Recruitment of Compensatory Mechanisms in Sagittal Spinal Malalignment Is Age and Regional Deformity Dependent

Abstract

3.

Normative values of spino-pelvic sagittal alignment, balance, age, and health-related quality of life in a cohort of healthy adult subjects

“…On the other hand, KneeFlex and AnkleFlex were not significantly correlated with PI-LL (KneeFlex: R = 0.0696, p = 0.4386, AnkleFlex: R = 0.0871, p = 0.3323) ( Table 3), suggesting that pelvic alignment, represented by PT, is the primary mechanism for compensation in cases of spino-pelvic mismatch and the alignment of lower extremities are the last resort to compensate for standing whole skeletal alignment when PT is maximally functioning. These findings are compatible with a recent report [38]. ODI is a principal condition-specific outcome measure used in the management of low back disorders.…”

Spinal sagittal balance status affects postoperative actual falls and quality of life after decompression and fusion in-situ surgery in patients with lumbar spinal stenosis

“…We think this may have been caused by progressive agerelated spinal degeneration resulting to sagittal imbalance rather than as a compensatory mechanism of LSS, as has been shown in other studies. [20,21] There were significant preoperative differences in C7PL, LL, PT and PI-LL between SB and SI groups. Our SI group had similar radiologic parameters of PI-LL mismatch to the 10-30 degree group in Diebo et al's study, [21] who displayed the normal compensatory mechanism of sagittal malalignment without exhaustion.…”

“…[20,21] There were significant preoperative differences in C7PL, LL, PT and PI-LL between SB and SI groups. Our SI group had similar radiologic parameters of PI-LL mismatch to the 10-30 degree group in Diebo et al's study, [21] who displayed the normal compensatory mechanism of sagittal malalignment without exhaustion. The mean value of TK in the SI group was slightly lower than that in the SB group, but without statistical significance.…”

“…This is consistent with a previous study that reported moderate PI-LL mismatch (0-10 degrees and 10-20 degrees) with severe mismatch of 20 degrees; our measured value of PI-LL was approximately 20 degrees. [21] In the other study, PT of 22 degrees or more, SVA of 47 mm or more, and PI-LL of 11 degrees or more with ODI >40 considered threshold or guideline to make therapeutic decision to add corrective surgery for adult spinal deformity. [22] We think our study support the other previous studies but with the unique addition of actual falls and functional mobility tests as a means of evaluating functional outcomes along with QOL, which could be distinguished from other studies mainly focused on the radiologic parameters.…”

Correlation of Cervical Sagittal Alignment Parameters on Full-Length Spine Radiographs Compared with Dedicated Cervical Radiographs

“…Several studies have examined the complexity of adult scoliosis patients, based in part on the interaction of the deformity with the normal aging processes of the spine [2][3][4][5][6][7]. The intersection between degeneration and deformity is most evident in relation to the lumbar spine.…”