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What factors are associated with a better restoration of pelvic version after adult spinal deformity surgery? – Lumbar Spinal Stenosis

The article discusses the importance of restoring pelvic version after adult spinal deformity (ASD) surgery to reduce the risk of mechanical complications and improve quality of life. The study analyzed data from 177 patients with severe pelvic retroversion who underwent panlumbar fusions to the pelvis. Patients who showed improvement in pelvic version postoperatively were more likely to have undergone anterior lumbar interbody fusion (ALIF) procedures and posterior osteotomies. These patients also had better postoperative sagittal parameters, such as L4-S1 angle and lumbar lordosis, leading to improved sacral slope and global alignment. However, these improvements seemed to diminish over the 2-year follow-up period. The study highlights the impact of specific surgical techniques on pelvic version restoration and overall postoperative outcomes in ASD patients

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

Published article

CONCLUSIONS: ALIF procedures and posterior column osteotomies improved pelvic version postoperatively, and associated better L4-S1 and lumbar lordosis restoration, indirectly improving all other sagittal parameters. However, these improvements seemed to fade during the 2-year follow-up.

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Spine Deform. 2024 Apr 8. doi: 10.1007/s43390-024-00863-6. Online ahead of print. ABSTRACT INTRODUCTION: Poor restoration of pelvic version after adult spinal deformity (ASD) surgery is associated with an increased risk of mechanical complications and worse quality of life. We studied the factors linked to the improvement of postoperative pelvic version. MATERIALS AND METHODS: This is,

Spine Deform. 2024 Apr 8. doi: 10.1007/s43390-024-00863-6. Online ahead of print.

ABSTRACT

INTRODUCTION: Poor restoration of pelvic version after adult spinal deformity (ASD) surgery is associated with an increased risk of mechanical complications and worse quality of life. We studied the factors linked to the improvement of postoperative pelvic version.

MATERIALS AND METHODS: This is a retrospective analysis of a prospective multicenter ASD database. Selection criteria were: operated patients having preoperative severe pelvic retroversion as per GAP score (Relative Pelvic Version-RPV < - 15°); panlumbar fusions to the pelvis; 2-year follow-up. Group A comprised patients with any postoperative improvement of RPV score, and group B had no improvement. Groups were compared regarding baseline characteristics, surgical factors, and postoperative sagittal parameters. Parametric and non-parametric analyses were employed.

RESULTS: 177 patients were studied, median age 67 years (61; 72.5), 83.6% female. Groups were homogeneous in baseline demographics, comorbidities, and preoperative sagittal parameters (p > 0.05). The difference in RPV improvement was 11.56º. Group A (137 patients) underwent a higher percentage of ALIF procedures (OR = 6.66; p = 0.049), and posterior osteotomies (OR = 4.96; p < 0.001) especially tricolumnar (OR = 2.31; p = 0.041). It also showed a lower percentage of TLIF procedures (OR = 0.45; p = 0.028), and posterior decompression (OR = 0.44; p = 0.024). Group A displayed better postoperative L4-S1 angle and relative lumbar lordosis (RLL), leading to improved sacral slope (and RPV), and global alignment (RSA). Group A patients had longer instrumentations (11.45 vs 10; p = 0.047) and hospitalization time (13 vs 11; p = 0.045). All postoperative sagittal parameters remained significantly better in group A through follow-up. However, differences between the groups narrowed over time.

CONCLUSIONS: ALIF procedures and posterior column osteotomies improved pelvic version postoperatively, and associated better L4-S1 and lumbar lordosis restoration, indirectly improving all other sagittal parameters. However, these improvements seemed to fade during the 2-year follow-up.

PMID:38589595 | DOI:10.1007/s43390-024-00863-6

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What factors are associated with a better restoration of pelvic version after adult spinal deformity surgery?

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Spine Deform. 2024 Apr 8. doi: 10.1007/s43390-024-00863-6. Online ahead of print. ABSTRACT INTRODUCTION: Poor restoration of pelvic version after adult spinal deformity (ASD) surgery is associated with an increased risk of mechanical complications and worse quality of life. We studied the factors linked to the improvement of postoperative pelvic version. MATERIALS AND METHODS: This is

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