{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T18:20:23Z","timestamp":1777659623871,"version":"3.51.4"},"reference-count":30,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T00:00:00Z","timestamp":1691712000000},"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":[[2025,1]]},"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>Objective<\/jats:title>\n                    <jats:p>Restoration of lordosis in lumbar fusion reduces low back pain, decreases adjacent segment degeneration, and improves postoperative outcomes. However, the potential effects of changes in segmental lordosis on adjacent-level and global lordosis remain less understood. This study aims to examine the relationships between segmental (SL), adjacent-level, and global lumbar lordosis following L5-S1 Anterior Lumbar Interbody Fusion (ALIF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>80 consecutive patients who underwent single-level L5-S1 ALIF were divided into 3 groups based on the degree of change (\u2206) in index-level segmental lordosis: &lt;5\u00b0 (n = 23), 5\u00b0-10\u00b0 (n = 29), &gt;10\u00b0 (n = 28). Radiographic parameters measured included global lumbar, segmental, and adjacent level lordosis, sacral slope, pelvic tilt, pelvic incidence, and PI-LL mismatch.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients with \u2206SL 5\u00b0-10\u00b0 or \u2206SL &gt;10\u00b0 both showed significant increases in global lumbar lordosis from preoperative to final follow-up. However, patients with \u2206SL &gt;10\u00b0 showed statistically significant losses in adjacent level lordosis at both immediate postoperative and final follow-up compared to preoperative. When comparing patients with \u2206SL &gt;10\u00b0 to those with \u2206SL 5-10\u00b0, there were no significant differences in global lumbar lordosis at final follow-up, due to significantly greater losses of adjacent level lordosis in these patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The degree of compensatory loss of lordosis at the adjacent level L4-L5 correlated with the extent of segmental lordosis creation at the index L5-S1 level. This may suggest that the L4 to S1 segment acts as a \u201charmonious unit,\u201d able to accommodate only a certain amount of lordosis and further increases in segmental lordosis may be mitigated by loss of adjacent-level lordosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682231195777","type":"journal-article","created":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T10:42:23Z","timestamp":1691750543000},"page":"112-120","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["The Effect of Changes in Segmental Lordosis on Global Lumbar and Adjacent Segment Lordosis After L5-S1 Anterior Lumbar Interbody Fusion"],"prefix":"10.1177","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6451-4412","authenticated-orcid":false,"given":"Austin Q.","family":"Nguyen","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA"},{"name":"Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jackson P.","family":"Harvey","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3749-9282","authenticated-orcid":false,"given":"Vincent P.","family":"Federico","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9293-270X","authenticated-orcid":false,"given":"Michael T.","family":"Nolte","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krishn","family":"Khanna","sequence":"additional","affiliation":[{"name":"Orthopaedics Northeast P.C., Andover, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9250-1421","authenticated-orcid":false,"given":"Sapan D.","family":"Gandhi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4339-6079","authenticated-orcid":false,"given":"Evan D.","family":"Sheha","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew W.","family":"Colman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank M.","family":"Phillips","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, 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