scholarly journals Surgical correction for adult spinal deformity increases acetabular lateral coverage of femoral heads

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Qiang Luo ◽  
Yong-Chan Kim ◽  
Ki-Tack Kim ◽  
Kee-Yong Ha ◽  
Young-Soo Chun ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Pelvic Tilt ◽  
Adult Spinal Deformity ◽  
Linear Regression Analysis ◽  
Surgical Correction ◽  
Acetabular Coverage ◽  
Acetabular Orientation ◽  
Bivariate Correlation ◽  
Postoperative Changes ◽  
The Relationship

Abstract Background Studies explaining the relationship between hip and spine reported that spinal corrective surgery affected acetabular orientation and changes in pelvic tilt were capable of influencing radiographic measures of acetabular coverage. This study aimed to assess the change in coronal parameters for acetabular coverage as a result of adult spinal deformity (ASD) correction and to analyze the relationship between the postoperative changes in sagittal spinopelvic parameters and coronal acetabular coverage parameters. Methods Fifty-two consecutive patients who had undergone multilevel spinal surgical correction were enrolled and evaluated. Coronal acetabular coverage parameters included Tönnis angle (TA), lateral center edge angle (LCEA), and the angle of Sharp (SA). All radiographic parameters were evaluated at the preoperative and the postoperative 1 year. Paired t test was used to determine whether there were significant changes between the time points. Bivariate correlation and linear regression analysis were used to assess the relationship between the postoperative changes of spinal alignment and acetabular orientation. Results The surgical correction resulted in significant decrease of TA, increase of LCEA and SA, respectively (p < 0.001). The changes in pelvic tilt (PT) demonstrated weak correlation on TA (β = 0.117, p < 0.001 for right; β = 0.111, p < 0.001 for left). Conclusions Although the surgical correction of ASD significantly changed PT resulting in increased acetabular lateral coverage parameters, the correlation between the changes of PT following sagittal correction of ASD and acetabular coverage parameters was low. Trial registration This study was retrospectively registered with approval by the institutional review board (IRB) of our institution (approval number: KHNMC-2020-10-010).

Spontaneous improvement of cervical alignment after correction of global sagittal balance following pedicle subtraction osteotomy

2012 ◽  
Vol 17 (4) ◽  
pp. 300-307 ◽  
Author(s):  
Justin S. Smith ◽  
Christopher I. Shaffrey ◽  
Virginie Lafage ◽  
Benjamin Blondel ◽  
Frank Schwab ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Linear Regression Analysis ◽  
Pedicle Subtraction Osteotomy ◽  
Surgical Correction ◽  
Plumb Line ◽  
Multivariate Linear Regression Analysis ◽  
Cervical Lordosis ◽  
Sagittal Malalignment

Object Sagittal spinopelvic malalignment is a significant cause of pain and disability in patients with adult spinal deformity. Surgical correction of spinopelvic malalignment can result in compensatory changes in spinal alignment outside of the fused spinal segments. These compensatory changes, termed reciprocal changes, have been defined for thoracic and lumbar regions but not for the cervical spine. The object of this study was to evaluate postoperative reciprocal changes within the cervical spine following lumbar pedicle subtraction osteotomy (PSO). Methods This was a multicenter retrospective radiographic analysis of patients from International Spine Study Group centers. Inclusion criteria were as follows: adults (>18 years old) with spinal deformity treated using lumbar PSO, a preoperative C7–S1 plumb line greater than 5 cm, and availability of pre- and postoperative full-length standing radiographs. Results Seventy-five patients (60 women, mean age 59 years) were included. The lumbar PSO significantly improved sagittal alignment, including the C7–S1 plumb line, C7–T12 inclination, and pelvic tilt (p <0.001). After lumbar PSO, reciprocal changes were seen to occur in C2–7 cervical lordosis (from 30.8° to 21.6°, p <0.001), C2–7 plumb line (from 27.0 mm to 22.9 mm), and T-1 slope (from −38.9° to −30.4°, p <0.001). Ideal correction of sagittal malalignment (postoperative sagittal vertical alignment < 50 mm) was associated with the greatest relaxation of cervical hyperlordosis (−12.4° vs −5.7°, p = 0.037). A change in cervical lordosis correlated with changes in T-1 slope (r = −0.621, p <0.001), C7–T12 inclination (r = 0.418, p <0.001), T12–S1 angle (r = −0.339, p = 0.005), and C7–S1 plumb line (r = 0.289, p = 0.018). Radiographic parameters that correlated with changes in cervical lordosis on multivariate linear regression analysis included change in T-1 slope and change in C2–7 plumb line (r2 = 0.53, p <0.001). Conclusions Adults with positive sagittal spinopelvic malalignment compensate with abnormally increased cervical lordosis in an effort to maintain horizontal gaze. Surgical correction of sagittal malalignment results in improvement of the abnormal cervical hyperlordosis through reciprocal changes.

scholarly journals Coronal T1 Pelvic Tilt, a Novel Predictive Index for Global Coronal Alignment in Adult Spinal Deformity

