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Will coronal alignment postoperatively be deteriorating in adult spinal deformity after long-fusion surgery? – Lumbar Fusion

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The article investigates the development of coronal malalignment (CM) in adult spinal deformity (ASD) patients after long-fusion surgery. A total of 161 ASD patients from three medical centers were retrospectively reviewed and divided into consistency and opposition groups based on their coronal alignment. The study found that CM increased significantly from pre-operation to final follow-up, with risk factors including age ≥ 60, consistency coronal alignment, fixed-vertebra ≥ 8, CBD-correction ≥ 30 mm, and pelvic fixation. The research highlights the potential deterioration of coronal alignments in ASD patients post-surgery and identifies key factors associated with CM development

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : innovative spine facility on Harley Street UK

Published article

S: The coronal alignments in ASD patients underwent long-fusion surgeries may deteriorate during follow-up, for which the risk factors include the consistency CA, age ≥ 60, fixed-vertebra ≥ 8, CBD-correction ≥ 30 mm and pelvic fixation.

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Eur J Med Res. 2024 Mar 25;29(1):197. doi: 10.1186/s40001-024-01798-4.ABSTRACTBACKGROUND: To investigate whether the coronal alignment (CA) will deteriorate, and identify the risk factors for coronal malalignment (CM) developing in adult spinal deformity (ASD) after long-fusion surgery.METHODS: A multi-center retrospective study was performed, which included a total of 161 ASD patients who had undergone the surgical,

Eur J Med Res. 2024 Mar 25;29(1):197. doi: 10.1186/s40001-024-01798-4.

ABSTRACT

BACKGROUND: To investigate whether the coronal alignment (CA) will deteriorate, and identify the risk factors for coronal malalignment (CM) developing in adult spinal deformity (ASD) after long-fusion surgery.

METHODS: A multi-center retrospective study was performed, which included a total of 161 ASD patients who had undergone the surgical procedure of long-fusion (≥ 5 vertebras) with instrumentations in three medical centers. All of the participants were retrospectively reviewed, and subsequently assigned into the consistency group (C7 plumb line (C7PL) shifting towards the convex side of the main curve), and the opposition group (C7PL shifting towards the concave side). CM was considered if the coronal balance distance (CBD) being over 30 mm. A Kaplan-Meier curve and log-rank test were used to analyze the differences in CM-free survival during follow-up. Multivariate analysis via a Cox proportional hazards test was used to analyze the risk factors.

RESULTS: Patients showing CM equaled 35 (21.7%) at the pre-operation, and that increased significantly up to 51 (31.7%) at the final follow-up (P = 0.04). In the consistency group, the incidence of CM at the final follow-up was much higher than that preoperatively (35:16, P = 0.002). CM-free survival time decreased significantly in patients with larger CBD correction, pelvic fixation and more instrumented segments, respectively, during follow-up (P < 0.05, log-rank test). Age ≥ 60 years, the consistency CA, pelvic fixation, CBD-correction ≥ 30 mm and fixed-vertebra ≥ 8 were risk factors for CM happening after surgery using multivariate regression analysis (P < 0.05).

S: The coronal alignments in ASD patients underwent long-fusion surgeries may deteriorate during follow-up, for which the risk factors include the consistency CA, age ≥ 60, fixed-vertebra ≥ 8, CBD-correction ≥ 30 mm and pelvic fixation.

PMID:38528614 | PMC:PMC10962204 | DOI:10.1186/s40001-024-01798-4

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Will coronal alignment postoperatively be deteriorating in adult spinal deformity after long-fusion surgery?

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Eur J Med Res. 2024 Mar 25;29(1):197. doi: 10.1186/s40001-024-01798-4.ABSTRACTBACKGROUND: To investigate whether the coronal alignment (CA) will deteriorate, and identify the risk factors for coronal malalignment (CM) developing in adult spinal deformity (ASD) after long-fusion surgery.METHODS: A multi-center retrospective study was performed, which included a total of 161 ASD patients who had undergone the surgical

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