Overcorrection of lumbar lordosis for adult spinal deformity with sagittal imbalance: comparison of radiographic outcomes between overcorrection and undercorrection
Purpose To determine the correlation of the difference between postoperative lumbar lordosis (LL) and ideal LL with the sagittal vertical axis (SVA) at the final follow-up in patients with adult spinal deformity (ASD). Methods Fifty-one patients with degenerative lumbar kyphosis (DLK) (mean age 66.5...
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| Veröffentlicht in: | European spine journal 2016-08, Vol.25 (8), p.2668-2675 |
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| creator | Lee, Jung-Hee Kim, Ki-Tack Lee, Sang-Hun Kang, Kyung-Chung Oh, Hyun-Seok Kim, Young-Jun Jung, Hyuk |
| description | Purpose
To determine the correlation of the difference between postoperative lumbar lordosis (LL) and ideal LL with the sagittal vertical axis (SVA) at the final follow-up in patients with adult spinal deformity (ASD).
Methods
Fifty-one patients with degenerative lumbar kyphosis (DLK) (mean age 66.5 years) who underwent surgical correction with a minimum 2-year follow-up were evaluated. Based on the difference between postoperative LL and ideal LL using the Korean version of Legaye’s formula, we divided the 51 patients into two groups: overcorrection (degree of postoperative LL > ideal LL) and undercorrection (degree of postoperative LL |
| doi_str_mv | 10.1007/s00586-016-4441-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1811886862</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1807878131</sourcerecordid><originalsourceid>FETCH-LOGICAL-c448t-dc7914f7ccbad416bc2091805186d22ee13b90875d59f52c14ea94365bf42f3b3</originalsourceid><addsrcrecordid>eNqNkcFqFjEUhYMo9m_1AdxIwI2bqfdmMpnEnRS1hUI3uh4ySeZvysxkTDKWvk8ftPmZKlUQXAXO_c65SQ4hbxBOEaD9kAAaKSpAUXHOseLPyA55zSpQNXtOdqA4VKJFdUSOU7oBwEaBeEmOmJCyZkLsyP3VTxdNiNGZ7MNMw0DHdep1pGOINiSf6BAi1XYdM02Ln_VIrSvS5PMdvfX5mia99zkX3RffqGfjPlITpkVHn7bEqK0P-6iXa29oWHOZukR7l2-dK8CfN9Czpetsn2qvyItBj8m9fjxPyPcvn7-dnVeXV18vzj5dVoZzmStrWoV8aI3pteUoesNAoYQGpbCMOYd1r0C2jW3U0DCD3GnFa9H0A2dD3dcn5P2Wu8TwY3Upd5NPxo3lUS6sqUOJKKWQgv0HCq1sJdZY0Hd_oTdhjeUjC6Vk2c9bOFC4USaGlKIbuiX6Sce7DqE7tN1tbXel7e7QdseL5-1j8tpPzv52_Kq3AGwDUhnNexefrP5n6gPXA7jk</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1984364701</pqid></control><display><type>article</type><title>Overcorrection of lumbar lordosis for adult spinal deformity with sagittal imbalance: comparison of radiographic outcomes between overcorrection and undercorrection</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Lee, Jung-Hee ; Kim, Ki-Tack ; Lee, Sang-Hun ; Kang, Kyung-Chung ; Oh, Hyun-Seok ; Kim, Young-Jun ; Jung, Hyuk</creator><creatorcontrib>Lee, Jung-Hee ; Kim, Ki-Tack ; Lee, Sang-Hun ; Kang, Kyung-Chung ; Oh, Hyun-Seok ; Kim, Young-Jun ; Jung, Hyuk</creatorcontrib><description>Purpose
To determine the correlation of the difference between postoperative lumbar lordosis (LL) and ideal LL with the sagittal vertical axis (SVA) at the final follow-up in patients with adult spinal deformity (ASD).
Methods
Fifty-one patients with degenerative lumbar kyphosis (DLK) (mean age 66.5 years) who underwent surgical correction with a minimum 2-year follow-up were evaluated. Based on the difference between postoperative LL and ideal LL using the Korean version of Legaye’s formula, we divided the 51 patients into two groups: overcorrection (degree of postoperative LL > ideal LL) and undercorrection (degree of postoperative LL < ideal LL).
