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Research

Overview & History

We believe in continuously searching for the source/cause of scoliosis. To date, scientist have learned that scoliosis is a polygenetic, inheritable disorder that affects collagen in a way that allows for progressive curvature.  Our team at SWSI continues to conduct numerous studies regarding spine disorders, both physically and economically. We ask each of our patients to participate and keep track of why they initially came to see us, the symptoms they present with, what we did to help alleviate their pain, and how they are doing years after surgery.

We are also a member of the Scoliosis Research Society (SRS). “This society is an international society that was founded in 1966 with 35 members. It has gained recognition as one of the world’s premier spine societies. The SRS has maintained a commitment to research and education in the field of spinal deformities. Strict membership criteria ensure that the individual Fellows support that commitment. Current membership includes over 1,000 of the world’s leading spine surgeons, researchers, physician assistants and orthotists who are involved in research and treatment of spinal deformities.” http://www.srs.org

With our own team we and our study groups the goal is To learn more about scoliosis, by studying heredity, growth, structural and biochemical changes in disks and muscles, and track changes in the nervous system. Scientists now believe that the changes seen in disks and muscles are a consequence of the disease and not the reason for the disease. Research is also under way to determine the effectiveness of various treatments by understanding the outcomes.

Listing of current and past Research studies, articles and abstracts

Title Authors Journal Information
Analysis of Health Related Quality of Life Improvements among Patients with Adult Spinal Deformity Michael O’Brien, MD, Richard Hostin, MD, Ian McCarthy, PhD, Neil Fleming, PhD, Gerald Ogola, MS, Rustam Kudyakov, MD, MPH, Kathleen Richter, MS, Rajiv Saigal, MD, PhD, Sigurd Berven, MD, Vedat Deviren, MD, Christopher P. Ames, MD Spine J. 2012 Sep;12(9):S133
Analysis of the Direct Cost of Surgery for Four Diagnostic Categories of Adult Spinal Deformity McCarthy IM, Hostin RA, O’Brien MF, Fleming NS, Ogola G, Kudyakov R, Richter KM, Saigal R, Berven SH, Ames CP; International Spine Study Group. Spine J. 2013 Dec;13(12):1843-8.
Cost-Effectiveness of Surgical Treatment for Adult Spinal Deformity: A Comparison of Dollars per Quality of Life Improvement across Health Domains Ian McCarthy, PhD, Richard Hostin, MD, Michael O’Brien, MD, Neil Fleming, PhD, Gerald Ogola, PhD, Rustam Kudyakov, MD, MPH, Kathleen Richter, MS, MFA, Rajiv Saigal, MD, Sigurd Berven, MD, Vedat Deviren, MD, Christopher Ames, MD, International Spine Study Groupe Spine Deformity.2013 Jul; 1(4):293-298
Detection of Pseudarthrosis in Adult Spinal Deformity: The use of health-related quality-of-life outcomes to predict pseudarthrosis Klineberg E, Gupta M, McCarthy I, Hostin R. J Spinal Disord Tech. 2013 Dec 11.
Health Economic Analysis of Adult Deformity Surgery McCarthy I, Hostin R, O’Brien M, Saigal R, Ames CP. Neurosurg Clin N Am. 2013 Apr;24(2):293-304.
Identification of Decision Criteria for Revision Surgery among Patients with Proximal Junctional Failure following Surgical Treatment for Spinal Deformity. Hart R, McCarthy I, Oʼbrien M, Bess S, Line B, Adjei OB, Burton D, Gupta M, Ames C, Deviren V, Kebaish K, Shaffrey C, Wood K, Hostin R; International Spine Study Group. Spine (Phila Pa 1976). 2013 Jun 17.
Incidence, Mode, and Location of Acute Proximal Junctional Failures Following Surgical Treatment for Adult Spinal Deformity Hostin R, McCarthy I, O’Brien M, Bess S, Line B, Boachie-Adjei O, Burton D, Gupta M, Ames C, Deviren V, Kebaish K, Shaffrey C, Wood K, Hart R; International Spine Study Group. Spine (Phila Pa 1976). 2012 Sep 13
Incremental Cost-Effectiveness of Adult Spinal Deformity Surgery: Observed QALYs with Surgery Compared to Predicted QALYs without Surgery McCarthy I, O’Brien M, Ames C, Robinson C, Errico T, Polly DW Jr, Hostin R; International Spine Study Group. JNS Focus. 2014 May
Proximal junctional kyphosis and proximal junctional failure. Hart RA, McCarthy I, Ames CP, Shaffrey CI, Hamilton DK, Hostin R. Neurosurg Clin N Am. 2013 Apr;24(2):213-8
Retrospective Study of Anterior Interbody Fusion Rates and Patient Outcomes of Using Mineralized Collagen and Bone Marrow Aspirate in Multilevel Adult Spinal Deformity Surgery Hostin R, O’Brien M, McCarthy I, Bess S, Gupta M, Klineberg E; International Spine Study Group, Denver, CO. J Spinal Disord Tech. 2013 Nov 6.
