RT Journal Article
SR Electronic
T1 Postoperative Sagittal Spinal Alignment Changes Following Corrective Surgery in Adult Spinal Deformity
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 1082
OP 1089
DO 10.14444/8194
VO 15
IS 6
A1 Albayar, Ahmed
A1 Ramayya, Ashwin
A1 Sullivan, Patricia Zadnik
A1 Yoon, Jang
A1 Saifi, Comron
A1 Roche, Abigail
A1 Ali, Zarina S.
A1 Welch, William C.
A1 Arlet, Vincent
A1 Ozturk, Ali K.
YR 2021
UL https://www.ijssurgery.com/content/15/6/1082.abstract
AB Background There is a paucity of literature covering the spinal alignment changes following adult spinal deformities (ASD) corrective surgeries. In theory, patients’ posture and overall alignment may vary with postoperative pain, bracing, and other external variables requiring further radiographic follow-up. The purpose of the study is to investigate changes in sagittal alignment in the first 3 months postoperatively.Methods This is a retrospective case series of ASD patients who underwent deformity surgeries from October 2015 to June 2018. Patients < 40 years old, had < 6 levels fused, had acute proximal junctional kyphosis (PJK) or failure, or lacked imaging were excluded. Physiologic measures, spine alignment changes measured in whole-spine radiographs. Lumbar lordosis (LL), thoracic kyphosis (TK), and sagittal vertical axis (SVA) at immediate and 3-month postoperative time points were measured, then compared via 2-sample Student t tests. Furthermore, TK after upper thoracic to pelvis (UT-P) fusions was compared with lower thoracic to pelvis (LT-P) fusions via paired t test.Results Thirty-six patients (24 females, 67%) with a mean age of 61.5 years (range, 40–75 years) were included. Spinal alignment comparisons showed a significant increase in TK at the 3-month time point (P = 0.006). Additionally, wide variations in SVA (range, 47–144 mm) were noted, yet not statistically significant, likely due to the changes being in both positive and negative directions (P = 0.18). No significant difference was found when TK was compared in the UT-P vs LT-P groups.Conclusions Our results suggest that as postoperative pain subsides and the body settles into its new alignment, significant changes occur in spine sagittal parameters in the subacute period following surgery.Level of Evidence 4.