Adult spinal deformity correction surgery using age-adjusted alignment thresholds: clinical outcomes and mechanical complication rates. A systematic review of the literature

Quarto, E.; Zanirato, A.; Vitali, F.; Spatuzzi, M.; Bourret, S.; Le Huec, J. C.; Formica, M.

doi:10.1007/s00586-023-07949-1

Cited by 2 publications

(1 citation statement)

References 52 publications

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“…Though useful, there is significant room for improvement in using these parameters as their correlation with patient-reported outcomes can be relatively weak [21]. In an effort to address this, surgeons have begun to create patient-specific goals that take into account other factors including the age of the patient, the Roussouly four-type sagittal shape, and GAP score [1,[22][23][24][25][26]. However, the papers included in this review primarily report SVA, PI-LL, and PT goals in the classic fashion with static goals for all patients (SVA < 40° or < 50°, PI-LL < 10°, and PT < 20°).…”

Section: Discussionmentioning

confidence: 99%

Patient-specific rods in adult spinal deformity: a systematic review

Picton,

Stone,

Liang

et al. 2024

Spine Deform

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Purpose The purpose of this review was to evaluate the effectiveness of patient-specific rods for adult spinal deformity. Methods A systematic review of the literature was performed through an electronic search of the PubMed, Scopus, and Web of Science databases. Human studies between 2012 and 2023 were included. Sample size, sagittal vertical axis (SVA), pelvic incidence–lumbar lordosis (PI-LL), pelvic tilt (PT), operation time, blood loss, follow-up duration, and complications were recorded for each study when available. Results Seven studies with a total of 304 adult spinal deformity patients of various etiologies were included. All studies reported SVA, and PT; two studies did not report PI-LL. Four studies reported planned radiographic outcomes. Two found a significant association between preoperative plan and postoperative outcome in all three outcomes. One found a significant association for PI-LL alone. The fourth found no significant associations. SVA improved in six of seven studies, PI-LL improved in all five, and three of seven studies found improved postoperative PT. Significance of these results varied greatly by study. Conclusion Preliminary evidence suggests potential benefits of PSRs in achieving optimal spino-pelvic parameters in ASD surgery. Nevertheless, conclusions regarding the superiority of PSRs over traditional rods must be judiciously drawn, given the heterogeneity of patients and study methodologies, potential confounding variables, and the absence of robust randomized controlled trials. Future investigations should concentrate on enhancing preoperative planning, standardizing surgical methodologies, isolating specific patient subgroups, and head-to-head comparisons with traditional rods to fully elucidate the impact of PSRs in ASD surgery.

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