Sagittal balance spinopelvic impact on kyphoscoliosis thoracolumbar or lumbar and/or hypnosis: analysis o fase series of cases

Abstract

The proper restoration of the sagittal vertebral imbalance and the selection of the surgical technique in rigid deformities of the spine today are the necessary to achieve better clinical outcome pillar. To evaluate the overall global sagittal axis and correlate the spinopelvic parameters of patients who underwent surgery with kyphoscoliosis and/or kyphosis. A retrospective study of 16 cases from January 2011 to December 2014. In 7 (44%) patients underwent spondylectomy and in 9 (33%) pedicle subtraction. Preoperative Cobb angle of 79º kyphoscoliosis, with an average percentage of correction in the coronal plane 59% and 57% in the sagittal plane of 32% was observed. Comparing the angular parameters showed improvement of the negative sagittal unbalance, with a plumb line C7 line of the plumb bob with a displacement of 12.6 mm posterior to the upper rear corner of S1. Global sagittal axis increased with a decreased in retroversion of the pelvis and increased knee flexion. The lumbar lordosis showed a loss of 12º with correction and correspondence with the pelvic incidence of 37°. Complications in 11 patients, LCR fistula, nonunion, with blood loss of 700 ml, surgical time of 8 hours, and fusion 70% In patients with vertebral deformities and coronal plane is sagittal, the ideal realignment of the global sagittal axis and surgery play a key role in the preoperative period to avoid future complications.