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Claudio Lamartina - One of the best experts on this subject based on the ideXlab platform.
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Long fusions to S1 with or without Pelvic fixation can induce relevant acute variations in Pelvic Incidence: a retrospective cohort study of adult spine deformity surgery
European Spine Journal, 2017Co-Authors: Riccardo Cecchinato, Claudio Lamartina, Andrea Redaelli, Carlotta Martini, Carlotta Morselli, Jorge Hugo Villafañe, Pedro BerjanoAbstract:Purpose The purpose of this study is to verify if any changes occur in Pelvic Incidence (PI) in adult patients undergoing long fusion to sacrum for spine deformity and to describe the effect of fixation to pelvis on these variations. Methods We conducted a cross sectional study. Sixty-six adults patients, 87% females (mean ± SD age: 65.1 ± 7.6 years), undergoing fusion from the thoracic spine to the sacrum for adult spine deformity were included. Patients were divided in two different groups: Group A: sacral fixation alone and Group B: sacral fixation plus pelvis fixation. Pre and postoperative standardized full-standing X-rays were analyzed with measurement of: PI, Pelvic tilt (PT), lumbar lordosis (LL) and sagittal vertical axis (SVA). Results A significant effect of time interaction (preoperative to early postoperative; F = 59.93, F = 44.78 and F = 39.87, all p
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Successful correction of sagittal imbalance can be calculated on the basis of Pelvic Incidence and age
European Spine Journal, 2014Co-Authors: Pedro Berjano, Francesco Langella, Maryem-fama Ismael, Marco Damilano, Sergio Scopetta, Claudio LamartinaAbstract:Introduction Sagittal imbalance is an independent predictor of outcome in adult degenerative spinal deformity. Restoration of sagittal spinoPelvic parameters correlates with a better postoperative outcome. Several methods of preoperative calculation for sagittal correction have been proposed, most of them are geometrical. A non-geometrical method, based on data of spinoPelvic relationships in normal subjects that uses the patient’s Pelvic Incidence and age to calculate target lumbar lordosis and thoracic kyphosis is proposed. The goal of this study is to describe and validate this non-geometrical method in terms of sensitivity and specificity to predict satisfactory spinoPelvic alignment. Materials and methods Retrospective cohort study of patients operated for sagittal imbalance with pedicle subtraction osteotomies (PSO). Two calculation algorithms [method a: LL = −(32.56 + PI × 0.54), method b: LL = −(PI + 10°)]; in both TK = (PI/ r )-LL, see text for definitions] obtain theoretical lumbar lordosis (LL) and thoracic kyphosis (TK) solely based on Pelvic Incidence and age, for surgical planning. The sample is categorized according to two parameters: planning goals (LL and TK) achieved or not and satisfactory alignment (SVA
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successful correction of sagittal imbalance can be calculated on the basis of Pelvic Incidence and age
European Spine Journal, 2014Co-Authors: Pedro Berjano, Francesco Langella, Maryem-fama Ismael, Marco Damilano, Sergio Scopetta, Claudio LamartinaAbstract:Introduction Sagittal imbalance is an independent predictor of outcome in adult degenerative spinal deformity. Restoration of sagittal spinoPelvic parameters correlates with a better postoperative outcome. Several methods of preoperative calculation for sagittal correction have been proposed, most of them are geometrical. A non-geometrical method, based on data of spinoPelvic relationships in normal subjects that uses the patient’s Pelvic Incidence and age to calculate target lumbar lordosis and thoracic kyphosis is proposed. The goal of this study is to describe and validate this non-geometrical method in terms of sensitivity and specificity to predict satisfactory spinoPelvic alignment.
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Successful correction of sagittal imbalance can be calculated on the basis of Pelvic Incidence and age.
