T1 Pelvic Angle (TPA) Effectively Evaluates Sagittal Deformity and Assesses Radiographical Surgical Outcomes Longitudinally

Ryan, Devon; Protopsaltis, Themistocles S.; Ames, Christopher P.; Hostin, Richard A.; Klineberg, Eric O.; Mundis, Gregory M.; Obeid, Ibrahim; Kebaish, Khaled M.; Smith, Justin S.; Boachie-Adjei, Oheneba; Burton, Douglas C.; Hart, Robert A.; Gupta, Munish C.; Schwab, Frank J.; Lafage, Virginie

doi:10.1097/brs.0000000000000382

Cited by 123 publications

(93 citation statements)

References 18 publications

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“…This T1PA value accounts for both SVA and pelvic tilt, and according to the several references, this might be reduced to less than 10° in order to achieve optimal surgical outcome both radiologically and clinically811). The representability of T1PA instead of SVA was also reflected in our series; 11° for the normal SVA group and 22° for positive SVA group even after correction.…”

Section: Discussionsupporting

confidence: 63%

Surgical Outcomes of Post-Fusion Lumbar Flatback Deformity with Sagittal Imbalance

Kim

2016

J Korean Neurosurg Soc

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ObjectivesTo review surgical results of post-fusion lumbar flatback treated with pedicle subtraction osteotomy (PSO) or Smith-Petersen osteotomies (SPOs).MethodsTwenty-eight patients underwent osteotomies. Radiological outcomes by sagittal vertical axis (SVA), and pelvic tilt (PT), T1 pelvic angle (T1PA), and pelvic incidence (PI)-lumbar lordosis (LL) at preoperative, postoperative 1 month, and final were evaluated. Oswestry Disability Index (ODI), visual analog scale (VAS) score of back pain/leg pain, and Scoliosis Research Society-22 score (SRS-22r) were analyzed and compared. Patients were divided into 2 groups (SVA ≤5 cm : normal, SVA >5 cm : positive) at final and compared outcomes.ResultsNineteen patients (68%) had PSO and the other 9 patients had SPOs with anterior lumbar interbody fusions (ALIFs) (Mean age : 65 years, follow-up : 31 months). The PT, PI-LL, SVA, T1PA were significantly improved at 1 month and at final (p<0.01). VAS score, ODI, and SRS-22r were also significantly improved at the final (p<0.01). 23 patients were restored with normal SVA and the rest 5 patients demonstrated to positive SVA. SVA and T1PA at 1 month and SVA, PI-LL, and T1PA at final were significantly different (p<0.05) while the ODI, VAS, and SRS-22r did not differ significantly between the groups (p>0.05). Common reoperations were early 4 proximal junctional failures (14%) and late four rod fractures.ConclusionOur results demonstrate that PSO and SPOs with ALIFs at the lower lumbar are significantly improves sagittal balance. For maintenance of normal SVA, PI-LL might be made negative value and T1PA might be less than 11° even though positive SVA group was also significantly improved clinical outcomes.

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Section: Discussionsupporting

confidence: 63%

Surgical Outcomes of Post-Fusion Lumbar Flatback Deformity with Sagittal Imbalance

Kim

2016

J Korean Neurosurg Soc

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“…Another parameter recently described in the literature, and assessing the spinopelvic alignment is the T1 pelvic angle (TPA) [15][16][17]. The latter is defined as the angle between the line from the femoral head axis to the centroid of T1 and the line from the femoral head axis to the middle of the S1 endplate.…”

Section: Discussionmentioning

confidence: 99%

Global tilt: a single parameter incorporating spinal and pelvic sagittal parameters and least affected by patient positioning

Obeid¹,

Boissière²,

Yılgör

et al. 2016

Eur Spine J

113

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“…A systematic review concluded that there was only level IV evidence in support of the effectiveness of physical therapy, chiropractic care, and bracing in the treatment of adult scoliosis patients and level III evidence for steroid injection [66]. The long-term successful rate of conservative treatment of symptomatic adult scoliosis was only 27% [68,69].…”

Section: Treatmentmentioning

confidence: 99%

“…The poor outcomes of the above interventions are not unexpected, as the treatments were directed towards pain relief, but not the deformities and the global imbalance that are causing the symptoms [69]. Treatment approaches that target spinal deformities yielded better results in terms of reduction in pain and disability ratings in ADIS patients [70][71][72][73][74][75][76].…”

Section: Treatmentmentioning

confidence: 99%

Conservative Treatment of Degenerative Lumbar Scoliosis

Ng¹

2021

Spinal Deformities in Adolescents, Adults and Older Adults

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Degenerative lumbar scoliosis (DLS) is commonly seen in people over the age of 50 years. The prevalence increases with age. Patients with DLS often complain of low back pain and radiculopathy. Neurological complaints are rare. Current treatments are generally targeted at pain relief. Effects are temporary; this is understandable as the spinal deformities which are the cause of the pain are not addressed. A few studies have shown that scoliosis specific exercises and lordotic bracing stabilize or reduce the rate of curve progression in patients with DLS. Patients should also be instructed in performing corrective movements in daily activities. In the presence of sarcopenia or decreased bone mineral density (BMD), resistance exercises and nutritional supplements should also be prescribed, as reduction in paraspinal muscle mass and BMD are risk factors of DLS. In the presence of neurological involvement or when the symptoms are refractory to conservative treatment, referral for surgery is required.

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T1 Pelvic Angle (TPA) Effectively Evaluates Sagittal Deformity and Assesses Radiographical Surgical Outcomes Longitudinally

Abstract: 4.

Cited by 123 publications

References 18 publications

Surgical Outcomes of Post-Fusion Lumbar Flatback Deformity with Sagittal Imbalance

Surgical Outcomes of Post-Fusion Lumbar Flatback Deformity with Sagittal Imbalance

Global tilt: a single parameter incorporating spinal and pelvic sagittal parameters and least affected by patient positioning

Conservative Treatment of Degenerative Lumbar Scoliosis

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