Cargando…

Independent Risk Factors of Postoperative Coronal Imbalance after Adult Spinal Deformity Surgery

The aim of the present study is to elucidate preoperative risk factors for inadequate correction of coronal imbalance and/or creation of new postoperative coronal imbalance (iatrogenic CIB) in patients who undergo surgery for Adult Spinal Deformity (ASD). A retrospective review of adults who underwe...

Descripción completa

Detalles Bibliográficos
Autores principales: Ruffilli, Alberto, Barile, Francesca, Paolucci, Azzurra, Manzetti, Marco, Viroli, Giovanni, Ialuna, Marco, Vita, Fabio, Cerasoli, Tosca, Faldini, Cesare
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219564/
https://www.ncbi.nlm.nih.gov/pubmed/37240665
http://dx.doi.org/10.3390/jcm12103559
_version_ 1785049039778086912
author Ruffilli, Alberto
Barile, Francesca
Paolucci, Azzurra
Manzetti, Marco
Viroli, Giovanni
Ialuna, Marco
Vita, Fabio
Cerasoli, Tosca
Faldini, Cesare
author_facet Ruffilli, Alberto
Barile, Francesca
Paolucci, Azzurra
Manzetti, Marco
Viroli, Giovanni
Ialuna, Marco
Vita, Fabio
Cerasoli, Tosca
Faldini, Cesare
author_sort Ruffilli, Alberto
collection PubMed
description The aim of the present study is to elucidate preoperative risk factors for inadequate correction of coronal imbalance and/or creation of new postoperative coronal imbalance (iatrogenic CIB) in patients who undergo surgery for Adult Spinal Deformity (ASD). A retrospective review of adults who underwent posterior spinal fusion (>5 levels) for ASD was performed. Patients were divided into groups according to the Nanjing classification: type A (CSVL < 3 cm), type B (CSVL > 3 cm and C7 plumb line shifted to major curve concavity), and type C (CSVL > 3 cm and C7 plumb line shifted to major curve convexity). They were also divided according to postoperative coronal balance in balanced (CB) vs. imbalanced (CIB) and according to iatrogenic coronal imbalance (iCIB). Preoperative, postoperative, and last follow-up radiographical parameters and intraoperative data were recorded. A multivariate analysis was performed to identify independent risk factors for CIB. A total of 127 patients were included (85 type A, 30 type B, 12 type C). They all underwent long (average levels fused 13.3 ± 2.7) all-posterior fusion. Type C patients were more at risk of developing postoperative CIB (p = 0.04). Multivariate regression analysis indicated L5 tilt angle as a preoperative risk factor for CIB (p = 0.007) and indicated L5 tilt angle and age as a preoperative independent risk factors for iatrogenic CIB (p = 0.01 and p = 0.008). Patients with a preoperative trunk shift towards the convexity of the main curve (type C) are more prone to postoperative CIB and leveling the L4 and L5 vertebrae is the key to achieve coronal alignment preventing the “takeoff phenomenon”.
format Online
Article
Text
id pubmed-10219564
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-102195642023-05-27 Independent Risk Factors of Postoperative Coronal Imbalance after Adult Spinal Deformity Surgery Ruffilli, Alberto Barile, Francesca Paolucci, Azzurra Manzetti, Marco Viroli, Giovanni Ialuna, Marco Vita, Fabio Cerasoli, Tosca Faldini, Cesare J Clin Med Article The aim of the present study is to elucidate preoperative risk factors for inadequate correction of coronal imbalance and/or creation of new postoperative coronal imbalance (iatrogenic CIB) in patients who undergo surgery for Adult Spinal Deformity (ASD). A retrospective review of adults who underwent posterior spinal fusion (>5 levels) for ASD was performed. Patients were divided into groups according to the Nanjing classification: type A (CSVL < 3 cm), type B (CSVL > 3 cm and C7 plumb line shifted to major curve concavity), and type C (CSVL > 3 cm and C7 plumb line shifted to major curve convexity). They were also divided according to postoperative coronal balance in balanced (CB) vs. imbalanced (CIB) and according to iatrogenic coronal imbalance (iCIB). Preoperative, postoperative, and last follow-up radiographical parameters and intraoperative data were recorded. A multivariate analysis was performed to identify independent risk factors for CIB. A total of 127 patients were included (85 type A, 30 type B, 12 type C). They all underwent long (average levels fused 13.3 ± 2.7) all-posterior fusion. Type C patients were more at risk of developing postoperative CIB (p = 0.04). Multivariate regression analysis indicated L5 tilt angle as a preoperative risk factor for CIB (p = 0.007) and indicated L5 tilt angle and age as a preoperative independent risk factors for iatrogenic CIB (p = 0.01 and p = 0.008). Patients with a preoperative trunk shift towards the convexity of the main curve (type C) are more prone to postoperative CIB and leveling the L4 and L5 vertebrae is the key to achieve coronal alignment preventing the “takeoff phenomenon”. MDPI 2023-05-19 /pmc/articles/PMC10219564/ /pubmed/37240665 http://dx.doi.org/10.3390/jcm12103559 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ruffilli, Alberto
Barile, Francesca
Paolucci, Azzurra
Manzetti, Marco
Viroli, Giovanni
Ialuna, Marco
Vita, Fabio
Cerasoli, Tosca
Faldini, Cesare
Independent Risk Factors of Postoperative Coronal Imbalance after Adult Spinal Deformity Surgery
title Independent Risk Factors of Postoperative Coronal Imbalance after Adult Spinal Deformity Surgery
title_full Independent Risk Factors of Postoperative Coronal Imbalance after Adult Spinal Deformity Surgery
title_fullStr Independent Risk Factors of Postoperative Coronal Imbalance after Adult Spinal Deformity Surgery
title_full_unstemmed Independent Risk Factors of Postoperative Coronal Imbalance after Adult Spinal Deformity Surgery
title_short Independent Risk Factors of Postoperative Coronal Imbalance after Adult Spinal Deformity Surgery
title_sort independent risk factors of postoperative coronal imbalance after adult spinal deformity surgery
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219564/
https://www.ncbi.nlm.nih.gov/pubmed/37240665
http://dx.doi.org/10.3390/jcm12103559
work_keys_str_mv AT ruffillialberto independentriskfactorsofpostoperativecoronalimbalanceafteradultspinaldeformitysurgery
AT barilefrancesca independentriskfactorsofpostoperativecoronalimbalanceafteradultspinaldeformitysurgery
AT paolucciazzurra independentriskfactorsofpostoperativecoronalimbalanceafteradultspinaldeformitysurgery
AT manzettimarco independentriskfactorsofpostoperativecoronalimbalanceafteradultspinaldeformitysurgery
AT viroligiovanni independentriskfactorsofpostoperativecoronalimbalanceafteradultspinaldeformitysurgery
AT ialunamarco independentriskfactorsofpostoperativecoronalimbalanceafteradultspinaldeformitysurgery
AT vitafabio independentriskfactorsofpostoperativecoronalimbalanceafteradultspinaldeformitysurgery
AT cerasolitosca independentriskfactorsofpostoperativecoronalimbalanceafteradultspinaldeformitysurgery
AT faldinicesare independentriskfactorsofpostoperativecoronalimbalanceafteradultspinaldeformitysurgery