeons failed to achieve alignment goals in nearly two-thirds of 266 complex adult deformity surgery (CADS) cases. We assess whether personalized interbody spacers are associated with improved rates of achieving goal alignment following adult spinal deformity (ASD) surgery. Methods: ASD patients were included if their surgery utilized 3D-printed personalized interbody spacer(s) and they met ISSG CADS inclusion criteria. Planned alignment was personalized by the surgeon during interbody planning. Planned vs achieved alignment was assessed and compared with the ISSG CADS series that used stock interbodies. Results: For 65 patients with personalized interbodies, 62% were women, mean age was 70.3 years (SD = 8.3), mean instrumented levels was 9.9 (SD = 4.1), and the mean number of personalized interbodies per patient was 2.2 (SD = .8). Segmental alignment was achieved close to plan for levels with personalized interbodies, with mean difference between goal and achieved as follows: intervertebral lordosis = .9° (SD = 5.2°), intervertebral coronal angle = .1° (SD = 4.7°), and posterior disc height = -0.1 mm (SD = 2.3 mm). Achieved pelvic incidence-to-lumbar lordosis mismatch (PI-LL) correlated significantly with goal PI-LL (r = .668, P < .001). Compared with the ISSG CADS cohort, utilization of personalized interbodies resulted in significant improvement in achieving PI-LL <5° of plan ( P = .046) and showed a significant reduction in cases with PI-LL >15° of plan ( P = .012). Conclusions: This study supports use of personalized interbodies as a means of better achieving goal segmental sagittal and coronal alignment and significantly improving achievement of goal PI-LL compared with stock devices. Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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