From the Spinopelvic Parameters to Global Alignment and Proportion Scores in Adult Spinal Deformity

Abstract

In the last 20 years, sagittal alignment and balance of the spine have become one of the most important issues in the field of spine surgery. Recent studies emphasize that sagittal balance and alignment are more important for health-related quality of life. The understanding of normal and abnormal sagittal alignment of the spine is necessary for the diagnosis and appropriate treatment of adult spinal deformity (ASD), and we will discuss the currently used classification of ASD, the parameters of sagittal alignment that are essential for the diagnosis of spinal deformity, compensatory actions to maintain sagittal balance, and the relationship between sagittal alignment and clinical symptoms. Furthermore, we will also discuss the recently introduced Global Alignment and Proportion scores. The Korean Spinal Deformity Society is publishing a series of review articles on spinal deformities to help spine surgeons better understand spinal deformities.

Alleviation of shoulder injury related to vaccine administration (SIRVA) pain and disability following COVID-19 vaccine with chiropractic biophysics^® (CBP^®) methods: a case report and long-term follow-up with global implications

“…Radiography was critical in the proper diagnosis of the patient. Had the patient not received full spine films, the correct diagnosis and treatment approach could have been altered or missed and this would have likely contributed to worsening of his ASD and could have potentially led to results that likely would not have been as substantial both objectively and subjectively 15,42) . Plain film and digital radiography to determine diagnosis and differential diagnosis is safe, despite the erroneous assumptions in the past that there are dangers [43][44][45] .…”

“…Concomitant conditions can worsen the potential outcome of any treatment and must be correctly diagnosed to best treat the patient 4) . Adult spine deformity (ASD: scoliosis >20°, sagittal vertical axis >5 cm, pelvic tilt >25° (reduced distal lumbar lordosis) or thoracic kyphosis >60°) can cause or complicate neck and shoulder pain and should be addressed by the astute clinician 14,15) . This case demonstrates the dramatic improvement in posture and radiographic measurements as well as the alleviation of mild to severe neck pain and severe shoulder pain after a COVID-19 injection with a shoulder mobility and posture rehabilitation program.…”

Impact of Self-Reported Loss of Balance and Gait Disturbance on Outcomes following Adult Spinal Deformity Surgery

“…Outcomes of interest included the sagittal and coronal alignment parameters and PROMs. Radiological parameters included pelvic tilt (PT), PI-LL, sagittal vertical axis (SVA) T4-T12 kyphosis, T1 pelvic angle (T1PA), Upper Thoracic Cobb Angle, thoracic cobb angle, Thoracolumbar Cobb Angle, Lumbar Cobb Angle, and lumbosacral cobb angle [28,29]. The PROMs collected were the Oswestry disability index (ODI) [30], the SF-36 mental component score (SF-36 MCS), the SF-36 physical component score (SF-36 PCS) [31], and the SRS-22 total and activity, pain, appearance, mental, and satisfaction domain scores [32].…”

Failed back surgery syndrome successfully ameliorated with Chiropractic Biophysics^® structural rehabilitation improving pain, disability as well as sagittal and coronal balance: a Chiropractic Biophysics^® case report with a 6 year follow-up

“…These abnormal loads lead to changes in the tissues that increase degeneration, worsen spine instabilities and increase pain, disabilities and disease and ultimately worsen the burden on global healthcare 12 ) . The reduction of these abnormal loads has been the study of numerous surgical and non-surgical treatment approaches 13 ) . ASD is most common in individuals greater than 60 years; thus, ASD diagnosed in younger patients increases the necessity for rapid treatment to reduce the untoward trajectory associated with the evolution of ASD.…”