European spine journal : official publication of the European Spine Society the European Spinal Deformity Society and the European Section of the Cerv, 2014Co-Authors: Pedro Berjano, Francesco Langella, Maryem-fama Ismael, Marco Damilano, Sergio Scopetta, Claudio LamartinaAbstract:Sagittal imbalance is an independent predictor of outcome in adult degenerative spinal deformity. Restoration of sagittal spinoPelvic parameters correlates with a better postoperative outcome. Several methods of preoperative calculation for sagittal correction have been proposed, most of them are geometrical. A non-geometrical method, based on data of spinoPelvic relationships in normal subjects that uses the patient's Pelvic Incidence and age to calculate target lumbar lordosis and thoracic kyphosis is proposed. The goal of this study is to describe and validate this non-geometrical method in terms of sensitivity and specificity to predict satisfactory spinoPelvic alignment. Retrospective cohort study of patients operated for sagittal imbalance with pedicle subtraction osteotomies (PSO). Two calculation algorithms [method a: LL = -(32.56 + PI × 0.54), method b: LL = -(PI + 10°)]; in both TK = (PI/r)-LL, see text for definitions] obtain theoretical lumbar lordosis (LL) and thoracic kyphosis (TK) solely based on Pelvic Incidence and age, for surgical planning. The sample is categorized according to two parameters: planning goals (LL and TK) achieved or not and satisfactory alignment (SVA < 50 mm and PT < 20°) achieved or not. 2 × 2 tables are built and odds ratio, sensitivity and specificity and predictive positive value/predictive negative value (PPV/NPV) are calculated for each planning method. Different levels of tolerance for undercorrection are analyzed to refine the use of the method. Of the 50 patients included in the study, 23 presented satisfactory alignment postoperatively. With a tolerance of hypocorrection of 10° (LL) and 30° (TK), correction target was achieved in 23 patients according to method a [S = 0.89, Sp = 0.87 %, OR 53.33 (95 % CI 9.677-293.931), p < 0.001], 23 patients according to method b [S = 0.93, Sp = 0.91, OR 131.25 (95 % CI 17-1013), p < 0.001]. The best prediction of satisfactory alignment was obtained with method b and tolerance 0° (LL) and 10° (TK). All patients with complete correction of LL (both methods) achieved good alignment. 22/24 (91 %) patients with less than 10° of undercorrection of LL (method b) achieved good alignment. Calculation of the target lordosis and kyphosis based only in the value of PI and age is a reliable method that can predict good outcomes in terms of alignment. The rule LL = -(PI + 10°) is an easy to calculate and very effective method of planning for lumbar lordosis and good alignment can be expected with high confidence when the final lordosis is within 10° of undercorrection. Including TK in surgical planning can improve the results in terms of restoration of the less known "spinoPelvic balance" parameter.
Pedro Berjano - One of the best experts on this subject based on the ideXlab platform.
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Long fusions to S1 with or without Pelvic fixation can induce relevant acute variations in Pelvic Incidence: a retrospective cohort study of adult spine deformity surgery
European Spine Journal, 2017Co-Authors: Riccardo Cecchinato, Claudio Lamartina, Andrea Redaelli, Carlotta Martini, Carlotta Morselli, Jorge Hugo Villafañe, Pedro BerjanoAbstract:Purpose The purpose of this study is to verify if any changes occur in Pelvic Incidence (PI) in adult patients undergoing long fusion to sacrum for spine deformity and to describe the effect of fixation to pelvis on these variations. Methods We conducted a cross sectional study. Sixty-six adults patients, 87% females (mean ± SD age: 65.1 ± 7.6 years), undergoing fusion from the thoracic spine to the sacrum for adult spine deformity were included. Patients were divided in two different groups: Group A: sacral fixation alone and Group B: sacral fixation plus pelvis fixation. Pre and postoperative standardized full-standing X-rays were analyzed with measurement of: PI, Pelvic tilt (PT), lumbar lordosis (LL) and sagittal vertical axis (SVA). Results A significant effect of time interaction (preoperative to early postoperative; F = 59.93, F = 44.78 and F = 39.87, all p
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Successful correction of sagittal imbalance can be calculated on the basis of Pelvic Incidence and age
