{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T06:35:24Z","timestamp":1789799724752,"version":"4.0.1"},"reference-count":36,"publisher":"Asian Spine Journal (ASJ)","issue":"5","license":[{"start":{"date-parts":[[2024,10,22]],"date-time":"2024-10-22T00:00:00Z","timestamp":1729555200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["asianspinejournal.org"],"crossmark-restriction":true},"short-container-title":["Asian Spine J"],"published-print":{"date-parts":[[2024,10,31]]},"abstract":"<jats:p>Study Design: Retrospective cohort study.Purpose: To determine the incidence and success of three-column osteotomies (3COs) performed in primary and revision adult spine deformity (ASD) corrective surgeries.Overview of Literature: 3COs are often required to correct severe, rigid ASD presentations. However, controversy remains on the utility of 3COs, particularly in primary surgery.Methods: Patients ASD having 2-year data were included and divided into 3CO and non-3CO (remaining ASD cohort) groups. For the subanalysis, patients were stratified based on whether they were undergoing primary (P3CO) or revision (R3CO) surgery. Multivariate analysis controlling for age, Charlson comorbidity index, body mass index, baseline pelvic incidence\u2013lumbar lordosis, and fused levels evaluated the complication rates and radiographic and patient-reported outcomes between the 3CO and non-3CO groups.Results: Of the 436 patients included, 20% had 3COs. 3COs were performed in 16% of P3COs and 51% of R3COs. Both 3CO groups had greater severity in deformity and disability at baseline; however, only R3COs improved more than non-3COs. Despite greater segmental correction, 3COs had much lower rates of aligning in the lumbar distribution index (LDI), higher mechanical complications, and more reoperations when performed below L3. When comparing P3COs and R3COs, baseline lumbopelvic and global alignments, as well as disability, were different. The R3CO group had greater clinical improvements and global correction (both p&lt;0.04), although the P3CO group achieved alignment in LDI more often (odds ratio, 3.9; 95% confidence interval, 1.3\u20136.2; p=0.006). The P3CO group had more neurological complications (30% vs. 13%, p=0.042), whereas the R3CO tended to have higher mechanical complication rates (25% vs. 15%, p=0.2).Conclusions: 3COs showed greater improvements in realignment while failing to demonstrate the same clinical improvement as primaries without a 3CO. Overall, when suitably indicated, a 3CO offers superior utility for achieving optimal realignment across primary and revision surgeries for ASD correction.<\/jats:p>","DOI":"10.31616\/asj.2023.0388","type":"journal-article","created":{"date-parts":[[2024,10,22]],"date-time":"2024-10-22T04:12:39Z","timestamp":1729570359000},"page":"673-680","update-policy":"https:\/\/doi.org\/10.31616\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Determining the utility of three-column osteotomies in revision surgery compared with primary surgeries in the thoracolumbar spine: a retrospective cohort study in the United States"],"prefix":"10.31616","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2584-291X","authenticated-orcid":true,"given":"Tyler Kade","family":"Williamson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7488-3227","authenticated-orcid":true,"given":"Oluwatobi O","family":"Onafowokan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4340-7524","authenticated-orcid":true,"given":"Ankita","family":"Das","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3032-3225","authenticated-orcid":true,"given":"Jamshaid Mahmood","family":"Mir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7839-0032","authenticated-orcid":true,"given":"Oscar","family":"Krol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0580-5129","authenticated-orcid":true,"given":"Peter","family":"Tretiakov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1985-7093","authenticated-orcid":true,"given":"Rachel","family":"Joujon-Roche","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bailey","family":"Imbo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salman","family":"Ahmad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9451-4103","authenticated-orcid":true,"given":"Stephane","family":"Owusu-Sarpong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0932-8195","authenticated-orcid":true,"given":"Jordan","family":"Lebovic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6966-3270","authenticated-orcid":true,"given":"Shaleen","family":"Vira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3691-1215","authenticated-orcid":true,"given":"Andrew J","family":"Schoenfeld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7948-0232","authenticated-orcid":true,"given":"Muhammad Burhan","family":"Janjua","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7835-2263","authenticated-orcid":true,"given":"Bassel","family":"Diebo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4820-1835","authenticated-orcid":true,"given":"Renaud","family":"Lafage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0119-7111","authenticated-orcid":true,"given":"Virginie","family":"Lafage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1479-4070","authenticated-orcid":true,"given":"Peter Gust","family":"Passias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16744","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.22603\/ssrr.2017-0100"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1177\/2192568217699203"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.31616\/asj.2022.0376"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000188190.90034.be"},{"key":"ref5","first-page":"958","volume-title":"Short-term morbidity and mortality associated with correction of thoracolumbar fixed sagittal plane deformity: a report from the Scoliosis Research Society Morbidity and Mortality Committee","author":"Smith","year":"2011"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1227\/01.neu.0000320429.32113.85"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1227\/neu.0000000000000182o"},{"key":"ref8","first-page":"1895","volume-title":"Three-column osteotomy in adult spinal deformity: an analysis of temporal trends in usage and outcomes","author":"Passias","year":"2022"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.3171\/2009.12.focus09254"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0000000000000156"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.rboe.2017.03.016"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0000000000004342"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.31616\/asj.2018.0077"},{"key":"ref14","first-page":"218","volume-title":"Validation of a tool to measure pelvic and spinal parameters of sagittal balance","author":"Rillardon","year":"2003"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-005-0927-1"},{"key":"ref16","volume-title":"","author":"O\u2019Brien","year":"2008"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0000000000002146"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.14444\/6028"},{"key":"ref19","first-page":"1661","volume-title":"Global alignment and proportion (GAP) score: development and validation of a new method of analyzing spinopelvic alignment to predict mechanical complications after adult spinal deformity surgery","author":"Yilgor","year":"2017"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-024-08135-7"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-023-07593-9"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.3171\/2024.1.spine23802"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0b013e3182059bfd"},{"key":"ref24","first-page":"693","volume-title":"Complications and risk factors of primary adult scoliosis surgery: a multicenter study of 306 patients","author":"Charosky","year":"2012"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-012-2370-4"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2019.07.004"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.3171\/2014.2.focus1419"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.3171\/2016.10.spine16849"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0b013e31824fffde"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.3171\/2017.6.spine17357"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.3171\/2009.12.focus09259"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.3171\/foc.2003.15.3.1"},{"key":"ref33","first-page":"556","volume-title":"Rates of infection after spine surgery based on 108,419 procedures: a report from the Scoliosis Research Society Morbidity and Mortality Committee","author":"Smith","year":"2011"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.21037\/jss.2018.05.06"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1016\/j.jspd.2014.06.001"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.14245\/ns.2142470.235"}],"container-title":["Asian Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/asianspinejournal.org\/upload\/pdf\/asj-2023-0388.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/asianspinejournal.org\/journal\/view.php?doi=10.31616\/asj.2023.0388","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/asianspinejournal.org\/upload\/pdf\/asj-2023-0388.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,31]],"date-time":"2024-10-31T04:10:02Z","timestamp":1730347802000},"score":1,"resource":{"primary":{"URL":"http:\/\/asianspinejournal.org\/journal\/view.php?doi=10.31616\/asj.2023.0388"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,31]]},"references-count":36,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,10]]}},"URL":"https:\/\/doi.org\/10.31616\/asj.2023.0388","relation":{},"ISSN":["1976-1902","1976-7846"],"issn-type":[{"value":"1976-1902","type":"print"},{"value":"1976-7846","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,31]]},"assertion":[{"value":"2023-11-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-22","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-31","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}