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Sagittal Alignment in the Degenerative Lumbar Spine: Surgical Planning – Lumbar Fusion

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This article discusses the importance of sagittal alignment of the spine in spinal deformity surgery. The authors highlight the significance of restoring segmental lumbar lordosis and lumbar spinal shape according to the pelvic morphology when addressing degenerative lumbar pathologies. They emphasize that the distribution of caudal and cranial lordosis as a percentage of global lordosis varies based on pelvic incidence. The authors warn that spinal fusion surgeries can result in iatrogenic deformities if performed without considering the magnitude and location of lordosis in the lumbar spine. They conclude that having a solid understanding of optimal spinal sagittal alignment and careful planning and execution of lumbar fusions can improve patient outcomes

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : innovative spinal hospital in London

Published article

➤ Sagittal alignment of the spine has gained attention in the field of spinal deformity surgery for decades. However, emerging data support the importance of restoring segmental lumbar lordosis and lumbar spinal shape according to the pelvic morphology when surgically addressing degenerative lumbar pathologies such as degenerative disc disease and spondylolisthesis.➤ The distribution of caudal lordosis (L4-S1) and cranial lordosis (L1-L4) as a percentage of global lordosis varies by pelvic…

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J Bone Joint Surg Am. 2024 Jan 25. doi: 10.2106/JBJS.23.00672. Online ahead of print.ABSTRACT➤ Sagittal alignment of the spine has gained attention in the field of spinal deformity surgery for decades. However, emerging data support the importance of restoring segmental lumbar lordosis and lumbar spinal shape according to the pelvic morphology when surgically addressing degenerative,

J Bone Joint Surg Am. 2024 Jan 25. doi: 10.2106/JBJS.23.00672. Online ahead of print.

ABSTRACT

➤ Sagittal alignment of the spine has gained attention in the field of spinal deformity surgery for decades. However, emerging data support the importance of restoring segmental lumbar lordosis and lumbar spinal shape according to the pelvic morphology when surgically addressing degenerative lumbar pathologies such as degenerative disc disease and spondylolisthesis.➤ The distribution of caudal lordosis (L4-S1) and cranial lordosis (L1-L4) as a percentage of global lordosis varies by pelvic incidence (PI), with cephalad lordosis increasing its contribution to total lordosis as PI increases.➤ Spinal fusion may lead to iatrogenic deformity if performed without attention to lordosis magnitude and location in the lumbar spine.➤ A solid foundation of knowledge with regard to optimal spinal sagittal alignment is beneficial when performing lumbar spinal surgery, and thoughtful planning and execution of lumbar fusions with a focus on alignment may improve patient outcomes.

PMID:38271548 | DOI:10.2106/JBJS.23.00672

The London Spine Unit : innovative spinal hospital in London

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Sagittal Alignment in the Degenerative Lumbar Spine: Surgical Planning

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J Bone Joint Surg Am. 2024 Jan 25. doi: 10.2106/JBJS.23.00672. Online ahead of print.ABSTRACT➤ Sagittal alignment of the spine has gained attention in the field of spinal deformity surgery for decades. However, emerging data support the importance of restoring segmental lumbar lordosis and lumbar spinal shape according to the pelvic morphology when surgically addressing degenerative

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