• Changyu Pan, Bourghli Anouar, Yue Yang, Lei Li, Lei Kuang, Bing Wang, Guohua Lv, and Ibrahim Obeid.
• Department of Spine Surgery, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
• Eur Spine J. 2024 Feb 1; 33 (2): 610619610-619.

PurposeThis study aimed to explore the relationships between lumbar lordosis (LL) correction and improvement of postoperative global sagittal alignment and to establish corresponding linear regressions to predict the change in global tilt (GT) based on the corrected LL following adult spinal deformity (ASD) surgery.MethodsA total of 240 ASD patients who underwent lumbar correction were enrolled in this multicentre study. The following sagittal parameters were measured pre- and postoperatively: thoracic kyphosis (TK), LL, upper and lower LL (ULL and LLL), pelvic tilt (PT), sagittal vertical axis (SVA) and GT. The correlations among the changes in GT (△GT), SVA (△SVA), PT (△PT), TK (△TK), LL (△LL), ULL (△ULL) and LLL (△LLL) were assessed, and linear regressions were conducted to predict △GT, △SVA, △PT and △TK from △LL, △ULL and △LLL.Results△LL was statistically correlated with △GT (r = 0.798, P < 0.001), △SVA (r = 0.678, P < 0.001), △PT (r = 0.662, P < 0.001) and △TK (r = - 0.545, P < 0.001), and the outcomes of the linear regressions are: △GT = 3.18 + 0.69 × △LL (R2 = 0.636), △SVA = 4.78 + 2.57 × △LL (R2 = 0.459), △PT = 2.57 + 0.34 × △LL (R2 = 0.439), △TK = 7.06-0.43 × △LL (R2 = 0.297). In addition, △LLL had more correlations with △GT, △SVA and △PT, while △ULL had more correlations with △TK.ConclusionSurgical correction of LL could contribute to the restoration of global sagittal morphology following ASD surgery. These models were established to predict the changes in sagittal parameters, in particular △GT, determined by △LL, which has not been previously done and may help to customize a more precise correction plan for ASD patients.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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