European Spine Journal, 2014Co-Authors: Pedro Berjano, Francesco Langella, Maryem-fama Ismael, Marco Damilano, Sergio Scopetta, Claudio LamartinaAbstract:Introduction Sagittal imbalance is an independent predictor of outcome in adult degenerative spinal deformity. Restoration of sagittal spinoPelvic parameters correlates with a better postoperative outcome. Several methods of preoperative calculation for sagittal correction have been proposed, most of them are geometrical. A non-geometrical method, based on data of spinoPelvic relationships in normal subjects that uses the patient’s Pelvic Incidence and age to calculate target lumbar lordosis and thoracic kyphosis is proposed. The goal of this study is to describe and validate this non-geometrical method in terms of sensitivity and specificity to predict satisfactory spinoPelvic alignment. Materials and methods Retrospective cohort study of patients operated for sagittal imbalance with pedicle subtraction osteotomies (PSO). Two calculation algorithms [method a: LL = −(32.56 + PI × 0.54), method b: LL = −(PI + 10°)]; in both TK = (PI/ r )-LL, see text for definitions] obtain theoretical lumbar lordosis (LL) and thoracic kyphosis (TK) solely based on Pelvic Incidence and age, for surgical planning. The sample is categorized according to two parameters: planning goals (LL and TK) achieved or not and satisfactory alignment (SVA
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successful correction of sagittal imbalance can be calculated on the basis of Pelvic Incidence and age
European Spine Journal, 2014Co-Authors: Pedro Berjano, Francesco Langella, Maryem-fama Ismael, Marco Damilano, Sergio Scopetta, Claudio LamartinaAbstract:Introduction Sagittal imbalance is an independent predictor of outcome in adult degenerative spinal deformity. Restoration of sagittal spinoPelvic parameters correlates with a better postoperative outcome. Several methods of preoperative calculation for sagittal correction have been proposed, most of them are geometrical. A non-geometrical method, based on data of spinoPelvic relationships in normal subjects that uses the patient’s Pelvic Incidence and age to calculate target lumbar lordosis and thoracic kyphosis is proposed. The goal of this study is to describe and validate this non-geometrical method in terms of sensitivity and specificity to predict satisfactory spinoPelvic alignment.
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Successful correction of sagittal imbalance can be calculated on the basis of Pelvic Incidence and age.
European spine journal : official publication of the European Spine Society the European Spinal Deformity Society and the European Section of the Cerv, 2014Co-Authors: Pedro Berjano, Francesco Langella, Maryem-fama Ismael, Marco Damilano, Sergio Scopetta, Claudio LamartinaAbstract:Sagittal imbalance is an independent predictor of outcome in adult degenerative spinal deformity. Restoration of sagittal spinoPelvic parameters correlates with a better postoperative outcome. Several methods of preoperative calculation for sagittal correction have been proposed, most of them are geometrical. A non-geometrical method, based on data of spinoPelvic relationships in normal subjects that uses the patient's Pelvic Incidence and age to calculate target lumbar lordosis and thoracic kyphosis is proposed. The goal of this study is to describe and validate this non-geometrical method in terms of sensitivity and specificity to predict satisfactory spinoPelvic alignment. Retrospective cohort study of patients operated for sagittal imbalance with pedicle subtraction osteotomies (PSO). Two calculation algorithms [method a: LL = -(32.56 + PI × 0.54), method b: LL = -(PI + 10°)]; in both TK = (PI/r)-LL, see text for definitions] obtain theoretical lumbar lordosis (LL) and thoracic kyphosis (TK) solely based on Pelvic Incidence and age, for surgical planning. The sample is categorized according to two parameters: planning goals (LL and TK) achieved or not and satisfactory alignment (SVA < 50 mm and PT < 20°) achieved or not. 2 × 2 tables are built and odds ratio, sensitivity and specificity and predictive positive value/predictive negative value (PPV/NPV) are calculated for each planning method. Different levels of tolerance for undercorrection are analyzed to refine the use of the method. Of the 50 patients included in the study, 23 presented satisfactory alignment postoperatively. With a tolerance of hypocorrection of 10° (LL) and 30° (TK), correction target was achieved in 23 patients according to method a [S = 0.89, Sp = 0.87 %, OR 53.33 (95 % CI 9.677-293.931), p < 0.001], 23 patients according to method b [S = 0.93, Sp = 0.91, OR 131.25 (95 % CI 17-1013), p < 0.001]. The best prediction of satisfactory alignment was obtained with method b and tolerance 0° (LL) and 10° (TK). All patients with complete correction of LL (both methods) achieved good alignment. 22/24 (91 %) patients with less than 10° of undercorrection of LL (method b) achieved good alignment. Calculation of the target lordosis and kyphosis based only in the value of PI and age is a reliable method that can predict good outcomes in terms of alignment. The rule LL = -(PI + 10°) is an easy to calculate and very effective method of planning for lumbar lordosis and good alignment can be expected with high confidence when the final lordosis is within 10° of undercorrection. Including TK in surgical planning can improve the results in terms of restoration of the less known "spinoPelvic balance" parameter.
