Article Figures & Data
Figures
- Fig. 1
Full length standing PA radiograph of a patient (Case 2) with adult degenerative scoliosis and lumbar radiculopathy. There is a right T10-L2 curve measuring 25 degrees and a left L2-L5 curve measuring 33 degrees.
- Fig. 2
Full length standing lateral radiograph of the patient (Case 2). The SVA measures 4.2 cm, the pelvic incidence is 45 degrees, the pelvic tilt is 12 degrees and sacral slope is 33 degrees. Lumbar lordosis measures 43 degrees. Thoracic kyphosis measures 29 degrees.
- Fig. 3
Lateral radiograph of the lumbar spine (Case 2) demonstrates a grade 1 spondylolisthesis at L4-5 and grade 1 retrolisthesis at L3-4 and L2-3.
- Fig. 4
Sagittal T2 MRI images of the patient (Case 2) with slices going from the left to the right of the patient. They are notable for prior L3-4 and L4-5 laminectomies. There is central stenosis at L1-2 and L2-3 and foramenal stenosis on the left at L1-2 and L2-3.
- Fig. 5
Axial T2 MRI images showing central and lateral recess stenosis at L1-2 and L2-3 (Case 2).
- Fig. 6
Graphic depiction of the correlation between the percentage of spinal deformity in a surgeon's spine fellowship and the percentage of spine deformity in a surgeon's practice. There was a direct correlation with R=0.75, p=0.01.
- Fig. 7
Mean number of levels fused in each of the seven cases for each of the two groups of surgeons.
- Fig. 8
Graphic depiction of the correlation between the percentage of deformity within a surgeon's practice and the mean number of levels fused for each case. There was a direct correlation with R=0.84, p=0.001.
Tables
- Table 1
Surgeon Years in Practice Fellowship Location Fellowship% Deformity Practice% Deformity Degenerative 1 10 Plano, Texas 10 15 Degenerative 2 6 New York, NY 20 20 Degenerative 3 13 New York, NY 25 5 Degenerative 4 15 New York, NY 50 20 Degenerative 5 12 Baltimore, MD 20 20 Degenerative 6 16 Philadelphia, PA 20 10 Deformity 1 25 Toronto, Canada 80 80 Deformity 2 11 New York, NY 70 50 Deformity 3 14 New York, NY 50 90 Deformity 4 15 New York, NY 50 70 Deformity 5 35 Marseille, France 75 75 Deformity 6 4 New York, NY 35 65 Fellowship and Practice Data of Study Surgeons.
- Table 2
Magnitude of Curve (°) Pelvic Parameters (°) Case T1 TL2 L3 SVA4 (mm) PI5 PT6 SS7 Chief complaint 1 36 35 x 52 71 33 40 8/10 leg pain 2 x 25 33 42 45 12 33 9/10 leg pain (R > L) 3 x 24 x 77 59 23 38 9/10 leg pain (B/L) 4 x 23 33 52 61 44 17 6/10 leg pain 5 x 17 26 62 49 26 23 6/10 leg pain 6 x 32 x 59 47 32 15 8/10 leg pain 7 76 62 x 12 61 22 39 10/10 leg pain (R) - Table 3
Procedure 1 Posterior Decompression Alone 2 Posterior Decompression and Fusion - No Instrumentation 3 Fusion with Instrumentation +/- Decompression Approach 1 Posterior 2 Anterior/Posterior Interbody Spacer 1 Metallic Cage 2 Polyetheretherketone (PEEK) Cage 3 Structural Allograft 4 Bone morphogenetic protein 5 Demineralized bone matrix 6 Bone Marrow Aspirate 7 Other Preferred Bone Graft 1 Iliac crest bone graft 2 Bone morphogenetic protein 3 Local Autograft 4 Cancellous Allograft 5 Other Decompression 1 Laminotomy 2 Laminectomy 3 Foramenotomy Surgical planning data collected from each surgeon for each of the seven cases.
- Table 4
Surgeon Group Mean Levels Fused Posterior Approach (%) Approach/Posterior Approach (%) Decompression Alone (%) Interbody Material Preferred Bone Graft Structural Allograft (%) Metallic Cage (%) PEEK1 (%) Other (%) ICBG2 (%) Local Autograft (%) Allograft (%) BMP3 (%) BM4 Aspirate (%) Group 1: Degenerative 3.7 † 72.5 27.5 37.5 † 10.0 15.0 12.5 2.5 12.2 60 † 12.5 20.0 0.0 Group 2: Deformity 10.8 † 62.5 37.5 11.9 † 16.7 14.3 16.7 9.5 23.8 88.1 † 26.2 11.9 7.1 Surgeon responses with respect to specific parameters are summarized for Group 1 and Group 2 surgeons. The selection of each parameter was quantified for each group as a percentage of the total possible responses for the 7 cases by the 6 surgeons in each group. The percentages were compared between the groups using the paired student's t-test, with significant differences noted (†).
↵1 polyetheretherketone;
↵2 iliac crest bone graft;
↵3 bone morphogenetic protein;
↵4 bone marrow
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