title: Three-column osteotomy surgery versus standard surgical management for the correction of adult spinal deformity: a cohort study.
abstract: BACKGROUND
  The aim of this study was to analyze and compare the surgical data, clinical outcomes, and complications between three-column osteotomy (3-COS) and standard surgical management (SSM) for the treatment of adult spine deformity (ASD).
  
  
  METHODS
  A total of 112 patients who underwent consecutive 3-COS (n = 48) and SSM (n = 64) procedures for ASD correction at a single institution from 2001 to 2011 were reviewed in this study. The outcomes were assessed using the Scoliosis Research Society (SRS)-22 scores. The complications of patients with 3-COS and SSM were also compared.
  
  
  RESULTS
  No significant differences were found in patient characteristics between SSM and 3-COS groups. Surgical data and radiographic parameters showed that the patients of the 3-COS group suffered more severe ASD than those of the SSM group. The distribution of surgical complications revealed that SSM group underwent more complications than 3-COS groups with no significant differences. At final follow-up, the total SRS-22 score of SSM was not significant between pre-operation and post-operation. However, the total SRS-22 score of 3-COS at final follow-up was significantly higher than pre-operation.
  
  
  CONCLUSIONS
  For severe ASD patients with high grade pelvic incidence (PI), pelvic tilt (PT), and PI/lumbar lordosis (LL) mismatch and who have subjected to spine surgeries more than twice before, 3-COS might be more effective than SSM in improving the clinical outcomes. However, due to the higher reoperation rate of 3-COS, SSM may be more appropriate than SSM for correcting the not serious ASD patients.
authors: Department of Orthopaedic Surgery, The General Hospital of People's Liberation Army (301 Hospital), 28 Fuxing Road, Wukesong, Beijing, 100000, China. jixinran@gmail.com.|Department of Orthopaedic Surgery, Medical Center, University of California, San Francisco, 500 Parnassus Ave., MU320W, San Francisco, CA, 94143-0728, USA. jixinran@gmail.com.
authors: Xinran
authors: X
authors: Ji
authors: Department of Orthopaedic Surgery, The General Hospital of People's Liberation Army (301 Hospital), 28 Fuxing Road, Wukesong, Beijing, 100000, China. chenhua0270@126.com.
authors: Hua
authors: H
authors: Chen
authors: Department of Orthopaedic Surgery, The General Hospital of People's Liberation Army (301 Hospital), 28 Fuxing Road, Wukesong, Beijing, 100000, China. ylzhang301@163.com.
authors: Yiling
authors: Y
authors: Zhang
authors: Department of Orthopaedic Surgery, The General Hospital of People's Liberation Army (301 Hospital), 28 Fuxing Road, Wukesong, Beijing, 100000, China. zhanglihai74@qq.com.
authors: Lihai
authors: L
authors: Zhang
authors: Department of Orthopaedic Surgery, The General Hospital of People's Liberation Army (301 Hospital), 28 Fuxing Road, Wukesong, Beijing, 100000, China. bszw@hotmail.com.
authors: Wei
authors: W
authors: Zhang
authors: Department of Orthopaedic Surgery, Spine Fellowship and Resident Education Program, University of California, San Francisco, 500 Parnassus Ave., MU320W, San Francisco, CA, 94143-0728, USA. BervenS@orthosurg.ucsf.edu.
authors: Sigurd
authors: S
authors: Berven
authors: Department of Orthopaedic Surgery, The General Hospital of People's Liberation Army (301 Hospital), 28 Fuxing Road, Wukesong, Beijing, 100000, China. ortho301@163.com.
authors: Peifu
authors: P
authors: Tang
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D006801:Humans; D008875:Middle Aged; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D011859:Radiography; D013121:Spinal Curvatures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome
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