• Eur Spine J · Dec 2022

    Effects of preoperative spinopelvic compensation states on the patient-reported outcomes of adult spinal deformity surgery: three-dimensional motion analysis results.

    • Dae-Woong Ham, Ho-Joong Kim, Sang-Min Park, Jiwon Park, Bong-Soon Chang, Juyoung Chung, and Jin S Yeom.
    • Spine Center and Department of Orthopaedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, 166 Gumiro, Bundang-gu, Sungnam, 463-707, Republic of Korea.
    • Eur Spine J. 2022 Dec 1; 31 (12): 368736953687-3695.

    PurposeThis study aimed to investigate how preoperative motion analysis results affect the postoperative clinical outcomes of patients undergoing surgery for adult spinal deformity (ASD).MethodsPatients who underwent surgery for ASD and whose motion analysis results were available were included. All patients underwent preoperative three-dimensional gait analysis using a motion analysis system. Univariate and multivariate regression analyses were performed to determine the predictive parameters of the 12-month postoperative Oswestry Disability Index (ODI). According to the mean anterior pelvic tilt (Ant-PT) angle in the motion analysis, the patients were divided into two groups: small and high Ant-PT angle groups. The 12-month postoperative ODI between the two groups was compared.ResultsA total of 111 patients who met the inclusion criteria were enrolled in the study. In the multivariate regression analysis, the preoperative sacral slope and mean Ant-PT angle were significant predictors of the 12-month postoperative ODI (p = 0.013 and p = 0.009, respectively). The high Ant-PT angle group showed a poorer 12-month postoperative ODI than did the small Ant-PT angle group, with a mean ODI of 21.9 ± 8.4 and 16.7 ± 8.5, respectively (p = 0.002). Simple linear regression analysis revealed that the Ant-PT angle was positively correlated with the postoperative sagittal vertical axis in all follow-up periods.ConclusionThe study highlights that a high preoperative Ant-PT angle in motion analyses is associated with poor clinical outcomes after surgery for ASD. Therefore, it is necessary to observe and consider the dynamic gait pattern related to the compensatory mechanism for sagittal imbalance in the decision-making process for ASD surgery.© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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