Spino-Pelvic Parameters After Surgery Can be Predicted

Lafage, Virginie; Schwab, Frank J.; Vira, Shaleen; Patel, Ashish; Ungar, Benjamin; Farcy, Jean-Pierre

doi:10.1097/brs.0b013e3181eb9469

Cited by 166 publications

(53 citation statements)

References 16 publications

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“…Reciprocal changes outside of the fused segments have previously been reported for the thoracic, lumbar and pelvic regions [7][8][9][10][11]. It has also been noted that changes in global spinal alignment following surgery affect the alignment of the cervical region [12][13][14][15].…”

Section: Introductionmentioning

confidence: 91%

Cervical spine alignment following lumbar pedicle subtraction osteotomy for sagittal imbalance

Obeid

Boniello²,

Boissière³

et al. 2015

Eur Spine J

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LL restoration decreased the need of compensation at the pelvis and thoracic spine. The distal CL and C7 slope decreased because there was no need for compensation at this level after the surgery, but the proximal cervical spine takes a slightly flexed position to maintain horizontal sight. EAM tilt measures the head position toward C7, and is close to 0° even in severe cases. Changes of this parameter after surgery are insignificant, probably due to the balance between upper and lower cervical segments; when one of these segments shifts backward the other shifts forward and the result is a balanced head over C7.

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Section: Introductionmentioning

confidence: 91%

Cervical spine alignment following lumbar pedicle subtraction osteotomy for sagittal imbalance

Obeid

Boniello²,

Boissière³

et al. 2015

Eur Spine J

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“…Recent research has provided reliable methods to predict the positional parameters PT and SVA from patient's age and morphological parameters (PI, LL, TK), thus permitting a calculation of the adequacy of alignment with the patient in decubitus. This finding is of paramount importance to intraoperatively predict the result of surgery in terms of alignment [10]. Different surgical maneuvers can be used to correct abnormal sagittal alignment.…”

Section: Introductionmentioning

confidence: 99%

Pedicle subtraction osteotomies (PSO) in the lumbar spine for sagittal deformities

Berjano

Aebi

2014

Eur Spine J

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Introduction The narrow correlation between sagittal alignment parameters and clinical outcomes has been widely established, demonstrating that improper sagittal alignment is a clinical condition that is associated with increased pain and limitations in patients' functional ability. Indication Lumbar pedicle subtraction osteotomy (PSO) is indicated in the treatment of large sagittal (more than 25°o f rigid loss of lordosis) deformities of the lumbar spine or its combination with coronal deformity, especially when they are rigid. Indication should be based on careful assessment of the severity of symptoms, functional impairment, functional expectations of the patient, general clinical condition and surgical and anesthesiological team experience. Risk should be carefully assessed and discussed to obtain appropriate informed consent. Surgical procedure Surgical planning includes selection of the safest levels for the upper and lower instrumented vertebra, site of the osteotomy, modality of fixation, and, most importantly angular value of the correction goal (target lumbar lordosis). Failure to adequately obtain the necessary amount of sagittal correction is the most frequent cause of failure and reoperation. Conclusion PSO is a valuable surgical procedure in correction of severe hypolordosis (=relative kyphosis) in the lumbar spine. It is a demanding procedure for the surgeon, the anesthesiologist and the intensive care team. Although its complication rate is high, it has a substantial positive impact in the quality of life of patients, including the elderly.

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“…This applies to the range of spinal pathologies from adolescent deformities, to degenerative pathologies, trauma and complex adult deformity. Additionally, the concepts of spinal alignment are important not only in the diagnosis but also in the treatment of spinal conditions whether using non-operative, minimally invasive or through open surgical procedures [31].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Effect of Posterior Dynamic Stabilization IntraSPIN System on Sagittal Spinal Balance using EOS® X-Ray Imaging System

Bistazzoni¹,

Angelis²,

D’Ercole³

et al. 2017

J Neurol Neurophysiol

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Aim of this prospective study is to assess the effect of posterior dynamic stabilization IntraSPINE system on sagittal spinal balance, using EOS ® X-Ray imaging system. Between March and December 2015, 8 patients affected by lumbar soft stenosis underwent indirect decompression of the lumbar canal by positioning of IntraSPINE ® device. Sagittal balance was evaluated considering following parameters: C7 Plum Line (C7PL), Thoracic Kyphosis (TK), Lumbar Lordosis (LL), Pelvic Tilt (PT), Pelvic Index (PI) and Sacral Slope (SS). The EOS ® 2D/3D system and corresponding sterEOS 3D software for surface 3D reconstruction has been used to calculate the above mentioned parameters. All patients had neurogenic claudication and low back pain for more than 6 months and resistant to drug treatment. They underwent clinical examination before surgery and 1 month after surgery. Statistical analyses were performed using Stata software. All results were considered significant if p<0.05. C7PL, TK, LL, PI and SS were not modified after surgery. PT increased after surgery. VAS, ODI and JOA significantly increased after surgery. The results show that the posterior dynamic stabilization offered by this device leads to a good symptoms control and does not seems to change the sagittal balance.

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Spino-Pelvic Parameters After Surgery Can be Predicted

Cited by 166 publications

References 16 publications

Cervical spine alignment following lumbar pedicle subtraction osteotomy for sagittal imbalance

Cervical spine alignment following lumbar pedicle subtraction osteotomy for sagittal imbalance

Pedicle subtraction osteotomies (PSO) in the lumbar spine for sagittal deformities

Evaluation of Effect of Posterior Dynamic Stabilization IntraSPIN System on Sagittal Spinal Balance using EOS® X-Ray Imaging System

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