Blake Holthaus, Nathan Ritchey, Joshua H Weinberg, Santino Cua, Eashwar Kantemneni, Kevin Agner, Luke Comisford, Heema Vyas, Yamenah Ambreen, Katelyn Sette, Witty Kwok, Abdul Karim Ghaith, Bryan Ladd, Siri Khalsa, David Xu, Stephanus Viljoen, Andrew Grossbach
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引用次数: 0
Abstract
Background context: Pelvic tilt (PT) reflects sagittal alignment compensation in adult spinal deformity and is associated with postoperative outcomes. Achievement of age-adjusted PT after long segment fusion demonstrates substantial improvements in health-related quality of life and a reduction of complications. However, many patients fail to normalize PT and predictors remain incompletely defined.
Purpose: This study aims to identify preoperative and surgical predictors of PT correction using age-adjusted thresholds in patients undergoing long-segment thoracolumbar fusion with pelvic fixation.
Outcome measures: Primary outcome was achievement of age-adjusted PT at 12 months postoperative. Radiographic parameters included pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), T1 pelvic angle (T1PA), and proportional correction measures normalized to PI.
Methods: Patients were dichotomized based on PT normalization at 12 months. Extent of spinopelvic correction and deviation from ideal was calculated and normalized by PI. Mixed-effects multivariable logistic regression controlled for confounding variables. Univariate area under curve (AUC) assessed predictive performance.
Results: Patients who normalized PT at 12 months had lower baseline PI, PT, SS, and LL. When normalized to PI, these associations became stronger. T1PA deviation ratio, ΔLL/PI, and PI were identified as independent predictors of PT normalization. T1PA had the highest discriminatory ability (AUC=0.803), while PI was the strongest negative predictor (AUC=0.745).
Conclusion: PT correction depends on both baseline alignment and extent of surgical correction. Greater correction of LL and T1PA proportional to PI, were independently associated with PT normalization.
期刊介绍：
The Spine Journal, the official journal of the North American Spine Society, is an international and multidisciplinary journal that publishes original, peer-reviewed articles on research and treatment related to the spine and spine care, including basic science and clinical investigations. It is a condition of publication that manuscripts submitted to The Spine Journal have not been published, and will not be simultaneously submitted or published elsewhere. The Spine Journal also publishes major reviews of specific topics by acknowledged authorities, technical notes, teaching editorials, and other special features, Letters to the Editor-in-Chief are encouraged.
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