Radiographic Outcomes of Adult Spinal Deformity Correction : A Critical Analysis of Variability and Failures Across Deformity Patterns

Bertrand Moal (1, 2) , Frank Schwab (3) , Christopher P. Ames (4) , Justin S. Smith (5) , Devon Ryan (3) , Praveen V. Mummaneni (4) , Gregory M. Mundis Jr (6) , Jamie S. Terran (3) , Eric Klineberg (7) , Robert A. Hart (8) , Oheneba Boachie-Adjei (9) , Christopher I. Shaffrey (5) , Wafa Skalli (2) , Lafage Virginie (3)

1 Department of spine surgery
2 LBM - Laboratoire de biomécanique
3 NYU Hospital for Joint Diseases
4 UC San Francisco - University of California [San Francisco]
5 University of Virginia Medical Center
6 San Diego Center for Spinal Disorders
7 UC Davis - University of California [Davis]
8 OHSU - Oregon Health and Science University [Portland]
9 Hospital for Special Surgery

Study Design: Multicenter, prospective, consecutive, surgical case series from the International Spine Study Group.Objectives: To evaluate the effectiveness of surgical treatment in restoring spinopelvic (SP) alignment.Summary of Background Data: Pain and disability in the setting of adult spinal deformity have been correlated with global coronal alignment (GCA), sagittal vertical axis (SVA), pelvic incidence/lumbar lordosis mismatch (PI-LL), and pelvic tilt (PT). One of the maingoals of surgery for adult spinal deformity is to correct these parameters to restore harmonious SP alignment.Methods: Inclusion criteria were operative patients (age greater than 18 years) with baseline (BL) and 1-year full-length X-rays. Thoracic and thoracolumbar Cobb angle and previous mentioned parameters were calculated. Each parameter at BL and 1 year was categorized as either pathological or normal. Pathologic limits were: Cobb greater than 30 , GCA greater than 40 mm, SVA greater than 40 mm, PI-LL greater than 10 , and PT greater than 20 . According to thresholds, corrected or worsened alignment groups of patients were identified and overall radiographic effectiveness of procedure was evaluated by combining the results from the coronal and sagittal planes.

Domaines: Biomécanique [physics.med-ph]

Bertrand Moal, Frank Schwab, Christopher P. Ames, Justin S. Smith, Devon Ryan, et al.. Radiographic Outcomes of Adult Spinal Deformity Correction : A Critical Analysis of Variability and Failures Across Deformity Patterns. Spine Deformity, 2014, 2, pp.219-225. ⟨10.1016/j.jspd.2014.01.003⟩. ⟨hal-01086753⟩