Peter G Passias - One of the best experts on this subject based on the ideXlab platform.
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Wednesday, September 26, 2018 7:35 AM–9:00 AM ePosters: P173. Pelvic Incidence affects age-adjusted alignment outcomes in a population of adult spinal deformity
The Spine Journal, 2018Co-Authors: Peter G Passias, Cyrus M. Jalai, Cole Bortz, Frank A Segreto, Samantha R Horn, Leah Steinmetz, Christopher Varlotta, Nicholas Stekas, Nicholas J Frangella, Tina RamanAbstract:BACKGROUND CONTEXT Current preoperative planning for surgical adult spinal deformity (ASD) patients takes into account patient age when establishing postoperative alignment targets for sagittal vertical axis (SVA), Pelvic tilt (PT) and spino-Pelvic-mismatch (PI-LL). Patient height and Pelvic Incidence (PI), however, have yet to be evaluated for their individual effects on achieving age-adjusted alignment targets. PURPOSE This study assesses the individual effects of patient height and PI on age-adjusted alignment outcomes of surgical ASD patients. STUDY DESIGN/SETTING Single center retrospective review. PATIENT SAMPLE A total of 205 operative ASD patients. OUTCOME MEASURES Postoperative alignment parameters (PT, SVA, PI-LL, and SS); health-related quality of life (HRQL) scores. METHODS Surgical ASD patients >18 years with full-body stereographic x-ray imaging at baseline (BL) and early postoperative follow-up ( 75th) for both BL height and PI. Correction groups were generated at postoperative follow-up for actual alignment compared to age-adjusted ideal values for PT, PI-LL, and SVA, and PI-adjusted ideal alignment values for SS, as derived from clinically relevant formulas. Chi-squared tests assessed differences in rates of matching age-adjusted alignment ideal (±10years threshold for age-adjusted targets; −7° to 5° measured minus ideal for SS target) across height and PI groups. Subanalysis of patients matching age-adjusted alignment ideal used ANOVA to compare clinical outcomes across height and PI groups. RESULTS Included: 205 ASD patients (59±16 year, 64% F, 27±6 kg/m2). Following surgery, patients showed significant improvement in PT, PI-LL and SVA (all p .05). Height groups also did not differ in age or BMI (all p>.05), although female patients comprised a greater proportion of the low (96% F vs. 4% M) and normative (75% F vs. 25% M) height groups (p 0.05). Although there were no differences across PI groups in rates of achieving ideal alignment for PI-LL, SVA or SS (all p>.05), patients with high PI reached age-adjusted ideal alignment for PT at a significantly lower rate (15%) than patients with normative (36%) or low PI (33%, p=.031). Of the 58% of patients that matched any adjusted alignment target in early follow-up, there were no significant differences in postoperative HRQL outcomes across patient height or PI groups (all p>.05). CONCLUSIONS Patients with high Pelvic Incidence reached ideal postoperative age-adjusted PT alignment at a significantly lower rate than patients with normative and low Pelvic Incidence. In contrast, patient height had no impact on postoperative age-adjusted alignment outcomes. These results suggest that current postoperative ideal alignment targets may warrant adjustment to account for the morphological factor of Pelvic Incidence.
