Spine deformity
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Retrospective case-control. ⋯ Level III.
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Retrospective analysis of a prospectively collected multi-center database. ⋯ Level III, therapeutic.
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Intraoperative versus postoperative radiographic coronal balance for adult spinal deformity surgery.
Coronal malalignment in adult spinal deformity (ASD) has a close relationship with patient clinical outcomes. The purpose of this study is to evaluate the relationship between intra- and postoperative coronal radiographic parameters. A novel parameter, the central sacral pelvic line (CSPL), and its relation to the central sacral vertical line (CSVL) is explored. CSPL is a measure of spinal alignment referenced to the patient's pelvis as an intraoperative proxy for CSVL. CSVL is difficult to measure intraoperatively, because a C7-plumb line (referenced to gravity) cannot be drawn in the supine position. ⋯ In adult spinal surgery, the intraoperative coronal alignment measured using the novel C7-CSPL distance correlates well with postoperative C7-CSVL distance. This gives the surgeon an objective measurement of the correction they need after assessing initial intraoperative imaging. Our findings suggest an intraoperative C7-CSPL distance < 5 cm as a threshold value to predict postoperative C7-CSVL < 4 cm in 97% of patients tested.