Results
Our clinical series of patients comprised 24 in the overcorrection and 27 in the undercorrection group. No significant differences were found in preoperative pelvic incidence (PI 52.6° vs. 57.3°), sacral slope (SS 23.3° vs. 18.3°), LL (−6.9° vs. −2.3°), thoracic kyphosis (TK 4.7° vs. 4.9°) and SVA (140 vs. 139 mm) except pelvic tilt (PT 29.4° vs. 39.0°), between the two groups. All the patients in the overcorrection group and 16 in the undercorrection group achieved postoperative optimal sagittal balance based on SVA ≤ 50 mm. In addition, significant differences in PT (10.5° vs. 26.7°), SS (42.1° vs. 30.6°), LL (−64.3° vs. −37.1°), TK (22.6° vs. 15.8°), and SVA (−1 vs. 41 mm) between the two groups were observed postoperatively. Furthermore, four patients (16.7 %) in the overcorrection group and eight (50 %) in the undercorrection group had sagittal decompensation at the final follow-up. Our results showed that the difference between postoperative LL and ideal LL had a significant correlation with postoperative and final follow-up SVA in our clinical series.
Conclusion
Overcorrection of LL is an effective treatment modality to maintain optimal sagittal alignment in patients with DLK; this suggests that it should be considered in preoperative planning for patients with ASD with sagittal imbalance.</description><identifier>ISSN: 0940-6719</identifier><identifier>EISSN: 1432-0932</identifier><identifier>DOI: 10.1007/s00586-016-4441-4</identifier><identifier>PMID: 26883266</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aged ; Degenerative disc disease ; Humans ; Kyphosis ; Kyphosis - diagnostic imaging ; Kyphosis - physiopathology ; Kyphosis - surgery ; Lordosis - diagnostic imaging ; Lordosis - etiology ; Lordosis - physiopathology ; Lumbar Vertebrae - diagnostic imaging ; Lumbar Vertebrae - surgery ; Medicine ; Medicine & Public Health ; Middle Aged ; Neurosurgery ; Original Article ; Pelvis ; Postoperative Complications - diagnostic imaging ; Postoperative Complications - physiopathology ; Sacrum ; Surgical Orthopedics ; Thorax ; Tomography, X-Ray Computed</subject><ispartof>European spine journal, 2016-08, Vol.25 (8), p.2668-2675</ispartof><rights>Springer-Verlag Berlin Heidelberg 2016</rights><rights>European Spine Journal is a copyright of Springer, (2016). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c448t-dc7914f7ccbad416bc2091805186d22ee13b90875d59f52c14ea94365bf42f3b3</citedby><cites>FETCH-LOGICAL-c448t-dc7914f7ccbad416bc2091805186d22ee13b90875d59f52c14ea94365bf42f3b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00586-016-4441-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00586-016-4441-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26883266$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Jung-Hee</creatorcontrib><creatorcontrib>Kim, Ki-Tack</creatorcontrib><creatorcontrib>Lee, Sang-Hun</creatorcontrib><creatorcontrib>Kang, Kyung-Chung</creatorcontrib><creatorcontrib>Oh, Hyun-Seok</creatorcontrib><creatorcontrib>Kim, Young-Jun</creatorcontrib><creatorcontrib>Jung, Hyuk</creatorcontrib><title>Overcorrection of lumbar lordosis for adult spinal deformity with sagittal imbalance: comparison of radiographic outcomes between overcorrection and undercorrection</title><title>European spine journal</title><addtitle>Eur Spine J</addtitle><addtitle>Eur Spine J</addtitle><description>Purpose
To determine the correlation of the difference between postoperative lumbar lordosis (LL) and ideal LL with the sagittal vertical axis (SVA) at the final follow-up in patients with adult spinal deformity (ASD).
Methods
Fifty-one patients with degenerative lumbar kyphosis (DLK) (mean age 66.5 years) who underwent surgical correction with a minimum 2-year follow-up were evaluated. Based on the difference between postoperative LL and ideal LL using the Korean version of Legaye’s formula, we divided the 51 patients into two groups: overcorrection (degree of postoperative LL > ideal LL) and undercorrection (degree of postoperative LL < ideal LL).