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wednesday september 26 2018 7 35 am 9 00 am eposters p173 Pelvic Incidence affects age adjusted alignment outcomes in a population of adult spinal deformity
The Spine Journal, 2018Co-Authors: Peter G Passias, Cyrus M. Jalai, Cole Bortz, Frank A Segreto, Samantha R Horn, Leah Steinmetz, Christopher Varlotta, Nicholas Stekas, Nicholas J Frangella, Tina RamanAbstract:BACKGROUND CONTEXT Current preoperative planning for surgical adult spinal deformity (ASD) patients takes into account patient age when establishing postoperative alignment targets for sagittal vertical axis (SVA), Pelvic tilt (PT) and spino-Pelvic-mismatch (PI-LL). Patient height and Pelvic Incidence (PI), however, have yet to be evaluated for their individual effects on achieving age-adjusted alignment targets. PURPOSE This study assesses the individual effects of patient height and PI on age-adjusted alignment outcomes of surgical ASD patients. STUDY DESIGN/SETTING Single center retrospective review. PATIENT SAMPLE A total of 205 operative ASD patients. OUTCOME MEASURES Postoperative alignment parameters (PT, SVA, PI-LL, and SS); health-related quality of life (HRQL) scores. METHODS Surgical ASD patients >18 years with full-body stereographic x-ray imaging at baseline (BL) and early postoperative follow-up ( 75th) for both BL height and PI. Correction groups were generated at postoperative follow-up for actual alignment compared to age-adjusted ideal values for PT, PI-LL, and SVA, and PI-adjusted ideal alignment values for SS, as derived from clinically relevant formulas. Chi-squared tests assessed differences in rates of matching age-adjusted alignment ideal (±10years threshold for age-adjusted targets; −7° to 5° measured minus ideal for SS target) across height and PI groups. Subanalysis of patients matching age-adjusted alignment ideal used ANOVA to compare clinical outcomes across height and PI groups. RESULTS Included: 205 ASD patients (59±16 year, 64% F, 27±6 kg/m2). Following surgery, patients showed significant improvement in PT, PI-LL and SVA (all p .05). Height groups also did not differ in age or BMI (all p>.05), although female patients comprised a greater proportion of the low (96% F vs. 4% M) and normative (75% F vs. 25% M) height groups (p 0.05). Although there were no differences across PI groups in rates of achieving ideal alignment for PI-LL, SVA or SS (all p>.05), patients with high PI reached age-adjusted ideal alignment for PT at a significantly lower rate (15%) than patients with normative (36%) or low PI (33%, p=.031). Of the 58% of patients that matched any adjusted alignment target in early follow-up, there were no significant differences in postoperative HRQL outcomes across patient height or PI groups (all p>.05). CONCLUSIONS Patients with high Pelvic Incidence reached ideal postoperative age-adjusted PT alignment at a significantly lower rate than patients with normative and low Pelvic Incidence. In contrast, patient height had no impact on postoperative age-adjusted alignment outcomes. These results suggest that current postoperative ideal alignment targets may warrant adjustment to account for the morphological factor of Pelvic Incidence.
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lumbosacral stress and age may contribute to increased Pelvic Incidence an analysis of 1625 adults
European Spine Journal, 2018Co-Authors: Barthelemy Liabaud, Bassel G. Diebo, Jeffrey Varghese, Renaud Lafage, Cyrus M. Jalai, Subaraman Ramchandran, Gregory W. Poorman, Thomas J. Errico, Themistocles S Protopsaltis, Peter G PassiasAbstract:PURPOSE: While there is a consensus that Pelvic Incidence (PI) remains constant after skeletal maturity, recent reports argue that PI increases after 60 years. This study aims to investigate whether PI increases with age and to determine potential associated factors. METHODS: 1510 patients with various spinal degenerative and deformity pathologies were enrolled, along with an additional 115 asymptomatic volunteers. Subjects were divided into six age subgroups with 10-year intervals. RESULTS: PI averaged 54.1° in all patients. PI was significantly higher in the 45-54-year age group than 35-44-year age group (55.8° vs. 49.7°). There were significant PI differences between genders after age 45. Linear regression revealed age, gender and malalignment as associated factors for increased PI with R 2 of 0.22 (p < 0.001). CONCLUSIONS: PI is higher in female patients and in older patients, especially those over 45 years old. Spinal malalignment also may have a role in increased PI due to increased L5-S1 bending moment.
Tina Raman - One of the best experts on this subject based on the ideXlab platform.