Risk Factors for Major Peri-Operative Complications in Adult Spinal Deformity Surgery Schwab FJ, Hawkinson N, Lafage V, Smith JS, Hart R, Mundis G, Burton DC, Line B, Akbarnia B, Boachie-Adjei O, Hostin R, Shaffrey CI, Arlet V, Wood K, Gupta M, Bess S, Mummaneni PV; International Spine Study Group. Eur Spine J. 2012 Dec;21(12):2603-10.
Total Costs of Multilevel Fusion Surgery Including Outpatient Care Ian McCarthy,PhD; Chessie Robinson, MA; Michael O’Brien, MD; Richard Hostin, MD. SpineLine. 2014 May/June 15(3)
Total Hospital Costs of Surgical Treatment for Adult Spinal Deformity: An Extended Follow-up Study McCarthy IM, Hostin RA, Ames CP, Kim HJ, Smith JS, Boachie-Adjei O, Schwab FJ, Klineberg EO, Shaffrey CI, Gupta MC, Polly DW; International Spine Study Group. Spine J. 2014 Jan 24
A standardized nomenclature for cervical spine soft-tissue release and osteotomy for deformity correction. Ames CP, Smith JS, Scheer JK, Shaffrey CI, Lafage V, Deviren V, Moal B, Protopsaltis T, Mummaneni PV, Mundis GM Jr, Hostin R, Klineberg E, Burton DC, Hart R, Bess S, Schwab FJ; International Spine Study Group. J Neurosurg Spine. 2013 Jul 5. [Epub ahead of print]
Acute Reciprocal Changes Distant from the Site of Spinal Osteotomies Affect Global Postoperative Alignment Klineberg E, Schwab F, Ames C, Hostin R, Bess S, Smith JS, Gupta MC, Boachie O, Hart RA, Akbarnia BA, Burton DC, Lafage V. Adv Orthop. 2011;2011:415946.
Change in Classification Grade by the SRS-Schwab Adult Spinal Deformity Classification Predicts Impact on Health-Related Quality of Life Measures: Prospective Analysis of Operative and Non-operative Treatment. Smith JS, Klineberg E, Schwab F, Shaffrey CI, Moal B, Ames CP, Hostin R, Fu KM, Burton D, Akbarnia B, Gupta M, Hart R, Bess S, Lafage V; International Spine Study Group. Spine (Phila Pa 1976). 2013 Jun 11. [Epub ahead of print]
Changes in Thoracic Kyphosis Negatively Impact Sagittal Alignment After Lumbar Pedicle Subtraction Osteotomy: A Comprehensive Radiographic Analysis Lafage V, Ames C, Schwab F, Klineberg E, Akbarnia B, Smith J, Boachie-Adjei O, Burton D, Hart R, Hostin R, Shaffrey C, Wood K, Bess S; International Spine Study Group. Spine 2012 Feb 1;37(3):E180-7.
Chapter 22: Complications in Surgery for Spinal Deformity Newton, Peter O., and Michael F. O’Brien, eds. Idiopathic Scoliosis: The Harms Study Group Treatment Guide. Thieme. 2010
Clinical improvement through nonoperative treatment of adult spinal deformity: who is likely to benefit? Slobodyanyuk K, Poorman CE, Smith JS, Protopsaltis TS, Hostin R, Bess S, Mundis GM Jr, Schwab FJ, Lafage V; International Spine Study Group. Neurosurg Focus. 2014 May;36(5):E2. doi: 10.3171/2014.3.FOCUS1426.
Comparison of Patient and Surgeon Perceptions of Adverse Events Following Adult Spinal Deformity Surgery Hart RA, Cabalo A, Bess S, Akbarnia BA, Boachie-Adjei O, Burton D, Cunningham ME, Gupta M, Hostin R, Kebaish K, Klineberg E, Mundis G, Shaffrey C, Smith JS, Wood K; International Spine Study Group. Spine (Phila Pa 1976). 2012 Nov 2. [Epub ahead of print]
Complications and intercenter variability of three-column osteotomies for spinal deformity surgery: a retrospective review of 423 patients. Bianco K, Norton R, Schwab F, Smith JS, Klineberg E, Obeid I, Mundis G Jr, Shaffrey CI, Kebaish K, Hostin R, Hart R, Gupta MC, Burton D, Ames C, Boachie-Adjei O, Protopsaltis TS, Lafage V; International Spine Study Group. Neurosurg Focus. 2014 May;36(5):E18. doi: 10.3171/2014.2.FOCUS1422.
