Journal ArticleDOI
Correlation of radiographic parameters and clinical symptoms in adult scoliosis
TLDR
This study suggests that restoration of a more normal sagittal balance is the critical goal for any reconstructive spine surgery and suggests that magnitude of coronal deformity and extent of Coronal correction are less critical parameters.Abstract:
Study design This study is a retrospective review of the initial enrollment data from a prospective multicentered study of adult spinal deformity. Objectives The purpose of this study is to correlate radiographic measures of deformity with patient-based outcome measures in adult scoliosis. Summary of background data Prior studies of adult scoliosis have attempted to correlate radiographic appearance and clinical symptoms, but it has proven difficult to predict health status based on radiographic measures of deformity alone. The ability to correlate radiographic measures of deformity with symptoms would be useful for decision-making and surgical planning. Methods The study correlates radiographic measures of deformity with scores on the Short Form-12, Scoliosis Research Society-29, and Oswestry profiles. Radiographic evaluation was performed according to an established positioning protocol for anteroposterior and lateral 36-inch standing radiographs. Radiographic parameters studied were curve type, curve location, curve magnitude, coronal balance, sagittal balance, apical rotation, and rotatory subluxation. Results The 298 patients studied include 172 with no prior surgery and 126 who had undergone prior spine fusion. Positive sagittal balance was the most reliable predictor of clinical symptoms in both patient groups. Thoracolumbar and lumbar curves generated less favorable scores than thoracic curves in both patient groups. Significant coronal imbalance of greater than 4 cm was associated with deterioration in pain and function scores for unoperated patients but not in patients with previous surgery. Conclusions This study suggests that restoration of a more normal sagittal balance is the critical goal for any reconstructive spine surgery. The study suggests that magnitude of coronal deformity and extent of coronal correction are less critical parameters.read more
Citations
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Journal ArticleDOI
The Impact of Positive Sagittal Balance in Adult Spinal Deformity
Steven D. Glassman,Keith H. Bridwell,John R. Dimar,William C. Horton,Sigurd Berven,Frank J. Schwab +5 more
TL;DR: This study shows that although even mildly positive sagittal balance is somewhat detrimental, severity of symptoms increases in a linear fashion with progressive sagittal imbalance, and shows that kyphosis is more favorable in the upper thoracic region but very poorly tolerated in the lumbar spine.
Journal ArticleDOI
Pelvic tilt and truncal inclination: two key radiographic parameters in the setting of adults with spinal deformity.
TL;DR: This study confirms that pelvic position measured via PT correlates withHRQOL in the setting of adult deformity and demonstrates significant T1–SPI correlation with HRQOL measures and outperforms SVA.
Journal ArticleDOI
Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity: a prospective multicenter analysis.
Frank J. Schwab,Benjamin Blondel,Benjamin Blondel,Shay Bess,Richard A. Hostin,Christopher I. Shaffrey,Justin S. Smith,Oheneba Boachie-Adjei,Douglas C. Burton,Behrooz A. Akbarnia,Gregory M. Mundis,Christopher P. Ames,Khaled M. Kebaish,Robert A. Hart,J.-P. Farcy,Virginie Lafage +15 more
TL;DR: In this article, the authors evaluated correlations between spinopelvic parameters and health-related quality of life (HRQOL) scores in patients with spinal deformity and found that spinopels can provide a more complete assessment of the sagittal plane.
Journal ArticleDOI
Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ATP, LLIF and ALIF.
TL;DR: The present study aims to comprehensively review the available literature and evidence for different lumbar inter body fusion (LIF) techniques, and proposes a set of recommendations and guidelines for the indications for interbody fusion options.
Journal ArticleDOI
Cervical spine alignment, sagittal deformity, and clinical implications: A review
Justin K. Scheer,Jessica A. Tang,Justin S. Smith,Frank L. Acosta,Themistocles S. Protopsaltis,Benjamin Blondel,Shay Bess,Christopher I. Shaffrey,Vedat Deviren,Virginie Lafage,Frank J. Schwab,Christopher P. Ames +11 more
TL;DR: The article details mechanisms by which cervical kyphotic deformity potentially leads to ASD and discusses previous studies that suggest how postoperative sagittal malalignment may promote ASD, with discussions of health-related quality of life (HRQOL).
References
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Journal ArticleDOI
Segmental analysis of the sagittal plane alignment of the normal thoracic and lumbar spines and thoracolumbar junction
Mark Bernhardt,Keith H. Bridwell +1 more
TL;DR: There is a wide range of normal sagittal alignment of the thoracic and lumbar spines, and when using composite measurements of the combined frontal and sagittal plane deformity of scoliosis, this widerange of sagittal variance should be taken into consideration.
Journal ArticleDOI
An analysis of sagittal spinal alignment in 100 asymptomatic middle and older aged volunteers
TL;DR: The majority of asymptomatic individuals are able to maintain their sagittal alignment despite advancing age, and increasing age correlated to a more forward sagittal vertical axis with loss of distal lumbar lordosis but without an increase in thoracic or thoracolumbar kyphosis.
Journal ArticleDOI
Health and function of patients with untreated idiopathic scoliosis: a 50-year natural history study.
Stuart L. Weinstein,Lori A. Dolan,Kevin F. Spratt,Kirk K. Peterson,Mark J. Spoonamore,Ignacio V. Ponseti +5 more
TL;DR: Untreated adults with LIS are productive and functional at a high level at 50-year follow-up and cause little physical impairment other than back pain and cosmetic concerns.
Journal ArticleDOI
Idiopathic scoliosis: long-term follow-up and prognosis in untreated patients.
TL;DR: Two hundred and nineteen patients with untreated adolescent idiopathic scoliosis who were seen at the University of Iowa between 1932 and 1948 were studied, and recent information was available on 194 of the patients.
Long-term follow-up and prognosis in untreated patients*
TL;DR: Two hundred and nineteen patients with untreated adolescent idiopathic scoliosis who were seen at the University of Iowa between 1932 and 1948 were studied, and recent information was available on 194 of the patients.