{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T12:42:54Z","timestamp":1791549774092,"version":"4.3.4"},"reference-count":24,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2022,4,20]],"date-time":"2022-04-20T00:00:00Z","timestamp":1650412800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Identify optimal lumbar lordosis in adult deformity correction to achieve age-adjusted targets and sustained alignment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Surgical adult spinal deformity patients reaching an age-adjusted ideal alignment at one year were identified. Multilinear regression analysis was used to identify the relationship between regional curvatures (LL and TK) that enabled achievement of a given global alignment (T1 pelvic angle, TPA) based on pelvic incidence (PI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>347 patients out of 1048 available reached their age-adjusted TPA within 5\u00b0 (60-year-old, 72% women, body mass index 29 \u00b1 6.2). They had a significant improvement in all sagittal parameters (except PI) from pre-operative baseline to 1\u00a0year following surgery ( P &lt; .001). Multilinear regression predicting L1-S1 based on TK, TPA, and PI demonstrated excellent results (R2 = .85). Simplification of the coefficients of prediction combined with a conversion to an age-based formula led to the following: LL = PI - 0.3TK - 0.5Age + 10. Internal validation of the formula led to a mean error of \u2212.4\u00b0, and an absolute error of 5.0\u00b0. Internal validation on patients with an age-adjusted alignment revealed similar accuracy across the entire age-adjusted TPA spectrum (ranges of LL errors: ME = .2\u00b0 to 1.7\u00b0, AE = 4.0\u00b0 to 5.3\u00b0).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study provides a simple guideline to identify the amount of LL needed to reach a given alignment (i.e., age-adjusted target) based on PI and associated TK. Implementation of this predictive formula during pre-operative surgical planning may help to reduce unexpected sub-optimal post-operative alignment outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682221092003","type":"journal-article","created":{"date-parts":[[2022,4,20]],"date-time":"2022-04-20T14:02:47Z","timestamp":1650463367000},"page":"41-48","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["How Much Lumbar Lordosis does a Patient Need to Reach their Age-Adjusted Alignment Target? A Formulated Approach Predicting Successful Surgical Outcomes"],"prefix":"10.1177","volume":"14","author":[{"given":"Michael H.","family":"McCarthy","sequence":"first","affiliation":[{"name":"Indiana Spine Group, Carmel, IN, USA; Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4820-1835","authenticated-orcid":false,"given":"Renaud","family":"Lafage","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Hospital for Special Surgery, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0467-5534","authenticated-orcid":false,"given":"Justin S.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia, Charlottesville, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shay","family":"Bess","sequence":"additional","affiliation":[{"name":"Denver International Spine Center, Denver, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher P.","family":"Ames","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric O.","family":"Klineberg","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of California Davis, Sacramento, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2170-3592","authenticated-orcid":false,"given":"Han J.","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Hospital for Special Surgery, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher I.","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas C.","family":"Burton","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The University of Kansas Medical Center, Kansas City, KS, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory M.","family":"Mundis","sequence":"additional","affiliation":[{"name":"San Diego Center for Spinal Disorders, La Jolla, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4711-4377","authenticated-orcid":false,"given":"Manish C.","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Washington University, St. Louis, MO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank J.","family":"Schwab","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Northwell Health, Lenox Hill Hospital, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0119-7111","authenticated-orcid":false,"given":"Virginie","family":"Lafage","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Northwell Health, Lenox Hill Hospital, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"International Spine Study Group (ISSG)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,4,20]]},"reference":[{"key":"bibr1-21925682221092003","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000179086.30449.96"},{"key":"bibr2-21925682221092003","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-014-3542-1"},{"key":"bibr3-21925682221092003","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000001202"},{"key":"bibr4-21925682221092003","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31829ec563"},{"key":"bibr5-21925682221092003","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181aad219"},{"key":"bibr6-21925682221092003","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000248126.96737.0f"},{"key":"bibr7-21925682221092003","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000000844"},{"key":"bibr8-21925682221092003","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-011-1930-3"},{"key":"bibr9-21925682221092003","first-page":"479","author":"Dubousset J","year":"1994","journal-title":"The Pediatric Spine: Principles and Practices. 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