{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T03:18:03Z","timestamp":1792034283152,"version":"4.4.0"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2020,4,16]],"date-time":"2020-04-16T00:00:00Z","timestamp":1586995200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurosurg.","NEUROS"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Anterior column realignment (ACR) is a less invasive alternative to 3-column osteotomy for the correction of sagittal imbalance. We hypothesized that ACR would correct sagittal imbalance with an acceptable neurological risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To assess long-term neurological and radiographic outcomes after ACR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Patients\u00a0\u226518 yr who underwent ACR from 2005 to 2013 were eligible. Standing scoliosis radiographs were studied at preoperation, postoperation (\u22646 wk), and at minimum 2 yr of follow-up. Clinical\/radiographic data were collected through a retrospective chart review, with thoracic 1 spino-pelvic inclination (T1SPi) used as the angular surrogate for sagittal vertical axis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      A total of 26 patients had complete data, with a mean follow-up of 2.8 yr (1.8-7.4). Preoperative, sagittal parameters were lumbar lordosis (LL) of \u221216.1\u00b0, pelvic incidence (PI)-LL of 41.7\u00b0, T1SPi of 3.6\u00b0, and pelvis tilt (PT) of 32.4\u00b0. LL improved by 30.6\u00b0 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&lt;\u00a0.001) postoperation. Mean changes in PT (\u22128.3), sacral slope (8.9), T1SPi (\u22124.9), and PI-LL (\u221233.5) were all significant. The motion segment angle improved by 26.6\u00b0, from 5.2\u00b0 to \u221221.4\u00b0 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&lt;\u00a0.001). Neurological complications occurred in 32% patients postoperation (n\u00a0=\u00a08; 1 patient with both sensory and motor). New thigh numbness\/paresthesia developed in 3 (13%) patients postoperation; only 1 (4%) persisted at latest follow-up. A total of 6 (24%) patients developed a new lower extremity motor deficit postoperation, with 4 (8%) having persistent new weakness at last follow-up. Out of 8 patients with preoperative motor deficit, half saw improvement postoperation and 75% improved by last follow-up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>There was net motor improvement, with 24% of patients improving and 16% having persistent new weakness at latest follow-up; 60% were unchanged. Radiographic results demonstrate that ACR is a useful tool to treat severe sagittal plane deformity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/neuros\/nyaa064","type":"journal-article","created":{"date-parts":[[2020,4,4]],"date-time":"2020-04-04T00:37:52Z","timestamp":1585960672000},"page":"E347-E354","source":"Crossref","is-referenced-by-count":15,"title":["Anterior Column Realignment: Analysis of Neurological Risk and Radiographic Outcomes"],"prefix":"10.1227","volume":"87","author":[{"given":"Rajiv","family":"Saigal","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Behrooz A","family":"Akbarnia","sequence":"additional","affiliation":[{"name":"Department of Research, San Diego Spine Foundation, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert K","family":"Eastlack","sequence":"additional","affiliation":[{"name":"Department of Research, San Diego Spine Foundation, San Diego, California"},{"name":"Department of Orthopaedics, Scripps Clinic, La Jolla, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Bagheri","sequence":"additional","affiliation":[{"name":"Department of Research, San Diego Spine Foundation, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacie","family":"Tran","sequence":"additional","affiliation":[{"name":"Department of Research, San Diego Spine Foundation, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Drew","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Research, San Diego Spine Foundation, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramin","family":"Bagheri","sequence":"additional","affiliation":[{"name":"Department of Research, San Diego Spine Foundation, San Diego, California"},{"name":"Department of Orthopaedics, Scripps Clinic, La Jolla, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory M","family":"Mundis","sequence":"additional","affiliation":[{"name":"Department of Research, San Diego Spine Foundation, San Diego, California"},{"name":"Department of Orthopaedics, Scripps Clinic, La Jolla, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,9]]},"reference":[{"issue":"18","key":"bib1-20231011","doi-asserted-by":"crossref","first-page":"2024","DOI":"10.1097\/01.brs.0000179086.30449.96","article-title":"The impact of positive sagittal balance in adult spinal 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