Does vertebral level of Pedicle Subtraction Osteotomy correlate with degree of spino-pelvic parameter correction? Lafage V, Schwab F, Vira S, Hart R, Burton D, Smith JS, Boachie-Adjei O, Shelokov A, Hostin R, Shaffrey CI, Gupta M, Akbarnia BA, Bess S, Farcy JP. J Neurosurg Spine. 2011 Feb;14(2):184-91. Epub 2010 Dec 24.
Does recombinant human bone morphogenetic protein-2 use in adult spinal deformity increase complications and are complications associated with location of rhBMP-2 use? A prospective, multicenter study of 279 consecutive patients. Bess S, Line BG, Lafage V, Schwab F, Shaffrey CI, Hart RA, Boachie-Adjei O, Akbarnia BA, Ames CP, Burton DC, Deverin V, Fu KM, Gupta M, Hostin R, Kebaish K, Klineberg E, Mundis G, O’Brien M, Shelokov A, Smith JS; International Spine Study Group ISSG. Spine (Phila Pa 1976). 2014 Feb 1;39(3):233-42. doi: 10.1097/BRS.0000000000000104.
Dynamic changes of the pelvis and spine are key to predicting postoperative sagittal alginment after pedicle subtraction osteotomy: a critical analysis of preoperative planning techniques Smith JS, Bess S, Shaffrey CI, Burton DC, Hart RA, Hostin R, Klineberg E; International Spine Study Group. Spine (Phila Pa 1976). 2012 May 1;37(10):845-53
Efficacy of Hemivertebra Resection for Congenital Scoliosis:a multicenter retrospective comparison of three surgical techniques. Yaszay, Burt MD; O’Brien, Michael MD; Shufflebarger, Harry L. MD; Betz, Randal R. MD; Lonner, Baron MD; Shah, Suken A. MD; Boachie-Adjei, Oheneba MD; Crawford, Alvin MD; Letko, Lynn MD; Harms, Jurgen MD; Gupta, Munish C. MD; Sponseller, Paul D. MD; Abel, Mark F. MD; Flynn, John MD; Macagno, Angel MD; Newton, Peter O. MD Spine (Phila Pa 1976). 2011 Nov 15;36(24):2052-60.
Impact of age on the likelihood of reaching a minimum clinically important difference in 374 three-column spinal osteotomies: clinical article. Scheer JK, Lafage V, Smith JS, Deviren V, Hostin R, McCarthy IM, Mundis GM, Burton DC, Klineberg E, Gupta MC, Kebaish KM, Shaffrey CI, Bess S, Schwab F, Ames CP; International Spine Study Group. J Neurosurg Spine. 2014 Mar;20(3):306-12. doi: 10.3171/2013.12.SPINE13680. Epub 2014 Jan 3.
Likelihood of reaching minimal clinically important difference in adult spinal deformity: a comparison of operative and nonoperative treatment. Liu S, Schwab F, Smith JS, Klineberg E, Ames CP, Mundis G, Hostin R, Kebaish K, Deviren V, Gupta M, Boachie-Adjei O, Hart RA, Bess S, Lafage V. Ochsner J. 2014 Spring;14(1):67-77.
Maintenance of radiographic correction at 2 years following lumbar pedicle subtraction osteotomy is superior with upper thoracic compared with thoracolumbar junction upper instrumented vertebra. Scheer JK, Lafage V, Smith JS, Deviren V, Hostin R, McCarthy IM, Mundis GM, Burton DC, Klineberg E, Gupta M, Kebaish K, Shaffrey CI, Bess S, Schwab F, Ames CP; International Spine Study Group (ISSG). Eur Spine J. 2014 Jun 1. [Epub ahead of print]
Multicenter validation of a formula predicting postoperative spinopelvic alignment. Lafage V, Bharucha NJ, Schwab F, Hart RA, Burton D, Boachie-Adjei O, Smith JS, Hostin R, Shaffrey C, Gupta M, Akbarnia BA, Bess S. J Neurosurg Spine. 2012 Jan;16(1):15-21. Epub 2011 Sep 23
Outcomes and Complications of Extension of Previous Long Fusion to the Sacro-Pelvis: Does Surgical Approach Make a Difference? Fu KM, Smith JS, Burton DC, Shaffrey CI, Boachie-Adjei O, Carlson B, Schwab FJ, Lafage V, Hostin R, Bess S, Akbarnia BA, Mundis G, Klineberg E, Gupta M; International Spine Study Group. World Neurosurg. 2013 Jan;79(1):177-81.
