Change in Classification Grade by the SRS-Schwab Adult Spinal Deformity Classification Predicts Impact on Health-Related Quality of Life Measures

Smith, Justin S.; Klineberg, Eric O.; Schwab, Frank J.; Shaffrey, Christopher I.; Moal, Bertrand; Ames, Christopher P.; Hostin, Richard A.; Fu, Kai-Ming; Burton, Douglas C.; Akbarnia, Behrooz A.; Gupta, Munish C.; Hart, Robert A.; Bess, Shay; Lafage, Virginie; Group, International Spine Study

doi:10.1097/brs.0b013e31829ec563

Cited by 264 publications

(83 citation statements)

References 23 publications

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“…Defining ideal sagittal parameters is currently the subject of ongoing research. The reference normal values are therefore presented as a vehicle for rough comparison with asymptomatic adults, and does not intend to include the specificity of the chains of correlations established in the literature [19,20,38,41].…”

Section: Discussionmentioning

confidence: 99%

Cervical spine alignment following lumbar pedicle subtraction osteotomy for sagittal imbalance

Obeid

Boniello²,

Boissière³

et al. 2015

Eur Spine J

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LL restoration decreased the need of compensation at the pelvis and thoracic spine. The distal CL and C7 slope decreased because there was no need for compensation at this level after the surgery, but the proximal cervical spine takes a slightly flexed position to maintain horizontal sight. EAM tilt measures the head position toward C7, and is close to 0° even in severe cases. Changes of this parameter after surgery are insignificant, probably due to the balance between upper and lower cervical segments; when one of these segments shifts backward the other shifts forward and the result is a balanced head over C7.

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Section: Discussionmentioning

confidence: 99%

Cervical spine alignment following lumbar pedicle subtraction osteotomy for sagittal imbalance

Obeid

Boniello²,

Boissière³

et al. 2015

Eur Spine J

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“…Recreating the patient's lumbar sagittal alignment reduces the need for adjacent non-fused segments of the spine to compensate for any sagittal deformity at the site of fusion. The importance of normal sagittal alignment has been increasingly recognised in multi-segmental fusions for spinal deformity [1][2][3]. With increasing focus on patient-related outcomes, there is mounting evidence that optimum sagittal alignment in lumbar fusion is associated with improved outcomes across differing pathologies [1,[4][5][6][7][8][9], reduced post-surgical pain [1-3, 5-8, 10-13], reduced adjacent segment degeneration [4,5,7,[9][10][11][12][13][14], and reduced revision rates [1-5, 7, 9-11, 13, 15-18].…”

Section: Introductionmentioning

confidence: 99%

“…It is interesting, however, that with interbody reconstruction, the degree of lordosis recreation can be limited and may not recreate normality [1][2][3][16][17][18]]-a concern when we recognise the significant lordosis in the normal L4/5 and L5/S1 discs [1,5,7,12].…”

Section: Introductionmentioning

confidence: 99%

Do position and size matter? An analysis of cage and placement variables for optimum lordosis in PLIF reconstruction

2017

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Purpose To examine monosegmental lordosis after posterior lumbar interbody fusion (PLIF) surgery and relate lordosis to cage size, shape, and placement. Methods Eighty-three consecutive patients underwent single-level PLIF with paired identical lordotic cages involving a wide decompression and bilateral facetectomies. Cage parameters relating to size (height, lordosis, and length) and placement (expressed as a ratio relative to the length of the inferior vertebral endplate) were recorded. Centre point ratio (CPR) was the distance to the centre of both cages and indicated mean position of both cages. Posterior gap ratio (PGR) was the distance to the most posterior cage and indicated position and cage length indirectly. Relationships between lordosis and cage parameters were explored. Results Mean lordosis increased by 5.98°(SD 6.86°). The cages used varied in length from 20 to 27 mm, in lordosis from 10°to 18°, and in anterior cage height from 10 to 17 mm. The mean cage placement as determined by CPR was 0.54 and by PGR was 0.16. The significant correlations were: both CPR and PGR with lordosis gain at surgery (r = 0.597 and 0.537, respectively, p \ 0.001 both), cage lordosis with the final lordosis (r = 0.234, p \ 0.05), and anterior cage height was negatively correlated with a change in lordosis (r = -0.297, p \ 0.01).Conclusion Cage size, shape, and position, in addition to surgical technique, determine lordosis during PLIF surgery. Anterior placement with sufficient ''clear space'' behind the cages is recommended. In addition, cages should be of moderate height and length, so that they act as an effective pivot for lordosis.

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“…These data were the first to provide surgeons with defined threshold spino-pelvic parameters to evaluate patients and guide spinal reconstructive procedures. Several studies have demonstrated that the correlation of the sagittal malalignment implies a clinical benefit for the patients [45,46]. Blondel et al [45] underlined that the correlation of the SVA improves the clinical outcomes of patients at 2 years.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Effect of Posterior Dynamic Stabilization IntraSPIN System on Sagittal Spinal Balance using EOS® X-Ray Imaging System

Bistazzoni¹,

Angelis²,

D’Ercole³

et al. 2017

J Neurol Neurophysiol

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Aim of this prospective study is to assess the effect of posterior dynamic stabilization IntraSPINE system on sagittal spinal balance, using EOS ® X-Ray imaging system. Between March and December 2015, 8 patients affected by lumbar soft stenosis underwent indirect decompression of the lumbar canal by positioning of IntraSPINE ® device. Sagittal balance was evaluated considering following parameters: C7 Plum Line (C7PL), Thoracic Kyphosis (TK), Lumbar Lordosis (LL), Pelvic Tilt (PT), Pelvic Index (PI) and Sacral Slope (SS). The EOS ® 2D/3D system and corresponding sterEOS 3D software for surface 3D reconstruction has been used to calculate the above mentioned parameters. All patients had neurogenic claudication and low back pain for more than 6 months and resistant to drug treatment. They underwent clinical examination before surgery and 1 month after surgery. Statistical analyses were performed using Stata software. All results were considered significant if p<0.05. C7PL, TK, LL, PI and SS were not modified after surgery. PT increased after surgery. VAS, ODI and JOA significantly increased after surgery. The results show that the posterior dynamic stabilization offered by this device leads to a good symptoms control and does not seems to change the sagittal balance.

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Change in Classification Grade by the SRS-Schwab Adult Spinal Deformity Classification Predicts Impact on Health-Related Quality of Life Measures

Abstract: 3.

Cited by 264 publications

References 23 publications

Cervical spine alignment following lumbar pedicle subtraction osteotomy for sagittal imbalance

Cervical spine alignment following lumbar pedicle subtraction osteotomy for sagittal imbalance

Do position and size matter? An analysis of cage and placement variables for optimum lordosis in PLIF reconstruction

Evaluation of Effect of Posterior Dynamic Stabilization IntraSPIN System on Sagittal Spinal Balance using EOS® X-Ray Imaging System

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