TY - JOUR
T1 - Postoperative Sagittal Spinal Alignment Changes Following Corrective Surgery in Adult Spinal Deformity
AU - Albayar, Ahmed
AU - Ramayya, Ashwin
AU - Sullivan, Patricia Zadnik
AU - Yoon, Jang
AU - Saifi, Comron
AU - Roche, Abigail
AU - Ali, Zarina S.
AU - Welch, William C.
AU - Arlet, Vincent
AU - Ozturk, Ali K.
N1 - Publisher Copyright:
© 2021 ISASS.
PY - 2021/12/1
Y1 - 2021/12/1
N2 - 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.
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.
KW - Adult spine deformity
KW - Flat back syndrome
KW - Sagittal vertical axis
KW - Subacute postoperative change
KW - Thoracic kyphosis
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U2 - 10.14444/8194
DO - 10.14444/8194
M3 - Article
AN - SCOPUS:85124431312
SN - 2211-4599
VL - 15
SP - 1082
EP - 1089
JO - International Journal of Spine Surgery
JF - International Journal of Spine Surgery
IS - 6
ER -