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393
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Introduction
Spine surgery
ibrahim.obeid@gmail.com
+33535544142
Clinique du dos
2 Avenue Terrefort
33520 Bruges-Bordeaux
France
Spine and spinal deformity surgery, scoliosis, kyphosis and spinal malalignment, sagittal and coronal imbalance, revision and complex salvage procedures.
Skills and Expertise
Publications
Publications (393)
Study design:
Multicenter, prospective study of consecutive adult spinal deformity (ASD) patients.
Objective:
To Validate Schwab's classification accuracy for surgical indication, and to evaluate a simplified sagittal modifier.
Summary of background data:
The SRS-Schwab Radiologic Classification based on clinical impact parameters, offers 27 d...
Purpose
Ochronotic spondyloarthropathy is an uncommon disease, and its association to sagittal malalignment in the context of a pseudarthrosis has never been described.
Methods
We present the case of a 56-year-old female, who underwent previously L4L5 laminectomy for central canal stenosis and started later on to complain of progressively severe l...
Background:
Mid-term clinical and radiological evaluation of a carbon-fiber cage in multilevel cervical spondylosis (MCS). Anterior cervical corpectomy and fusion (ACCF) using titanium mesh cages (TMC) has shown satisfactory outcomes, but with subsidence of up to 20%. Conventional long-fiber carbon fiber cages have shown a safe profile in discecto...
OBJECTIVE
Achieving high patient satisfaction with management is often one of the goals after adult spinal deformity (ASD) surgery. However, literature on associated factors and their correlations with patient satisfaction is limited. The aim of this study was to determine the clinical and radiographic factors independently correlated with patient...
Study design:
Retrospective analysis of prospectively-collected, multicenter adult spinal deformity (ASD) databases.
Objective:
To predict the likelihood of reaching minimum clinically important differences in patient-reported outcomes after ASD surgery.
Summary of background data:
ASD surgeries are costly procedures that do not always provide...
Purpose
We aimed to develop and internally validate a simple scoring system: the adult spinal deformity (ASD) surgical decision-making (ASD-SDM) score, which is specific to the decision-making process for ASD patients aged below 40 years.
Methods
A multicentre prospective ASD database was retrospectively reviewed. The scoring system was developed...
Purpose:
Firstly, to describe two cases of cerebral ischaemia complicating anterior upper thoracic spinal surgery and define the likely cause of this complication. Secondly, to describe preventative measures and the effect these have had in reducing this complication within our institution.
Methods:
Firstly, a review of two cases of cerebral isc...
Study design:
Case-control study.
Objectives:
To analyse global sagittal alignment including the cranial center of mass (CCOM) and proximal junctional kyphosis (PJK) in adolescent idiopathic scoliosis (AIS) patients treated with posterior instrumentation.
Summary of background data:
PJK plays an important role in the global sagittal alignment...
STUDY DESIGN:
Retrospective review of prospectively-collected, multicenter adult spinal deformity (ASD) databases.
OBJECTIVE:
To apply artificial intelligence (AI)-based hierarchical clustering as a step toward a classification scheme that optimizes overall quality, value, and safety for ASD surgery.
SUMMARY OF BACKGROUND DATA:
Prior ASD classifi...
Purpose
The aim of this study was to evaluate factors that distinguish between patients with adult spinal deformity (ASD) with and without an indication for surgery, irrespective of their final treatment.
Methods
Baseline variables (demographics, medical history, outcome measures, coronal, sagittal and neurologic parameters) were evaluated in a mu...
Introduction
In adult spinal deformity (ASD), sagittal imbalance and sagittal malalignment have been extensively described in the literature during the past decade, whereas coronal imbalance and coronal malalignment (CM) have been given little attention. CM can cause severe impairment in adult scoliosis and ASD patients, as compensatory mechanisms...
Study design:
Retrospective study of prospectively collected data.
Objectives:
The purpose of this study was to evaluate the relationship between apical vertebral axial rotation and pretreatment patient-reported health-related quality of life (HRQOL), disability, and pain in patients with adult degenerative scoliosis (ADS) using a novel radiogra...
Purpose
To investigate the different cervical strategies for maintaining horizontal gaze in asymptomatic subjects.
