Journal ArticleDOI
Pelvic tilt and truncal inclination: two key radiographic parameters in the setting of adults with spinal deformity.
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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.Abstract:
STUDY DESIGN Prospective radiographic and clinical analysis. OBJECTIVE Investigate the relationship between spino-pelvic parameters and patient self reported outcomes on adult subjects with spinal deformities. SUMMARY OF BACKGROUND DATA It is becoming increasingly recognized that the study of spinal alignment should include pelvic position. While pelvic incidence determines lumbar lordosis, pelvic tilt (PT) is a positional parameter reflecting compensation to spinal deformity. Correlation between plumbline offset (sagittal vertical axis [SVA]) and Health Related Quality of Life (HRQOL) measures has been demonstrated, but such a study is lacking for PT. METHODS This prospective study was carried out on 125 adult patients suffering from spinal deformity (mean age: 57 years). Full-length free-standing radiographs including the spine and pelvis were available for all patients. HRQOL instruments included: Oswestry Disability Index, Short Form-12, Scoliosis Research Society. Correlation analysis between radiographic spinopelvic parameters and HRQOL measures was pursued. RESULTS Correlation analysis revealed no significance pertaining to coronal plane parameters. Significant sagittal plane correlations were identified. SVA and truncal inclination measured by T1 spinopelvic inclination (T1-SPI) (angle between T1-hip axis and vertical) correlated with: Scoliosis Research Society (appearance, activity, total score), Oswestry Disability Index, and Short Form-12 (physical component score). Correlation coefficients ranged from 0.42 < r < 0.55 (P < 0.0001). T1-SPI revealed greater correlation with HRQOL compared to SVA. PT showed correlation with HRQOL (0.28 < r < 0.42) and with SVA (r = 0.64, P < 0.0001). CONCLUSION This study confirms that pelvic position measured via PT correlates with HRQOL in the setting of adult deformity. High values of PT express compensatory pelvic retroversion for sagittal spinal malalignment. This study also demonstrates significant T1-SPI correlation with HRQOL measures and outperforms SVA. This parameter carries the advantage of being an angular measurement which avoids the error inherent in measuring offsets in noncalibrated radiographs.read more
Citations
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Journal ArticleDOI
Scoliosis Research Society-Schwab adult spinal deformity classification: a validation study.
Frank J. Schwab,Benjamin Ungar,Benjamin Blondel,Jacob M. Buchowski,Jeffrey A. Coe,Donald Deinlein,Christopher J. DeWald,Hossein Mehdian,Christopher I. Shaffrey,Clifford B. Tribus,Virginie Lafage +10 more
TL;DR: Data from this study show that there is excellent inter- and intra- rater reliability and inter-rater agreement for curve type and each modifier and the high degree of reliability demonstrates that applying the classification system is easy and consistent.
Journal ArticleDOI
Adult spinal deformity-postoperative standing imbalance: how much can you tolerate? An overview of key parameters in assessing alignment and planning corrective surgery.
TL;DR: Good clinical outcome requires achieving proper spinopelvic alignment in the treatment of adult spinal deformity, and restoring low sagittal vertical axis and pelvic tilt values are critical goals, and should be combined with proportional lumbar lordosis to pelvic incidence.
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
The impact of standing regional cervical sagittal alignment on outcomes in posterior cervical fusion surgery.
Jessica A. Tang,Justin K. Scheer,Justin S. Smith,Vedat Deviren,Shay Bess,Robert A. Hart,Virginie Lafage,Christopher I. Shaffrey,Frank J. Schwab,Christopher P. Ames +9 more
TL;DR: The findings demonstrate that, similar to the thoracolumbar spine, the severity of disability increases with positive sagittal malalignment following surgical reconstruction.
Journal ArticleDOI
Incidence, risk factors and classification of proximal junctional kyphosis: surgical outcomes review of adult idiopathic scoliosis.
TL;DR: Despite the occurrence of PJK in 20% of adult scoliosis patients undergoing long fusion, no significant differences were found in SRS outcome scores and ODI in PJK and non-PJK patients.
References
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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 incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves
TL;DR: An anatomical parameter, the pelvic incidence, appears to be the main axis of the sagittal balance of the spine, which controls spinal curves in accordance with the adaptability of the other parameters.
Journal ArticleDOI
Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position.
TL;DR: To describe, quantify, and classify common variations in the sagittal alignment of the spine, sacrum, and pelvis may help to discover the association between spinal balance and the development of degenerative changes in the spine.
Journal ArticleDOI
Correlation of radiographic parameters and clinical symptoms in adult scoliosis
TL;DR: 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.
Journal ArticleDOI
Radiographic analysis of the sagittal alignment and balance of the spine in asymptomatic subjects.
TL;DR: The T9 sagittal offset, reflecting the sagittal balance of the spine, was dependent on three separate factors: a linear combination of the pelvic incidence, maximum lumbar lordosis, and sacral slope; the pelvic tilt; and the thoracic kyphosis.