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Poor sagittal alignment has been shown to correlate highly with poor preoperative and postoperative patient-reported outcomes.
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Surgical techniques exist to correct sagittal alignment, including osteotomies; however, there is a lack of a clear standardized methodology for planning and executing surgical corrections.
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New digital tools can make surgical planning, in particular osteotomy planning, more effective and accurate.
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This article offers a logical and thoughtful process in surgical planning
Use of Surgimap Spine in Sagittal Plane Analysis, Osteotomy Planning, and Correction Calculation
Section snippets
Key points
Case Presentation
The patient is a 73-year-old man complaining of low back pain for about 7 years. The patient feels he also has marked truncal shift anteriorly. He underwent spine surgery with an interspinous device in 2008 and experienced mild relief of some leg pain, but over time, particularly the last 4 years, he has noted increasing low back pain (7 out of 10 on a visual analog scale), with fatigue to the lower extremities and loss of standing and ambulatory endurance. The patient denies any neurologic
Summary
Surgical planning should not be simply an academic or purely theoretical exercise. It is critical that surgeons adopt planning tools to encourage better outcomes for their patients. This article offers a pragmatic and systematic approach involving measurement of the key spinopelvic parameters, evaluation if the compensatory mechanisms, identification of the amount of correction needed, and selection of surgical tools needed to achieve outlined objectives.
Depending on the severity of sagittal
References (45)
- et al.
Influence of screw type on initial coronal and sagittal radiological correction with hybrid constructs in adolescent idiopathic scoliosis. Correction priorities
Orthop Traumatol Surg Res
(2012) - et al.
Sagittal balance disorders in severe degenerative spine. Can we identify the compensatory mechanisms?
Eur Spine J
(2011) - et al.
Sagittal balance of the pelvis-spine complex and lumbar degenerative diseases. A comparative study about 85 cases
Eur Spine J
(2007) - et al.
Sagittal alignment of the cervical spine in adolescent idiopathic scoliosis treated by posteromedial translation
Eur Spine J
(2012) - et al.
Pre- and post-operative sagittal balance in idiopathic scoliosis: a comparison over the ages of two cohorts of 132 adolescents and 52 adults
Eur Spine J
(2012) - et al.
Spondylolisthesis, pelvic incidence, and spinopelvic balance: a correlation study
Spine
(2004) - et al.
Sagittal alignment of the spine and pelvis in the presence of L5-s1 isthmic lysis and low-grade spondylolisthesis
Spine
(2006) - et al.
Pelvic tilt and truncal inclination: two key radiographic parameters in the setting of adults with spinal deformity
Spine
(2009) - et al.
Combined assessment of pelvic tilt, pelvic incidence/lumbar lordosis mismatch and sagittal vertical axis predicts disability in adult spinal deformity: a prospective analysis
(2011) - et al.
Correlation of radiographic and functional measurements in patients who underwent primary scoliosis surgery in adult age
Spine
(2012)
Adult spinal deformity-postoperative standing imbalance: how much can you tolerate? An overview of key parameters in assessing alignment and planning corrective surgery
Spine
A clinical impact classification of scoliosis in the adult
Spine
Impact of magnitude and percentage of global sagittal plane correction on health-related quality of life at 2-years follow-up
Neurosurgery
Sagittal realignment failures following pedicle subtraction osteotomy surgery: are we doing enough?: clinical article
J Neurosurg Spine
Sagittal spino-pelvic alignment failures following three column thoracic osteotomy for adult spinal deformity
Eur Spine J
Assessment of symptomatic rod fracture following posterior instrumented fusion for adult spinal deformity
Neurosurgery
Impact of spinopelvic alignment on decision making in deformity surgery in adults: a review
J Neurosurg Spine
The Lenke classification of adolescent idiopathic scoliosis: how it organizes curve patterns as a template to perform selective fusions of the spine
Spine
Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis
J Bone Joint Surg Am
Adult scoliosis: a quantitative radiographic and clinical analysis
Spine
Correlation of radiographic parameters and clinical symptoms in adult scoliosis
Spine
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