{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T03:14:44Z","timestamp":1793070884609,"version":"4.5.0"},"reference-count":27,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:sec>\n<jats:title>OBJECT<\/jats:title>\n<jats:p>The object of this study was to investigate correlations between sagittal spinopelvic alignment and improvements in clinical and quality-of-life (QOL) outcomes after lumbar decompression surgery for lumbar spinal canal stenosis (LCS) without coronal imbalance.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The authors retrospectively reviewed data from consecutive patients treated for LCS with decompression surgery in the period from 2009 through 2011. They examined correlations between preoperative or postoperative sagittal vertical axis (SVA) and radiological parameters, clinical outcomes, and health-related (HR)QOL scores in patients divided according to SVA. Clinical outcomes were assessed according to Japanese Orthopaedic Association (JOA) and visual analog scale (VAS) scores. Health-related QOL was evaluated using the Roland-Morris Disability Questionnaire (RMDQ) and the JOA Back Pain Evaluation Questionnaire (JOABPEQ).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>One hundred nine patients were eligible for inclusion in the study. Compared to patients with normal sagittal alignment prior to surgery (Group A: SVA &lt; 50 mm), those with preoperative sagittal imbalance (Group B: SVA \u2265 50 mm) had significantly smaller lumbar lordosis and thoracic kyphosis angles and larger pelvic tilt. In Group B, there was a significant decrease in postoperative SVA compared with the preoperative SVA (76.3 \u00b1 29.7 mm vs 54.3 \u00b1 39.8 mm, p = 0.004). The patients in Group B with severe preoperative sagittal imbalance (SVA &gt; 80 mm) had residual sagittal imbalance after surgery (82.8 \u00b1 41.6 mm). There were no significant differences in clinical and HRQOL outcomes between Groups A and B. Compared to patients with normal postoperative SVA (Group C: SVA &lt; 50 mm), patients with a postoperative SVA \u2265 50 mm (Group D) had significantly lower JOABPEQ scores, both preoperative and postoperative, for walking ability (preop: 36.6 \u00b1 26.3 vs 22.7 \u00b1 26.0, p = 0.038, respectively; postop: 71.1 \u00b1 30.4 vs 42.5 \u00b1 29.6, p &lt; 0.001) and social functioning (preop: 38.7 \u00b1 18.5 vs 30.2 \u00b1 16.7, p = 0.045; postop: 67.0 \u00b1 25.8 vs 49.6 \u00b1 20.0, p = 0.001), as well as significantly higher postoperative RMDQ (4.9 \u00b1 5.2 vs 7.9 \u00b1 5.7, p = 0.015) and VAS scores for low-back pain (2.68 \u00b1 2.69 vs 3.94 \u00b1 2.59, p = 0.039).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Preoperative sagittal balance was not significantly correlated with clinical or HRQOL outcomes after decompression surgery in LCS patients without coronal imbalance. Decompression surgery improved the SVA value in patients with preoperative sagittal imbalance; however, the patients with severe preoperative sagittal imbalance (SVA &gt; 80 mm) had residual imbalance after decompression surgery. Both clinical and HRQOL outcomes were negatively affected by postoperative residual sagittal imbalance.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2015.1.spine14642","type":"journal-article","created":{"date-parts":[[2015,7,3]],"date-time":"2015-07-03T15:46:05Z","timestamp":1435938365000},"page":"451-458","source":"Crossref","is-referenced-by-count":108,"title":["Impact of sagittal spinopelvic alignment on clinical outcomes after decompression surgery for lumbar spinal canal stenosis without coronal imbalance"],"prefix":"10.3171","volume":"23","author":[{"given":"Tomohiro","family":"Hikata","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kota","family":"Watanabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuyuki","family":"Fujita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akio","family":"Iwanami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naobumi","family":"Hosogane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Ishii","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaya","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiaki","family":"Toyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morio","family":"Matsumoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-spine14642","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"2214","DOI":"10.1097\/BRS.0b013e31817c0466","article-title":"Age-gender matched comparison of SRS in strument scores between adult deformity and normal adults: are all SRS domains disease specific?","volume":"33","author":"Baldus","year":"2008"},{"key":"b2-spine14642","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"1459","DOI":"10.1007\/s00586-006-0294-6","article-title":"Sagittal balance of the pelvis-spine complex and lumbar degenerative diseases. 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