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Defining Spino-Pelvic Alignment Thresholds: Should Operative Goals in Adult Spinal Deformity Surgery Account for Age?
| Content Provider | Semantic Scholar |
|---|---|
| Author | Liabaud, Barthelemy Schwab, Frank Challier, Vincent Henry, Jensen K. Gum, Jeffrey L. Smith, Justin Davis Hostin, Richard A. Shaffrey, Christopher I. Diebo, Bassel G. Ames, Christopher J. H. Scheer, Justin K. Klineberg, Eric Otto Burton, Douglas C. Lafage, Virginie |
| Copyright Year | 2016 |
| Abstract | STUDY DESIGN Retrospective review of prospective, multicenter database. OBJECTIVE The aim of the study was to determine age-specific spino-pelvic parameters, to extrapolate age-specific Oswestry Disability Index (ODI) values from published Short Form (SF)-36 Physical Component Score (PCS) data, and to propose age-specific realignment thresholds for adult spinal deformity (ASD). SUMMARY OF BACKGROUND DATA The Scoliosis Research Society-Schwab classification offers a framework for defining alignment in patients with ASD. Although age-specific changes in spinal alignment and patient-reported outcomes have been established in the literature, their relationship in the setting of ASD operative realignment has not been reported. METHODS ASD patients who received operative or nonoperative treatment were consecutively enrolled. Patients were stratified by age, consistent with published US-normative values (Norms) of the SF-36 PCS (<35, 35-44, 45-54, 55-64, 65-74, >75 y old). At baseline, relationships between between radiographic spino-pelvic parameters (lumbar-pelvic mismatch [PI-LL], pelvic tilt [PT], sagittal vertical axis [SVA], and T1 pelvic angle [TPA]), age, and PCS were established using linear regression analysis; normative PCS values were then used to establish age-specific targets. Correlation analysis with ODI and PCS was used to determine age-specific ideal alignment. RESULTS Baseline analysis included 773 patients (53.7 y old, 54% operative, 83% female). There was a strong correlation between ODI and PCS (r = 0.814, P < 0.001), allowing for the extrapolation of US-normative ODI by age group. Linear regression analysis (all with r > 0.510, P < 0.001) combined with US-normative PCS values demonstrated that ideal spino-pelvic values increased with age, ranging from PT = 10.9 degrees, PI-LL = -10.5 degrees, and SVA = 4.1 mm for patients under 35 years to PT = 28.5 degrees, PI-LL = 16.7 degrees, and SVA = 78.1 mm for patients over 75 years. Clinically, older patients had greater compensation, more degenerative loss of lordosis, and were more pitched forward. CONCLUSION This study demonstrated that sagittal spino-pelvic alignment varies with age. Thus, operative realignment targets should account for age, with younger patients requiring more rigorous alignment objectives. |
| Starting Page | 45 |
| Ending Page | 54 |
| Page Count | 10 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://s9ab564d99fcaaf1d.jimcontent.com/download/version/1455048779/module/10961300757/name/Defining%20Spino-Pelvic%20Alignment%20Thresholds.pdf |
| PubMed reference number | 26689395v1 |
| Alternate Webpage(s) | https://doi.org/10.1097/BRS.0000000000001171 |
| DOI | 10.1097/BRS.0000000000001171 |
| Journal | Spine |
| Volume Number | 41 |
| Issue Number | 1 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Abnormal degeneration Alignment Axis vertebra Body mass index Congenital Abnormality Isoelectric Point Lordosis Neurodegenerative Disorders Nevus sebaceous Patients Pelvic Inflammatory Disease Pelvic Neoplasms Photon Correlation Spectroscopy Pitch - substance Regression Analysis Sagittal plane Scientific Publication Scoliosis, unspecified Spinal Cord Neoplasms Spinal deformities |
| Content Type | Text |
| Resource Type | Article |
