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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...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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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 |
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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 |
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