Spine ◽  
2020 ◽  
Vol 45 (19) ◽  
pp. 1335-1340
Author(s):  
Jiandang Zhang ◽  
Zheng Wang ◽  
Pengfei Chi ◽  
Cheng Chi
Keyword(s):  
Spinal Deformity ◽  
Pelvic Tilt ◽  
Adult Spinal Deformity ◽  
Coronal Alignment ◽  
Predictive Index

Preoperative patient-reported outcome score thresholds predict the likelihood of reaching MCID with surgical correction of adult spinal deformity

2020 ◽  
Vol 9 (1) ◽  
pp. 207-219
Author(s):  
Andrea Leyton-Mange ◽  
Eeric Truumees ◽  
Kevin J. Bozic ◽  
Devender Singh ◽  
Tiffany C. Liu ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Patient Reported Outcome ◽  
Surgical Correction ◽  
Outcome Score ◽  
Patient Reported ◽  
Preoperative Patient

93. Cost utility analysis of a combined approach for surgical correction of adult spinal deformity

2020 ◽  
Vol 20 (9) ◽  
pp. S45-S46
Author(s):  
Waleed Ahmad ◽  
Peter G. Passias ◽  
Virginie Lafage ◽  
Renaud Lafage ◽  
Khaled M. Kebaish ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Surgical Correction ◽  
Combined Approach ◽  
Utility Analysis

Cervical Alignment Changes in Patients Developing Proximal Junctional Kyphosis Following Surgical Correction of Adult Spinal Deformity

Neurosurgery ◽  
2017 ◽  
Vol 83 (4) ◽  
pp. 675-682 ◽  
Author(s):  
Peter G Passias ◽  
Samantha R Horn ◽  
Cyrus M Jalai ◽  
Subaraman Ramchandran ◽  
Gregory W Poorman ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Surgical Correction ◽  
Proximal Junctional Kyphosis ◽  
Cervical Alignment ◽  
Junctional Kyphosis

Alterations in acetabular orientation and hip morphology in subjects with adult spinal deformity

2017 ◽  
Vol 103 (7) ◽  
pp. S100-S101
Author(s):  
Ayman Assi ◽  
Ziad Bakouny ◽  
Nour Khalil ◽  
Fares Yared ◽  
Joeffroy Otayek ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Acetabular Orientation ◽  
Hip Morphology

scholarly journals Upper instrumented vertebra–femoral angle and correlation with proximal junctional kyphosis in adult spinal deformity

2021 ◽  
Author(s):  
Hao-Hua Wu ◽  
Dean Chou ◽  
Kevork Hindoyan ◽  
Jeremy Guinn ◽  
Joshua Rivera ◽  
...  
Keyword(s):  
Femoral Head ◽  
Spinal Deformity ◽  
Lumbar Lordosis ◽  
Adult Spinal Deformity ◽  
Surgical Correction ◽  
Proximal Junctional Kyphosis ◽  
Upper Instrumented Vertebra ◽  
Femoral Head Center ◽  
Junctional Kyphosis

Abstract Introduction Although matching lumbar lordosis (LL) with pelvic incidence (PI) is an important surgical goal for adult spinal deformity (ASD), there is concern that overcorrection may lead to proximal junctional kyphosis (PJK). We introduce the upper instrumented vertebra–femoral angle (UIVFA) as a measure of appropriate postoperative position in the setting of lower thoracic to pelvis surgical correction for patients with sagittal imbalance. We hypothesize that a more posterior UIV position in relation to the center of the femoral head is associated with an increased risk of PJK given compensatory hyperkyphosis above the UIV. Methods In this retrospective cohort study, adult patients undergoing lower thoracic (T9–T12) to pelvis correction of ASD with a minimum of 2-year follow-up were included. UIVFA was measured as the angle subtended by a line from the UIV centroid to the femoral head center to the vertical axis. Patients who developed PJK and those who did not were compared with preoperative and postoperative UIVFA as well as change between postoperative and preoperative UIVFA (deltaUIVFA). Results Of 119 patients included with an average 3.6-year follow-up, 51 (42.9%) had PJK and 24 (20.2%) had PJF. Patients with PJK had significantly higher postoperative UIVFA (12.6 ± 4.8° vs. 9.4 ± 6.6°, p = 0.04), deltaUIVFA (6.1 ± 7.6° vs. 2.1 ± 5.6°, p < 0.01), postoperative pelvic tilt (27.3 ± 9.2 vs. 23.3 ± 11, p = 0.04), postoperative lumbar lordosis (47.7 ± 13.9° vs. 42.4 ± 13.1, p = 0.04) and postoperative thoracic kyphosis (44.9 ± 13.2 vs. 31.6 ± 18.8) than patients without PJK. With multivariate logistic regression, postoperative UIVFA and deltaUIVFA were found to be independent risk factors for PJK (p < 0.05). DeltaUIVFA was found to be an independent risk factor for PJF (p < 0.05). A receiver operating characteristic (ROC) curve for UIVFA as a predictor for PJK was established with an area under the curve of 0.67 (95% CI 0.59–0.76). Per the Youden index, the optimal UIVFA cut-off value is 11.5 degrees. Conclusion The more posterior the UIV is from the femoral head center after lower thoracic to pelvis surgical correction for ASD, the more patients are at risk for PJK. The greater the magnitude of posterior translation of the UIV from the femoral head center from preop to postop, the greater the likelihood for PJF.

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