Methods
One hundred and forty-four asymptomatic adults filled the SF-36 quality of life questionnaire and underwent full-body biplanar radiographs. Chin brow vertical angle (CBVA) and postural and cervical parameters were measured. Su...
OBJECTIVE
The surgical correction of adult spinal deformity (ASD) often involves modifying lumbar lordosis (LL) to restore ideal sagittal alignment. However, corrections that include large changes in LL increase the risk for development of proximal junctional kyphosis (PJK). Little is known about the impact of cranial versus caudal correction in th...
Study design:
Retrospective, longitudinal observational study.
Purpose:
To describe the natural history of anterior bone loss (ABL) in cervical disc arthroplasty (CDA) and introduce a classification system for its assessment.
Overview of literature:
ABL has recently been recognized as a complication of CDA, but its cause and clinical effects r...
Purpose
The impact of deep surgical site infection (SSI) on surgical outcomes after adult spinal deformity (ASD) surgery is still unclear. We aimed to study the morbidity of SSI in ASD and its impact on deformity correction and functional outcome.
Methods
Prospective multicenter matched-cohort study including consecutively enrolled ASD patients. P...
Purpose: Sagittal parameters do not have the same fluctuation and accuracy during adult spinal deformity (ASD) surgery follow-up.The relationship between sagittal radiographic parameters and health related quality of life (HRQoL) scores is well known in ASD. Sagittal vertical axis (SVA) and pelvic tilt (PT) are commonly used. Global tilt (GT) was r...
Hypothesis: Oswestry Disability Index (ODI) globally improves after spinopelvic fusion for adult spinal deformity (ASD), but some ODI domains do not improve. Design: Retrospective analysis of prospective data including operated patients from a multicenter database with a 2-year follow-up. Introduction: Posterior instrumented fusion is a successful...
Purpose:
We aimed to elucidate the factors for the decision-making process in the treatment of adult spinal deformity (ASD), including sagittal parameters, that impact health-related quality of life (HRQOL).
Methods:
A multicenter prospective ASD database was retrospectively reviewed. The demographic data, HRQOL, and radiographic measures were a...
Purpose:
To assess the ability of the recently developed adult spinal deformity frailty index (ASD-FI) to predict odds of perioperative complications, odds of reoperation, and length of hospital stay after adult spinal deformity (ASD) surgery using a database other than the one used to create the index.
Methods:
We used the ASD-FI to calculate f...
Purpose:
The literature shows controversies concerning surgical treatment of Scheuermann's kyphosis between posterior-only fixation and combined anterior/posterior fusion. The aim of this study is to compare the clinical and radiological results and the rate of complications between these two techniques.
Methods:
We performed a multicentric retr...
PurposeGunshot injury to the spine can be devastating, and it has increased in the civilian population during the last decade. Methods
We present the case of a 30-year-old male, who received a bullet in his back after exchange of fire with the police. Initial assessment revealed paraparesis with cerebrospinal fluid leak (CSF) from the bullet entry...
BACKGROUND CONTEXT
Few predictive models allow for proper patient selection, adjustment of invasiveness and patient frailty optimization to predict and reduce postoperative major complications (MC), hospital readmissions (READMIT), and unplanned surgery (UNPLAN).
PURPOSE
The objective of this project is to create accurate predictive models for the...
BACKGROUND CONTEXT
Adult spinal deformity (ASD) surgery is responsible for 6% of all United States (US) healthcare costs. There has been increasing interest in cost prediction for bundled payment models and risk sharing initiatives. Catastrophic cost (CC) outliers are typically excluded in bundled payment settings making their preoperative identifi...
BACKGROUND CONTEXT
Adult spinal deformity (ASD) surgery is costly with variable outcomes; in some series only 50% of patients achieve clinically important (MCID) improvements. Predictive modeling with machine learning is a relatively unexplored area of patient-reported outcomes research. These methods may be useful in shared-decision making, surgic...
BACKGROUND CONTEXT
Adult spinal deformity (ASD) is a highly heterogeneous condition with a broad range of surgical options. Unsupervised machine-based pattern clustering of patient types based on radiographic parameters and quality of life measures alongside combinations of surgical options may simplify ASD patient types, procedures and outcomes. A...