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wednesday september 26 2018 7 35 am 9 00 am eposters p173 Pelvic Incidence affects age adjusted alignment outcomes in a population of adult spinal deformity
The Spine Journal, 2018Co-Authors: Peter G Passias, Cyrus M. Jalai, Cole Bortz, Frank A Segreto, Samantha R Horn, Leah Steinmetz, Christopher Varlotta, Nicholas Stekas, Nicholas J Frangella, Tina RamanAbstract:BACKGROUND CONTEXT Current preoperative planning for surgical adult spinal deformity (ASD) patients takes into account patient age when establishing postoperative alignment targets for sagittal vertical axis (SVA), Pelvic tilt (PT) and spino-Pelvic-mismatch (PI-LL). Patient height and Pelvic Incidence (PI), however, have yet to be evaluated for their individual effects on achieving age-adjusted alignment targets. PURPOSE This study assesses the individual effects of patient height and PI on age-adjusted alignment outcomes of surgical ASD patients. STUDY DESIGN/SETTING Single center retrospective review. PATIENT SAMPLE A total of 205 operative ASD patients. OUTCOME MEASURES Postoperative alignment parameters (PT, SVA, PI-LL, and SS); health-related quality of life (HRQL) scores. METHODS Surgical ASD patients >18 years with full-body stereographic x-ray imaging at baseline (BL) and early postoperative follow-up ( 75th) for both BL height and PI. Correction groups were generated at postoperative follow-up for actual alignment compared to age-adjusted ideal values for PT, PI-LL, and SVA, and PI-adjusted ideal alignment values for SS, as derived from clinically relevant formulas. Chi-squared tests assessed differences in rates of matching age-adjusted alignment ideal (±10years threshold for age-adjusted targets; −7° to 5° measured minus ideal for SS target) across height and PI groups. Subanalysis of patients matching age-adjusted alignment ideal used ANOVA to compare clinical outcomes across height and PI groups. RESULTS Included: 205 ASD patients (59±16 year, 64% F, 27±6 kg/m2). Following surgery, patients showed significant improvement in PT, PI-LL and SVA (all p .05). Height groups also did not differ in age or BMI (all p>.05), although female patients comprised a greater proportion of the low (96% F vs. 4% M) and normative (75% F vs. 25% M) height groups (p 0.05). Although there were no differences across PI groups in rates of achieving ideal alignment for PI-LL, SVA or SS (all p>.05), patients with high PI reached age-adjusted ideal alignment for PT at a significantly lower rate (15%) than patients with normative (36%) or low PI (33%, p=.031). Of the 58% of patients that matched any adjusted alignment target in early follow-up, there were no significant differences in postoperative HRQL outcomes across patient height or PI groups (all p>.05). CONCLUSIONS Patients with high Pelvic Incidence reached ideal postoperative age-adjusted PT alignment at a significantly lower rate than patients with normative and low Pelvic Incidence. In contrast, patient height had no impact on postoperative age-adjusted alignment outcomes. These results suggest that current postoperative ideal alignment targets may warrant adjustment to account for the morphological factor of Pelvic Incidence.
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Wednesday, September 26, 2018 7:35 AM–9:00 AM ePosters: P173. Pelvic Incidence affects age-adjusted alignment outcomes in a population of adult spinal deformity
The Spine Journal, 2018Co-Authors: Peter G Passias, Cyrus M. Jalai, Cole Bortz, Frank A Segreto, Samantha R Horn, Leah Steinmetz, Christopher Varlotta, Nicholas Stekas, Nicholas J Frangella, Tina RamanAbstract:BACKGROUND CONTEXT Current preoperative planning for surgical adult spinal deformity (ASD) patients takes into account patient age when establishing postoperative alignment targets for sagittal vertical axis (SVA), Pelvic tilt (PT) and spino-Pelvic-mismatch (PI-LL). Patient height and Pelvic Incidence (PI), however, have yet to be evaluated for their individual effects on achieving age-adjusted alignment targets. PURPOSE This study assesses the individual effects of patient height and PI on age-adjusted alignment outcomes of surgical ASD patients. STUDY DESIGN/SETTING Single center retrospective review. PATIENT SAMPLE A total of 205 operative ASD patients. OUTCOME MEASURES Postoperative alignment parameters (PT, SVA, PI-LL, and SS); health-related quality of life (HRQL) scores. METHODS Surgical ASD patients >18 years with full-body stereographic x-ray imaging at baseline (BL) and early postoperative follow-up ( 75th) for both BL height and PI. Correction groups were generated at postoperative follow-up for actual alignment compared to age-adjusted ideal values for PT, PI-LL, and SVA, and PI-adjusted ideal alignment values for SS, as derived from