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A 66-year-old female presents to your clinic complaining of back pain, difficulty standing-up straight, weakness in her legs, and neurogenic claudication. On upright thoracolumbar radiographs, there is a 75 degree thoracolumbar curve with the apex at L2, and the C7 plumb line falls 12 cm anterior to the posterosuperior corner of S1. Aside from a decompression of the stenotic levels, which of the following choices will lead to the MOST reliable decrease in overall disability?
Ensuring the lumbar lordosis is within 15 degrees of the pelvic incidence
Decreasing the cobb angle to less than 25 degrees
Correcting the sagittal vertical axis to +3 cm from neutral
Increasing the pelvic tilt to greater than 20 degrees
Stopping the fusion at L5
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Which of the following figures show an asterisk that correctly quantifies the amount of sagittal imbalance?
A 53-year-old woman is seen in the adult spine clinic for long-standing back pain. History reveals she had untreated scoliosis as a child. Her current radiographs are shown in Figures A and B. Due to discomfort with ADLs and progressive pain, surgical intervention is planned. Which of the following factors would increase her risk of nonunion?
An anterior thoracoabdominal approach
Preoperative Cobb angle of 60 degrees
Age greater than 35 years
A posterior midline approach
Positive sagittal balance < 5 cm
In adult patients with scoliosis, severity of symptoms correlates with which of the following variables?
Magnitude of coronal Cobb angle
Number of spine levels involved in the deformity
Level of the apex of the curve
What is the incidence of major complications following adult spinal deformity surgery?
In patients with adult scoliosis requiring long thoracolumbar fusions, which of the following is the major advantage of extending the fusion to the sacrum as opposed to ending at L5.
Improved function outcomes
Decreased pseudoarthosis rates
Decreased major medical complications
Improved correction and maintenance of sagittal balance
Improved curve correction in the coronal plane