Background context:
Health-related quality of life (HRQOL) parameters has been shown to be reliable and valid in patients with adult spinal deformity (ASD). Minimum clinically important difference (MCID) has become increasingly important to clinicians in evaluating patients with a threshold of improvement that is clinically relevant.
Purpose:
To...
Study design:
Retrospective analysis of data collected prospectively in an adult spine deformity multicenter database.
Objective:
To determine the impact of adult scoliosis (AS) on the type of Roussouly's sagittal shape in terms of classification applicability, scoliosis modification of a patient theoretical sagittal shape, and coronal-sagittal...
Study design:
Inter- and intraobserver reliability study.
Object:
To assess the reliability of a new radiographic classification of degenerative spondylolisthesis of the lumbar spine (DSLS).
Summary of background data:
DSLS is a common cause of chronic low back and leg pain in adults. To this date, there is no consensus for a comprehensive ana...
Purpose:
To understand whether a spondylolisthesis in the sub-axial spine cranial to a cervical disc arthroplasty (CDA) construes a risk of adjacent level disease (ALD).
Methods:
A retrospective review of 164 patients with a minimum 5-year follow-up of a cervical disc arthroplasty was performed. Multi-level surgeries, including hybrid procedures...
OBJECTIVE
The objective of this study was to identify the risk factors of anterior bone loss (ABL) in cervical disc arthroplasty (CDA) and the subsequent effect of this phenomenon.
METHODS
The authors performed a retrospective radiological review of 185 patients with a minimum 5-year follow-up after CDA (using Bryan, Discocerv, Mobi-C, or Baguera...
Study Design
Retrospective review of prospectively collected data from a multicentric database.
Objectives
To determine the clinical impact of diagnosis, age, and gender on treatment outcomes in surgically treated adult spinal deformity (ASD) patients.
Methods
A total of 199 surgical patients with a minimum follow-up of 1 year were included and a...
Purpose:
To assess the efficacy of bisphosphonate therapy in the management of spinal aneurysmal bone cysts (ABCs).
Methods:
A prospective study of six consecutive patients aged between 7 and 22 years with spinal ABCs treated with pamidronate (1 mg/kg) or zoledronate (4 mg). A visual analogue scale (VAS) for pain and radiological (contrast-enhan...
Study design:
This was a retrospective multicentric study.
Objective:
The objective of this study was to determine the different risk factors for development of proximal junctional kyphosis (PJK) in patients with adult scoliosis.
Summary of background data:
This study was conducted as the reasons for development of PJK in adult scoliosis are s...
OBJECTIVE
Previous studies have demonstrated that among patients with adult spinal deformity (ASD), sagittal plane malalignment is poorly tolerated and correlates with suboptimal patient-reported health-related quality of life (HRQOL). These studies included a broad range of radiographic abnormalities and various types of ASD. However, the clinical...
Objective:
The objective of this retrospective study is to identify the best immediate postoperative radiological predictors for the occurrence of proximal junctional kyphosis (PJK). Four proposed methods will be explored.
Methods:
A homogeneous database of adult scoliosis from multiple centers was used. Patients with whole spine X-rays at the r...
Purpose:
Designed for patients with adolescent idiopathic scoliosis, the SRS-22 is now widely used as an outcome instrument in patients with adult spinal deformity (ASD). No studies have confirmed the four-factor structure (pain, function, self-image, mental health) of the SRS-22 in ASD and under different contexts. Factorial invariance of an inst...
Purpose:
To evaluate the radiographic, functional outcomes, complications and surgical specificities of L5 pedicle subtraction osteotomy for fixed sagittal and coronal malalignment.
Methods:
A retrospective cohort of consecutive patients with prospectively collected data. Ten patients who underwent PSO at L5 were eligible for a 2-year minimum fo...
Purpose:
Pedicle Subtraction Osteotomy (PSO) is an effective surgical technique for the correction of fixed sagittal malalignment of the spine. It is a demanding technique that requires a long learning curve. The aim of this study is to analyze a surgeon's learning curve for lumbar PSO in relation to the preoperative, perioperative, and postoperat...