Patients with adult spinal deformity treated operatively report greater baseline pain and disability than patients treated nonoperatively; however, deformities differ between age groups. Fu KM, Bess S, Shaffrey CI, Smith JS, Lafage V, Schwab F, Burton DC, Akbarnia BA, Ames CP, Boachie-Adjei O, Deverin V, Hart RA, Hostin R, Klineberg E, Gupta M, Kebaish K, Mundis G, Mummaneni PV; International Spine Study Group. Spine (Phila Pa 1976). 2014 Aug 1;39(17):1401-7. doi: 10.1097/BRS.0000000000000414.
Prevalence and type of cervical deformity among 470 adults with thoracolumbar deformity. Smith JS, Lafage V, Schwab FJ, Shaffrey CI, Protopsaltis T, Klineberg E, Gupta M, Scheer JK, Fu KM, Mundis G, Hostin R, Deviren V, Hart R, Burton DC, Bess S, Ames CP; International Spine Study Group. Spine (Phila Pa 1976). 2014 Aug 1;39(17):E1001-9. doi: 10.1097/BRS.0000000000000432.
Pain and disability determine treatment modality for older patients with adult scoliosis, while deformity guides treatment for younger patients. Bess S, Boachie-Adjei O, Burton D, Cunningham M, Shaffrey C, Shelokov A, Hostin R, Schwab F, Wood K, Akbarnia B; International Spine Study Group. Spine (Phila Pa 1976). 2009 Sep 15;34(20):2186-90
Prospective multicenter assessment of risk factors for rod fracture following surgery for adult spinal deformity. Smith JS, Shaffrey E, Klineberg E, Shaffrey CI, Lafage V, Schwab FJ, Protopsaltis T, Scheer JK, Mundis GM Jr, Fu KM, Gupta MC, Hostin R, Deviren V, Kebaish K, Hart R, Burton DC, Line B, Bess S, Ames CP; International Spine Study Group. J Neurosurg Spine. 2014 Dec;21(6):994-1003. doi: 10.3171/2014.9.SPINE131176. Epub 2014 Oct 17.
Radiographic Spino-pelvic Parameters and Disability in the Setting of Adult Spinal Deformity: A Prospective Multicenter Analysis. Schwab FJ, Blondel B, Bess S, Hostin R, Shaffrey CI, Smith JS, Boachie-Adjei O, Burton DC, Akbarnia BA, Mundis GM, Ames CP, Kebaish K, Hart RA, Farcy JP, Lafage V; International Spine Study Group (ISSG). Spine (Phila Pa 1976). 2013 Mar 25. [Epub ahead of print]
Reoperation Rates and Impact on Outcome in a Large Prospective Multicenter Adult Spinal Deformity Database Scheer JK, Tang JA, Smith JS, Klineberg E, Hart RA, Mundis GM Jr, Burton DC, Hostin R, O’Brien MF, Bess S, Kebaish KM, Deviren V, Lafage V, Schwab F, Shaffrey CI, Ames CP; International Spine Study Group. J Neurosurg Spine. 2013 Aug 23. [Epub ahead of print]
Revision extension to the pelvis versus primary spinopelvic instrumentation in adult deformity: comparison of clinical outcomes and complications. Fu KM, Smith JS, Burton DC, Kebaish KM, Shaffrey CI, Schwab F, Lafage V, Arlet V, Hostin R, Boachie O, Akbarnia B, Bess S; International Spine Study Group. World Neurosurg. 2014 Sep-Oct;82(3-4):e547-52. doi: 10.1016/j.wneu.2013.02.059. Epub 2013 Feb 21. Review.
Revision Surgery After Three-Column Osteotomy in 335 Adult Spinal Deformity Patients: Inter-Center Variability and Risk Factors. Maier S, Smith JS, Schwab F, Obeid I, Mundis G, Klineberg E, Hostin R, Hart R, Burton D, Boachie-Adjei O, Gupta M, Ames C, Protopsaltis T, Lafage V, International Spine Study Group. Spine (Phila Pa 1976). 2014 Feb 27. [Epub ahead of print]
Sagittal realignment failures following pedicle subtraction osteotomy surgery: are we doing enough? Schwab FJ, Patel A, Shaffrey CI, Smith JS, Farcy JP, Boachie-Adjei O, Hostin RA, Hart RA, Akbarnia BA, Burton DC, Bess S, Lafage V. J Neurosurg Spine. 2012 Jun;16(6):539-46. Epub 2012 Mar 30.