Results
Our clinical series of patients comprised 24 in the overcorrection and 27 in the undercorrection group. No significant differences were found in preoperative pelvic incidence (PI 52.6° vs. 57.3°), sacral slope (SS 23.3° vs. 18.3°), LL (−6.9° vs. −2.3°), thoracic kyphosis (TK 4.7° vs. 4.9°) and SVA (140 vs. 139 mm) except pelvic tilt (PT 29.4° vs. 39.0°), between the two groups. All the patients in the overcorrection group and 16 in the undercorrection group achieved postoperative optimal sagittal balance based on SVA ≤ 50 mm. In addition, significant differences in PT (10.5° vs. 26.7°), SS (42.1° vs. 30.6°), LL (−64.3° vs. −37.1°), TK (22.6° vs. 15.8°), and SVA (−1 vs. 41 mm) between the two groups were observed postoperatively. Furthermore, four patients (16.7 %) in the overcorrection group and eight (50 %) in the undercorrection group had sagittal decompensation at the final follow-up. Our results showed that the difference between postoperative LL and ideal LL had a significant correlation with postoperative and final follow-up SVA in our clinical series.
Conclusion
Overcorrection of LL is an effective treatment modality to maintain optimal sagittal alignment in patients with DLK; this suggests that it should be considered in preoperative planning for patients with ASD with sagittal imbalance.</description><subject>Aged</subject><subject>Degenerative disc disease</subject><subject>Humans</subject><subject>Kyphosis</subject><subject>Kyphosis - diagnostic imaging</subject><subject>Kyphosis - physiopathology</subject><subject>Kyphosis - surgery</subject><subject>Lordosis - diagnostic imaging</subject><subject>Lordosis - etiology</subject><subject>Lordosis - physiopathology</subject><subject>Lumbar Vertebrae - diagnostic imaging</subject><subject>Lumbar Vertebrae - surgery</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neurosurgery</subject><subject>Original Article</subject><subject>Pelvis</subject><subject>Postoperative Complications - diagnostic imaging</subject><subject>Postoperative Complications - physiopathology</subject><subject>Sacrum</subject><subject>Surgical Orthopedics</subject><subject>Thorax</subject><subject>Tomography, X-Ray Computed</subject><issn>0940-6719</issn><issn>1432-0932</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkcFqFjEUhYMo9m_1AdxIwI2bqfdmMpnEnRS1hUI3uh4ySeZvysxkTDKWvk8ftPmZKlUQXAXO_c65SQ4hbxBOEaD9kAAaKSpAUXHOseLPyA55zSpQNXtOdqA4VKJFdUSOU7oBwEaBeEmOmJCyZkLsyP3VTxdNiNGZ7MNMw0DHdep1pGOINiSf6BAi1XYdM02Ln_VIrSvS5PMdvfX5mia99zkX3RffqGfjPlITpkVHn7bEqK0P-6iXa29oWHOZukR7l2-dK8CfN9Czpetsn2qvyItBj8m9fjxPyPcvn7-dnVeXV18vzj5dVoZzmStrWoV8aI3pteUoesNAoYQGpbCMOYd1r0C2jW3U0DCD3GnFa9H0A2dD3dcn5P2Wu8TwY3Upd5NPxo3lUS6sqUOJKKWQgv0HCq1sJdZY0Hd_oTdhjeUjC6Vk2c9bOFC4USaGlKIbuiX6Sce7DqE7tN1tbXel7e7QdseL5-1j8tpPzv52_Kq3AGwDUhnNexefrP5n6gPXA7jk</recordid><startdate>20160801</startdate><enddate>20160801</enddate><creator>Lee, Jung-Hee</creator><creator>Kim, Ki-Tack</creator><creator>Lee, Sang-Hun</creator><creator>Kang, Kyung-Chung</creator><creator>Oh, Hyun-Seok</creator><creator>Kim, Young-Jun</creator><creator>Jung, Hyuk</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20160801</creationdate><title>Overcorrection of lumbar lordosis for adult spinal deformity with sagittal imbalance: comparison of radiographic outcomes between overcorrection and undercorrection</title><author>Lee, Jung-Hee ; Kim, Ki-Tack ; Lee, Sang-Hun ; Kang, Kyung-Chung ; Oh, Hyun-Seok ; Kim, Young-Jun ; Jung, Hyuk</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c448t-dc7914f7ccbad416bc2091805186d22ee13b90875d59f52c14ea94365bf42f3b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Degenerative disc disease</topic><topic>Humans</topic><topic>Kyphosis</topic><topic>Kyphosis - diagnostic imaging</topic><topic>Kyphosis - physiopathology</topic><topic>Kyphosis - surgery</topic><topic>Lordosis - diagnostic imaging</topic><topic>Lordosis - etiology</topic><topic>Lordosis - physiopathology</topic><topic>Lumbar Vertebrae - diagnostic imaging</topic><topic>Lumbar Vertebrae - surgery</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neurosurgery</topic><topic>Original Article</topic><topic>Pelvis</topic><topic>Postoperative