Objectives:
To identify the factors that affect SF-36 mental component summary (MCS) in patients with adult spinal deformity (ASD) at the time of presentation, and to analyse the effect of SF-36 MCS on clinical outcomes in surgically treated patients.
Methods:
Prospectively collected data from a multicentric ASD database was analysed for baselin...
Background context:
Pelvic Tilt (PT) is used as an indicator of pelvic version with increased values indicating retroversion and disability. The concept of using PT solely as an absolute numerical value can be misleading, especially for the patients with Pelvic Incidence (PI) values near the upper and lower normal limits. Relative Pelvic Version (...
Study design:
Multicenter, prospective study of consecutive adult spinal deformity (ASD) patients.
Objective:
To evaluate back and leg pain as a combined score in ASD and compare their relative and cumulative correlations with HRQOL and sagittal parameters.
Summary of background data:
Pain and disability are commonly reported in patients with...
Unfortunately, two author names were missed out in author group of the original publication.
Background:
Three-column osteotomies (3CO) provide substantial correction for adult spinal deformity (ASD), but carry risks of complications and revisions. The risk-benefit balance of 3CO in the elderly remains unclear.
Objective:
To evaluate sagittal alignment and complications after 3CO in a population over 70-yr old.
Methods:
Radiographic r...
OBJECTIVE The subtraction of lumbar lordosis (LL) from the pelvic incidence (PI) offers an estimate of the LL required for a given PI value. Relative LL (RLL) and the lordosis distribution index (LDI) are PI-based individualized measures. RLL quantifies the magnitude of lordosis relative to the ideal lordosis as defined by the magnitude of PI. LDI...
Background:
Identifying the gluteal vessels during a posterior sacrectomy can be challenging. This study defines anatomical landmarks that can be used to approximate the location of the superior and inferior gluteal arteries (SGA and IGA) during a posterior sacrectomy.
Methods:
Cadaveric dissection of six fresh adult pelvises to determine the lo...
Introduction
L’Échelle d’Évaluation Numérique (EEN) lombaire et radiculaire est effectuée en routine clinique. L’évolution des symptômes, notamment après une chirurgie de déformation rachidienne, peut rendre difficile l’interprétation des résultats cliniques et de l’impact réel d’une chirurgie rachidienne. L’objectif de cette étude est d’évaluer l’...
Introduction
La prise de morphiniques avant une chirurgie rachidienne augmente le risque de dépendance aux morphiniques en postopératoire. L’évaluation postopératoire de prise d’antalgiques après une chirurgie de déformation rachidienne de l’adulte n’est pas bien évaluée. L’objectif de cette étude est d’évaluer cette prise d’antalgique avant et apr...
Introduction
La classification SRS-Schwab est une classification validée mais complexe, offrant 27 catégories pour l’analyse de l’équilibre sagittal. Une simplification de cette classification a été proposée en additionnant le nombre de « + » obtenu après mesure de la version pelvienne (VP), de la SVA et de la soustraction de l’incidence pelvienne...
Introduction
L’indication chirurgicale dans les déformations de l’adulte est difficile à poser, car elle concerne une population très hétérogène. L’âge est un paramètre reconnu, mais aucune étude exhaustive incluant l’ensemble des paramètres radioclinique n’est décrite. L’objectif est d’évaluer l’impact des paramètres radio-clinique sur l’indicatio...
Background:
The restoration of normal sagittal alignment is a critical goal in adult spinal deformity surgery to achieve favorable outcomes and prevent mechanical complications. Schwab sagittal modifiers have been accepted as targets for appropriate alignment, but addressing these targets does not always prevent high mechanical complication or rev...
Background Context
Revision surgery represents a major event for patients undergoing adult spinal deformity (ASD) surgery. Previous reports suggest that ASD surgery has minimal or no impact on health-related-quality of life (HRQOL) outcomes.
Purpose
The present study aims to investigate the impact of early reoperations within the first year on HRQ...
Study design:
Retrospective comparative analysis of data collected prospectively in an adult spine deformity (ASD) multicenter database.
Objective:
To evaluate the impact of the iliac screws on the quality of life of ASD patients compared with those instrumented above the pelvis (L5/S1/S2).
Summary of background data:
The impact on patient's d...
