{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T06:15:52Z","timestamp":1771481752284,"version":"3.50.1"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2021,10,18]],"date-time":"2021-10-18T00:00:00Z","timestamp":1634515200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurosurg.","NEUROS"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>BACKGROUND<\/jats:title>\n            <jats:p>Few reports focus on adults with severe scoliosis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>OBJECTIVE<\/jats:title>\n            <jats:p>To report surgical outcomes and complications for adults with severe scoliosis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS<\/jats:title>\n            <jats:p>A multicenter, retrospective review was performed on operatively treated adults with severe scoliosis (minimum coronal Cobb: thoracic [TH] \u2265 75\u00b0, thoracolumbar [TL] \u2265 50\u00b0, lumbar [L] \u2265 50\u00b0).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS<\/jats:title>\n            <jats:p>Of 178 consecutive patients, 146 (82%; TH\u00a0=\u00a08, TL\u00a0=\u00a088, L\u00a0=\u00a050) achieved minimum 2-yr follow-up (mean age\u00a0=\u00a053.9\u00a0\u00b1\u00a013.2\u2009yr, 92% women). Operative details included posterior-only (58%), 3-column osteotomy (14%), iliac fixation (72%), and mean posterior fusion\u00a0=\u00a013.2\u00a0\u00b1\u00a03.7\u00a0levels. Global coronal alignment (3.8 to 2.8\u2009cm, <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a0.001) and maximum coronal Cobb improved significantly (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0\u2264.020): TH (84\u00ba to 57\u00ba; correction\u00a0=\u00a032%), TL (67\u00ba to 35\u00ba; correction\u00a0=\u00a048%), L (61\u00ba to 29\u00ba; correction\u00a0=\u00a053%). Sagittal alignment improved significantly (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0&lt;\u00a0.001), most notably for L: C7-sagittal vertical axis 6.7 to 2.5\u2009cm, pelvic incidence-lumbar lordosis mismatch 18\u00ba to 3\u00ba. Health-related quality-of-life (HRQL) improved significantly (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0&lt;\u00a0.001), most notably for L: Oswestry Disability Index (44.4\u00a0\u00b1\u00a020.5\u00a0to 26.1\u00a0\u00b1\u00a018.3), Short Form-36 Physical Component Summary (30.2\u00a0\u00b1\u00a010.8\u00a0to 39.9\u00a0\u00b1\u00a09.8), and Scoliosis Research Society-22r Total (2.9\u00a0\u00b1\u00a00.7 to 3.8\u00a0\u00b1\u00a00.7). Minimal clinically important difference and substantial clinical benefit thresholds were achieved in 36% to 75% and 29% to 51%, respectively. Ninety-four (64%) patients had\u00a0\u22651 complication (total\u00a0=\u00a0191, 92 minor\/99 major, most common\u00a0=\u00a0rod fracture [13.0%]). Fifty-seven reoperations were performed in 37 (25.3%) patients, with most common indications deep wound infection (11) and rod fracture (10).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION<\/jats:title>\n            <jats:p>Although results demonstrated high rates of complications, operative treatment of adults with severe scoliosis was associated with significant improvements in mean HRQL outcome measures for the study cohort at minimum 2-yr follow-up.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1093\/neuros\/nyab352","type":"journal-article","created":{"date-parts":[[2021,9,8]],"date-time":"2021-09-08T11:41:57Z","timestamp":1631101317000},"page":"1012-1026","source":"Crossref","is-referenced-by-count":6,"title":["Operative Treatment of Severe Scoliosis in Symptomatic Adults: Multicenter Assessment of Outcomes and Complications With Minimum 2-Year Follow-up"],"prefix":"10.1227","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8137-524X","authenticated-orcid":false,"given":"Thomas J","family":"Buell","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia, USA"}]},{"given":"Justin S","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9760-8386","authenticated-orcid":false,"given":"Christopher I","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Duke University Medical Center, Durham, North Carolina, USA"}]},{"given":"Han Jo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hospital for Special Surgery, New York City, New York, USA"}]},{"given":"Eric O","family":"Klineberg","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of California, Davis, California, USA"}]},{"given":"Virginie","family":"Lafage","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hospital for Special Surgery, New York City, New York, USA"}]},{"given":"Renaud","family":"Lafage","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hospital for Special Surgery, New York City, New York, USA"}]},{"given":"Themistocles S","family":"Protopsaltis","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York, USA"}]},{"given":"Peter G","family":"Passias","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York, USA"}]},{"given":"Gregory M","family":"Mundis","sequence":"additional","affiliation":[{"name":"Scripps Clinic and San Diego Center for Spinal Disorders, La Jolla, California, USA"}]},{"given":"Robert K","family":"Eastlack","sequence":"additional","affiliation":[{"name":"Scripps Clinic and San Diego Center for Spinal Disorders, La Jolla, California, USA"}]},{"given":"Vedat","family":"Deviren","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of California, San Francisco, California, USA"}]},{"given":"Michael P","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Washington University, St. Louis, Missouri, USA"}]},{"given":"Alan H","family":"Daniels","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Brown University, Providence, Rhode Island, USA"}]},{"given":"Jeff L","family":"Gum","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Norton Leatherman Spine Center, Louisville, Kentucky, USA"}]},{"given":"Alex","family":"Soroceanu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Calgary, Calgary, AB, Canada"}]},{"given":"D Kojo","family":"Hamilton","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA"}]},{"given":"Munish C","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Washington University, St. Louis, Missouri, USA"}]},{"given":"Douglas C","family":"Burton","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA"}]},{"given":"Richard A","family":"Hostin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Southwest Scoliosis Institute, Baylor Scott and White Medical Center, Plano, Texas, USA"}]},{"given":"Khaled M","family":"Kebaish","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, Maryland, USA"}]},{"given":"Robert A","family":"Hart","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Swedish Neuroscience Institute, Seattle, Washington, USA"}]},{"given":"Frank J","family":"Schwab","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hospital for Special Surgery, New York City, New York, USA"}]},{"given":"Shay","family":"Bess","sequence":"additional","affiliation":[{"name":"Denver International Spine Center, Presbyterian\/St. Luke's Medical Center and Rocky Mountain Hospital for Children, Denver, Colorado, USA"}]},{"given":"Christopher P","family":"Ames","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, California, USA"}]},{"name":"on behalf of The International Spine Study Group 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