Complications - diagnostic imaging</topic><topic>Postoperative Complications - physiopathology</topic><topic>Sacrum</topic><topic>Surgical Orthopedics</topic><topic>Thorax</topic><topic>Tomography, X-Ray Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Jung-Hee</creatorcontrib><creatorcontrib>Kim, Ki-Tack</creatorcontrib><creatorcontrib>Lee, Sang-Hun</creatorcontrib><creatorcontrib>Kang, Kyung-Chung</creatorcontrib><creatorcontrib>Oh, Hyun-Seok</creatorcontrib><creatorcontrib>Kim, Young-Jun</creatorcontrib><creatorcontrib>Jung, Hyuk</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>European spine journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Jung-Hee</au><au>Kim, Ki-Tack</au><au>Lee, Sang-Hun</au><au>Kang, Kyung-Chung</au><au>Oh, Hyun-Seok</au><au>Kim, Young-Jun</au><au>Jung, Hyuk</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Overcorrection of lumbar lordosis for adult spinal deformity with sagittal imbalance: comparison of radiographic outcomes between overcorrection and undercorrection</atitle><jtitle>European spine journal</jtitle><stitle>Eur Spine J</stitle><addtitle>Eur Spine J</addtitle><date>2016-08-01</date><risdate>2016</risdate><volume>25</volume><issue>8</issue><spage>2668</spage><epage>2675</epage><pages>2668-2675</pages><issn>0940-6719</issn><eissn>1432-0932</eissn><abstract>Purpose
To determine the correlation of the difference between postoperative lumbar lordosis (LL) and ideal LL with the sagittal vertical axis (SVA) at the final follow-up in patients with adult spinal deformity (ASD).
Methods
Fifty-one patients with degenerative lumbar kyphosis (DLK) (mean age 66.5 years) who underwent surgical correction with a minimum 2-year follow-up were evaluated. Based on the difference between postoperative LL and ideal LL using the Korean version of Legaye’s formula, we divided the 51 patients into two groups: overcorrection (degree of postoperative LL > ideal LL) and undercorrection (degree of postoperative LL < ideal LL).
Results
Our clinical series of patients comprised 24 in the overcorrection and 27 in the undercorrection group. No significant differences were found in preoperative pelvic incidence (PI 52.6° vs. 57.3°), sacral slope (SS 23.3° vs. 18.3°), LL (−6.9° vs. −2.3°), thoracic kyphosis (TK 4.7° vs. 4.9°) and SVA (140 vs. 139 mm) except pelvic tilt (PT 29.4° vs. 39.0°), between the two groups. All the patients in the overcorrection group and 16 in the undercorrection group achieved postoperative optimal sagittal balance based on SVA ≤ 50 mm. In addition, significant differences in PT (10.5° vs. 26.7°), SS (42.1° vs. 30.6°), LL (−64.3° vs. −37.1°), TK (22.6° vs. 15.8°), and SVA (−1 vs. 41 mm) between the two groups were observed postoperatively. Furthermore, four patients (16.7 %) in the overcorrection group and eight (50 %) in the undercorrection group had sagittal decompensation at the final follow-up. Our results showed that the difference between postoperative LL and ideal LL had a significant correlation with postoperative and final follow-up SVA in our clinical series.
Conclusion
Overcorrection of LL is an effective treatment modality to maintain optimal sagittal alignment in patients with DLK; this suggests that it should be considered in preoperative planning for patients with ASD with sagittal imbalance.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>26883266</pmid><doi>10.1007/s00586-016-4441-4</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Degenerative disc disease Humans Kyphosis Kyphosis - diagnostic imaging Kyphosis - physiopathology Kyphosis - surgery Lordosis - diagnostic imaging Lordosis - etiology Lordosis - physiopathology Lumbar Vertebrae - diagnostic imaging Lumbar Vertebrae - surgery Medicine Medicine & Public Health Middle Aged Neurosurgery Original Article Pelvis Postoperative Complications - diagnostic imaging Postoperative Complications - physiopathology Sacrum Surgical Orthopedics Thorax Tomography, X-Ray Computed |
| title | Overcorrection of lumbar lordosis for adult spinal deformity with sagittal imbalance: comparison of radiographic outcomes between overcorrection and undercorrection |
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