This article is more than 5 years old. Information may no longer be current.
Preoperative plans for sagittal alignment correction led to over-correction vs age-adjusted ideals
Click Here to Manage Email Alerts
ORLANDO, Fla. — In comparison with age-adjusted ideals, preoperative plans for sagittal alignment correction resulted in over-correction, especially in elderly patients, while more severe deformity led to a greater likelihood of under-corrected plans, according to results presented here.
“This study showed that preoperative plans over-corrected vs. age-adjusted ideal alignment, especially in elderly patients, and it may be that these patients do not need as aggressive correction as our plans provide,” Jensen Henry, BA, said in her presentation.
Using a validated spine software, Henry and colleagues analyzed the baseline radiographs of 71 adult patients with adult spinal deformity undergoing corrective surgery. Researchers calculated planned postoperative alignment using software after the surgical strategy was determined, and also calculated age-adjusted ideal parameters based on validated formulas.
Jensen Henry
“Comparisons were made between all of these alignments using thresholds of within 10° for [pelvic incidence minus lumbar lordosis] PI-LL and [pelvic tilt] PT, and within 20 mm for [sagittal vertical axis] SVA,” Henry said.
Overall, results showed 80% of cases were revisions. Henry noted 76% of planned PTs, 65% of PI-LL and 49% of SVAs matched the ideal. Over-correction was found in 17% of PI-LL and 30% of SVA, while 21% of SVAs were under-corrected, according to results.
“These differences between the plans and ideals were not affected by BMI, gender, revision status, comorbidities or health-related quality of life scores,” Henry said. “However, as age increased, plans were significantly more likely to call for overcorrection vs. the age adjusted ideal.”
She also noted over-correction was found in 26% of PI-LL plans for patients older than 70 years vs. younger patients. However, under-corrected plans were more often found in patients with severe sagittal malalignment and high pelvic incidence. – by Casey Tingle
Reference:
Henry J, et al. Paper #496. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 1-5, 2016; Orlando, Fla.
Disclosure: Henry reports no relevant financial disclosures.