OBJECTIVE
Three-column osteotomy (3CO) is a demanding technique that is performed to correct sagittal spinal malalignment. However, the impact of the 3CO level on pelvic or truncal sagittal correction remains unclear. In this study, the authors assessed the impact of 3CO level and postoperative apex of lumbar lordosis on sagittal alignment correcti...
Introduction:
The incidence of pneumocephalus and pneumorrhachis after spinal surgery is unknown, with a paucity of literature on this complication.
Materials and methods:
We present the first published case of delayed onset tension pneumocephalus and pneumorrhachis associated with spinal surgery.
Results:
This complication occurred from a cer...
Epidural caudal steroid injections are commonly used to relieve radicular pains. If minor complications have widely been reported, few major complications have been described. This case presentation reports a cauda equina syndrome following caudal epidural injection. The magnetic resonance imaging (MRI) performed revealed a hematoma inside a caudal...
Purpose:
Chance fracture of the high thoracic spine is rare, and its impact on the adjacent cervical spine can be important.
Methods:
We present the case of a 16-year-old male, who fell down from a 2 m height, in an unknown context as he has a mental retardation, and no witness saw the accident. Initial CT scan revealed a comminuted depressed fr...
Purpose:
To evaluate the association in ASD patients between spinopelvic sagittal parameters and health-related quality of life (HRQL), adjusted for demographic and surgical variables.
Methods:
We constructed multiple linear regression models to investigate pre-operative (PreOp) and 6-month post-operative (PostOp) HRQL as assessed by the Oswestr...
Purpose:
ASD is assessed radiologically with the spinopelvic parameters and clinically with HRQOL scores. The revision rate after ASD surgery is high and usually occurs during the first or second postoperative year. The aim of this study is to find clinical or radiological factors that could predict revision surgery in the second postoperative yea...
BACKGROUND: Thoracic hyperkyphosis can display pathological deterioration, resulting in either hyperlordotic cervical compensation or sagittal malalignment. Various techniques have been described to treat fixed malalignment. Pedicle subtraction osteotomy (PSO) is commonly used in the lumbar spine and frequently limited to the distal thoracic spine....
Background:
In spinal deformity treatment, the increased utilization of 3-column (3CO) osteotomies reflects greater comfort and better training among surgeons. This study aims to evaluate the longitudinal performance and adverse events (complications or revisions) for a multicenter group following a decade of 3CO.
Objectives:
To investigate if p...
Background Context
In 2008, Mirza et al. designed and validated the first and only index capable of quantifying the complexity of spine surgery. However, this index is not fully applicable to adult spinal deformity (ASD) surgery, since it does not include the surgical techniques most commonly used and most strongly associated with perioperative com...
Study design:
Prospective radiographic analysis of cervical spondylotic myelopathy (CSM) OBJECTIVE.: To clarify the pathophysiology of CSM, and use the characteristic of global spinal alignment for determining the surgical strategy.
Summary of background data:
Radiographic evaluation of CSM, in general, comprises cervical magnetic resonance imag...
Background:
Tilt of the first distal uninstrumented vertebra (FDUV) reflects changes in the main curve and compensatory lumbar curve after posterior fusion to treat thoracic adolescent idiopathic scoliosis (AIS).
Hypothesis:
FDUV tilt 5 years or more post-fusiondepends chiefly on reduction of the maincurve and on other factors such as selection...
Objective:
The aim of this study was to analyze the impact of treatment complications on outcomes in adult spinal deformity (ASD) using a decision analysis (DA) model.
Methods:
The study included 535 ASD patients (371 with non-surgical (NS) and 164 with surgical (S) treatment) from an international multicentre database of ASD patients. DA was st...
Introduction:
Surgical treatment of spinal deformity is high risk in patients suffering from Parkinson's disease (PD). Several series have already reported a high rate of complications. However, none of these studies included more than 40 patients and none of the risk factors of complications were described. The aim of this study was to describe t...
Background:
Lumbar spinal stenosis is degenerative disc disease most common manifestation. If stenosis degree seems poorly related to symptom severity, lumbar muscles role is recognized. Many studies report imaging methods, to analyze muscle volumes and fat infiltration (FI), but remain limited due to the difficulty to represent entire muscle volu...