The spine journal : official journal of the North American Spine Society
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Fixed sagittal imbalance (FSI) may result from loss of adequate lumbar lordosis (LL) after spinal fusion. Pelvic incidence (PI) is a fixed anatomical parameter that determines LL and overall spinal sagittal alignment. ⋯ In the current series, patients with FSI after spinal fusion had an elevated PI and inadequate LL. They attempted to compensate for FSI with reduced TK and with increased pelvic retroversion (PT). Overall, it is important to identify sagittal spinopelvic parameters and promote sagittal balance when performing lumbar fusions.