Sagittal spino-pelvic alignment failures following three column thoracic osteotomy for adult spinal deformity. Lafage V, Smith JS, Bess S, Schwab FJ, Ames CP, Klineberg E, Arlet V, Hostin R, Burton DC, Shaffrey CI; International Spine Study Group. Eur Spine J. 2012 Apr;21(4):698-704. Epub 2011 Aug 12.
Spondylolisthesis, Pelvic Incidence, and Spinopelvic Balance Labelle, Hubert MD; Roussouly, Pierre MD; Berthonnaud, Éric PhD; Transfeldt, Ensor MD; O’Brien, Michael MD; Chopin, Daniel MD; Hresko, Timothy MD; Dimnet, Joannes PhD Spine (Phila Pa 1976). 2004 Sep 15;29(18):2049-54.
Surgical treatment of pathological loss of lumbar lordosis (flatback) in patients with normal sagittal vertical axis achieves similar clinical improvement as surgical treatment of elevated sagittal vertical axis: clinical article. Smith JS, Singh M, Klineberg E, Shaffrey CI, Lafage V, Schwab FJ, Protopsaltis T, Ibrahimi D, Scheer JK, Mundis G Jr, Gupta MC, Hostin R, Deviren V, Kebaish K, Hart R, Burton DC, Bess S, Ames CP; International Spine Study Group. J Neurosurg Spine. 2014 Aug;21(2):160-70. doi: 10.3171/2014.3.SPINE13580. Epub 2014 Apr 25.
Surgical Treatment of Lenke 1 Main Thoracic Idiopathic Scoliosis? Results of a Prospective, Multi-Center Study Newton PO, Marks MC, Bastrom TP, Betz R, Clements D, Lonner B, Crawford A, Shufflebarger H, OʼBrien M, Yaszay B; Harms Study Group. Spine (Phila Pa 1976). 2013 Feb 15;38(4):328-38.
Spontaneous improvement of cervical alignment after correction of global sagittal balance following pedicle subtraction osteotomy. Smith JS, Shaffrey CI, Lafage V, Blondel B, Schwab F, Hostin R, Hart R, O’Shaughnessy B, Bess S, Hu SS, Deviren V, Ames CP; International Spine Study Group. J Neurosurg Spine. 2012 Oct;17(4):300-7. doi: 10.3171/2012.6.SPINE1250. Epub 2012 Aug 3.
T1 pelvic angle (TPA) effectively evaluates sagittal deformity and assesses radiographical surgical outcomes longitudinally. Ryan DJ, Protopsaltis TS, Ames CP, Hostin R, Klineberg E, Mundis GM, Obeid I, Kebaish K, Smith JS, Boachie-Adjei O, Burton DC, Hart RA, Gupta M, Schwab FJ, Lafage V; International Spine Study Group. Spine (Phila Pa 1976). 2014 Jul 1;39(15):1203-10. doi: 10.1097/BRS.0000000000000382.
TheT1 pelvic angle, a novel radiographic measure of global sagittal deformity, accounts for both spinal inclination and pelvic tilt and correlates with health-related quality of life. Protopsaltis T, Schwab F, Bronsard N, Smith JS, Klineberg E, Mundis G, Ryan DJ, Hostin R, Hart R, Burton D, Ames C, Shaffrey C, Bess S, Errico T, Lafage V; International Spine Study Group. J Bone Joint Surg Am. 2014 Oct 1;96(19):1631-40. doi: 10.2106/JBJS.M.01459.
The SRS-Schwab Adult Spinal Deformity Classification: Assessment and Clinical Correlations Based on a Prospective Operative and Nonoperative Cohort. Terran J, Schwab F, Shaffrey CI, Smith JS, Devos P, Ames CP, Fu KM, Burton D, Hostin R, Klineberg E, Gupta M, Deviren V, Mundis G, Hart R, Bess S, Lafage V; International Spine Study Group. Neurosurgery. 2013 Jun 14. [Epub ahead of print]
Upper thoracic versus lower thoracic upper instrumented vertebrae endpoints have similar outcomes and complications in adult scoliosis. Kim HJ, Boachie-Adjei O, Shaffrey CI, Schwab F, Lafage V, Bess S, Gupta MC, Smith JS, Deviren V, Akbarnia B, Mundis GM, OʼBrien M, Hostin R, Ames C; International Spine Study Group. Spine (Phila Pa 1976). 2014 Jun 1;39(13):E795-9. doi: 10.1097/BRS.0000000000000339.