Each ICL360 is a cutting-edge CME course designed to provide a holistic learning experience, featuring curated video content sourced from expert-selected Instructional Course Lectures enhanced with insightful commentary and comprehensive assessment questions. This all-encompassing course goes beyond traditional learning by offering a complete 360° perspective on orthopedic topics. Explore additional resources, including full-text readings from the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), technique videos from Orthopaedic Video Theater (OVT), and links to external literature and PubMed. Elevate your clinical decision-making skills and gain a well-rounded understanding of essential orthopedic concepts with ICL360.
This Instructional Course Lecture (ICL) reviews the complex realm of adult spine deformity (ASD), which is a prevalent condition associated with a high rate of surgical complications. This lecture elucidates the various pitfalls associated with the surgical management of ASD and offers robust strategies to avoid them, thereby enhancing patient outcomes. As the aging population grows, the prevalence of ASD is expected to increase; therefore, the refinement of surgical techniques and patient treatment protocols is important to more effectively manage associated challenges.
Author
R. Dale Blasier, MD, FRCS(C), FAAOS, MBA
Reviewer
Mark D Price, MD, PhD, FAAOS
Learning Objectives
Evaluate and select appropriate patients with an adult spine deformity for surgical treatment based on comprehensive assessment criteria, including symptoms, the Cobb angle, and sagittal balance metrics.
Apply preoperative optimization strategies in patients with an adult spine deformity by addressing modifiable medical risk factors, such as smoking, vitamin D deficiency, poor nutritional status, and low bone density.
Create patient-specific surgical plans that include age-adjusted alignment parameters to minimize the risk of proximal junctional kyphosis and proximal junctional failure.
Implement surgical techniques that minimize complications associated with adult spine deformity procedures, including strategic pedicle screw placement and vertebral body augmentation.
Use the Global Alignment and Proportion score for planning and execution of spinal surgery to account for individual spine morphology and alignment needs.
Integrate the Roussouly classification system into surgical decision making to enhance outcomes by restoring physiologic lordotic curvature.
Prevent proximal junctional kyphosis and proximal junctional failure via advanced surgical constructs and reinforcement techniques, including appropriate upper instrumented vertebra selection and the use of sublaminar tethers or ligament augmentation.
Critically assess postoperative outcomes and identify indicators of success and areas for improvement via follow-up physical examinations and imaging studies.
Earn up to 5 AMA PRA Category 1 CME credits™.