clinically relevant formulas. Chi-squared tests assessed differences in rates of matching age-adjusted alignment ideal (±10years threshold for age-adjusted targets; −7° to 5° measured minus ideal for SS target) across height and PI groups. Subanalysis of patients matching age-adjusted alignment ideal used ANOVA to compare clinical outcomes across height and PI groups. RESULTS Included: 205 ASD patients (59±16 year, 64% F, 27±6 kg/m2). Following surgery, patients showed significant improvement in PT, PI-LL and SVA (all p .05). Height groups also did not differ in age or BMI (all p>.05), although female patients comprised a greater proportion of the low (96% F vs. 4% M) and normative (75% F vs. 25% M) height groups (p 0.05). Although there were no differences across PI groups in rates of achieving ideal alignment for PI-LL, SVA or SS (all p>.05), patients with high PI reached age-adjusted ideal alignment for PT at a significantly lower rate (15%) than patients with normative (36%) or low PI (33%, p=.031). Of the 58% of patients that matched any adjusted alignment target in early follow-up, there were no significant differences in postoperative HRQL outcomes across patient height or PI groups (all p>.05). CONCLUSIONS Patients with high Pelvic Incidence reached ideal postoperative age-adjusted PT alignment at a significantly lower rate than patients with normative and low Pelvic Incidence. In contrast, patient height had no impact on postoperative age-adjusted alignment outcomes. These results suggest that current postoperative ideal alignment targets may warrant adjustment to account for the morphological factor of Pelvic Incidence.
Legaye Jean - One of the best experts on this subject based on the ideXlab platform.
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Influence of age and sagittal balance of the spine on the value of the Pelvic Incidence
European Spine Journal, 2014Co-Authors: Legaye JeanAbstract:Background data The Pelvic Incidence (PI) was recognized as the key factor of the sagittal balance of the spine. Its value was described own for each individual and unchanged during adulthood. Purpose To bring out the effect of the age and of a sagittal imbalance in the variability of the value of PI. Materials and methods 200 subjects with chronic low back pain due to sagittal imbalance were compared to 89 normal subjects. For each groups, the cases were divided according to the age (19–40, 6–40 years, over 60 years). The PI and the sagittal positional parameters were measured on large radiographs in standardized standing position. Results The correlation between age and PI was observed significant only for the >60 years cases. The mean values of PI were significantly greater for these cases. Discussion An increase of the value of PI was attributable to a twisting mobilization within the sacroiliac joint. It results from a forward projection of the gravity due to a sagittal disturbance and a Pelvic compensatory backward rotation. This twisting into the sacroiliac joint was incriminated in the origin of chronic low back pain. Conclusion The sagittal pelvi-spinal imbalance may be incriminated in the increasing of the value of PI by a painful destabilization sacro-iliac, with leads to an increasing of the value of PI.
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influence of age and sagittal balance of the spine on the value of the Pelvic Incidence
European Spine Journal, 2014Co-Authors: Legaye JeanAbstract:BACKGROUND DATA: The Pelvic Incidence (PI) was recognized as the key factor of the sagittal balance of the spine. Its value was described own for each individual and unchanged during adulthood. PURPOSE: To bring out the effect of the age and of a sagittal imbalance in the variability of the value of PI. MATERIALS AND METHODS: 200 subjects with chronic low back pain due to sagittal imbalance were compared to 89 normal subjects. For each groups, the cases were divided according to the age (19-40, 6-40 years, over 60 years). The PI and the sagittal positional parameters were measured on large radiographs in standardized standing position. RESULTS: The correlation between age and PI was observed significant only for the >60 years cases. The mean values of PI were significantly greater for these cases. DISCUSSION: An increase of the value of PI was attributable to a twisting mobilization within the sacroiliac joint. It results from a forward projection of the gravity due to a sagittal disturbance and a Pelvic compensatory backward rotation. This twisting into the sacroiliac joint was incriminated in the origin of chronic low back pain. CONCLUSION: The sagittal pelvi-spinal imbalance may be incriminated in the increasing of the value of PI by a painful destabilization sacro-iliac, with leads to an increasing of the value of PI.