Update on pathology and surgical treatment for adult spinal deformity

Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association
Hiroshi Taneichi

Abstract

Update on pathologies of adult spinal deformity (ASD): With advancement of aging society, ASD has become one of the most notable topics of spinal disorders owing to its significant impact on health related quality of life. Treatment for ASD is challenging due to complex nature of deformity and high prevalence of comorbidities. Spino-pelvic harmony that is evaluated by pelvic incidence (PI) minus lumbar lordosis (LL) is the most important concept, which allows us to understand pathology of ASD more deeply. Proposed optimum "PI minus LL" is within ±10°. However, according to analysis of patients having good surgical outcomes, minimum requirement of postoperative "PI minus LL" is calculated by following equation: "PI minus LL" = 0.41PI - 11.12 (r = 0.45, p = 0.0059). "PI minus LL" is not fixed but flexible value reflecting the specific setting of the individual PI. To date, little is known about dynamic global sagittal alignment that is susceptible to compensatory mechanisms. Gait analysis revealed that compensated sagittal balance by pelvic retroversion in static standing was lost immediately after walking due to alignment change of the pelvis and worsened over time. Dynamic assessment of sagittal balance is recommended. Update o...Continue Reading

References

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Citations

Jun 9, 2016·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Yo ShibaYutaka Nohara
May 20, 2017·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Giuseppe BaroneLuca Proietti
Aug 12, 2017·Journal of Neurosurgery. Spine·Chang-Hyun LeeSeung-Jae Hyun
Aug 8, 2020·Journal of Korean Neurosurgical Society·Jong-Hwan HongBong Ju Moon
Aug 31, 2020·Spine Surgery and Related Research·Yohei IshiharaTomoaki Toyone
Mar 8, 2017·Journal of Korean Neurosurgical Society·Chang-Hyun LeeJung-Kil Lee
Sep 6, 2020·Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association·Tetsuro OhbaHirotaka Haro

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