{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T16:42:13Z","timestamp":1790959333481,"version":"4.1.0"},"reference-count":22,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Little is known about the relationship between sagittal spinal alignment in patients with lumbar spinal canal stenosis (LSS) and objective findings such as spinopelvic parameters, lumbar back muscle degeneration, and clinical data. The purpose of this study was to identify the preoperative clinical and radiological factors that predict improvement in sagittal spinal alignment after decompressive surgery in patients with LSS.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The records of 61 patients with LSS who underwent microendoscopic laminotomy and had pre- and postoperative clinical data collected were retrospectively reviewed. Spinopelvic parameters, including sagittal vertical axis (SVA), lumbar lordosis (LL), sacral slope, pelvic tilt, and pelvic incidence (PI), were evaluated. On T2-weighted MRI, the cross-sectional area and the percentage of fat infiltration of the paravertebral muscles (PVMs) before surgery were calculated. For patients with preoperative SVA &gt; 40 mm (n = 30), the correlation between SVA improvement and preoperative clinical and radiographic parameters was calculated.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>SVA improvement correlated with preoperative LL (r = \u22120.39) and PI \u2013LL (r = 0.54). Multiple regression analysis showed that preoperative PI \u2013LL (beta = 0.62; p &lt; 0.01) and symptom duration (beta = \u22120.40; p &lt; 0.05) were independently associated with SVA improvement. The percentage of fat infiltration of the PVM at L4\u20135 was significantly greater in patients with preoperative SVA \u2265 40 mm than in those patients with SVA &lt; 40 mm.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Preoperative PI \u2013LL and symptom duration were independently associated with SVA improvement in LSS patients with forward-bending posture. PVM degeneration at the lower lumbar level was significantly greater among patients with preoperative SVA \u2265 40 mm than in patients with SVA &lt; 40 mm.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2015.12.spine15805","type":"journal-article","created":{"date-parts":[[2016,3,11]],"date-time":"2016-03-11T15:01:50Z","timestamp":1457708510000},"page":"39-45","source":"Crossref","is-referenced-by-count":37,"title":["Factors associated with improvement in sagittal spinal alignment after microendoscopic laminotomy in patients with lumbar spinal canal stenosis"],"prefix":"10.3171","volume":"25","author":[{"given":"Sho","family":"Dohzono","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromitsu","family":"Toyoda","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinji","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomiya","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Osaka Rosai Hospital, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akinobu","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidetomi","family":"Terai","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-spine15805","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. A comparative study about 85 cases","volume":"16","author":"Barrey","year":"2007"},{"key":"b2-spine15805","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"999","DOI":"10.1007\/s00586-013-3148-z","article-title":"Image changes of paraspinal muscles and clinical correlations in patients with unilateral lumbar spinal stenosis","volume":"23","author":"Chen","year":"2014"},{"key":"b3-spine15805","series-title":"Man Ther","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1016\/j.math.2012.06.007","article-title":"Increased intramuscular fatty infiltration without differences in lumbar muscle cross-sectional area during remission of unilateral recurrent low back pain","volume":"17","author":"D'hooge","year":"2012"},{"key":"b4-spine15805","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"49","DOI":"10.3171\/2014.11.SPINE14452","article-title":"The influence of preoperative spinal sagittal balance on clinical outcomes after microendoscopic laminotomy in patients with lumbar spinal canal stenosis","volume":"23","author":"Dohzono","year":"2015"},{"key":"b5-spine15805","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1007\/s00586-009-1240-1","article-title":"Sagittal spinal alignment in patients with lumbar disc herniation","volume":"19","author":"Endo","year":"2010"},{"key":"b6-spine15805","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"703","DOI":"10.1097\/BRS.0000000000000708","article-title":"Radiological improvements in global sagittal alignment after lumbar decompression without fusion","volume":"40","author":"Fujii","year":"2015"},{"key":"b7-spine15805","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"2024","DOI":"10.1097\/01.brs.0000179086.30449.96","article-title":"The impact of positive sagittal balance in adult spinal deformity","volume":"30","author":"Glassman","year":"2005"},{"key":"b8-spine15805","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"624","DOI":"10.3171\/spi.2005.2.5.0624","article-title":"Short-term results of microendoscopic posterior decompression for lumbar spinal stenosis. Technical note","volume":"2","author":"Ikuta","year":"2005"},{"key":"b9-spine15805","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1611","DOI":"10.1097\/00007632-199407001-00010","article-title":"Radiographic analysis of sagittal plane alignment and balance in standing volunteers and patients with low back pain matched for age, sex, and size. A prospective controlled clinical study","volume":"19","author":"Jackson","year":"1994"},{"key":"b10-spine15805","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1227\/01.NEU.0000335642.14527.26","article-title":"Can patients with sagittally well-compensated lumbar degenerative kyphosis benefit from surgical treatment for intractable back pain?","volume":"64","author":"Jang","year":"2009"},{"key":"b11-spine15805","series-title":"Biometrics","doi-asserted-by":"publisher","first-page":"159","DOI":"10.2307\/2529310","article-title":"The measurement of observer agreement for categorical data","volume":"33","author":"Landis","year":"1977"},{"key":"b12-spine15805","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1097\/BRS.0b013e318162458f","article-title":"Quantitative analysis of back muscle degeneration in the patients with the degenerative lumbar flat back using a digital image analysis: comparison with the normal controls","volume":"33","author":"Lee","year":"2008"},{"key":"b13-spine15805","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1097\/00007632-198901000-00006","article-title":"Comparison of CT scan muscle measurements and isokinetic trunk strength in postoperative patients","volume":"14","author":"Mayer","year":"1989"},{"key":"b14-spine15805","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"786","DOI":"10.1148\/radiol.2403050820","article-title":"Fat content of lumbar paraspinal muscles in patients with chronic low back pain and in asymptomatic volunteers: quantification with MR spectroscopy","volume":"240","author":"Mengiardi","year":"2006"},{"key":"b15-spine15805","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1007\/s00586-009-0903-2","article-title":"Clinical outcomes of microendoscopic decompressive laminotomy for degenerative lumbar spinal stenosis","volume":"18","author":"Pao","year":"2009"},{"key":"b16-spine15805","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"2224","DOI":"10.1097\/BRS.0b013e3181ee6bd4","article-title":"Adult spinal deformity-postoperative standing imbalance: how much can you tolerate? An overview of key parameters in assessing alignment and planning corrective surgery","volume":"35","author":"Schwab","year":"2010"},{"key":"b17-spine15805","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.1097\/BRS.0b013e31823e15e2","article-title":"Scoliosis Research Society\u2014Schwab adult spinal deformity classification: a validation study","volume":"37","author":"Schwab","year":"2012"},{"key":"b18-spine15805","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1398","DOI":"10.1097\/BRS.0b013e31824c767e","article-title":"Asymmetric degeneration of paravertebral muscles in patients with degenerative lumbar scoliosis","volume":"37","author":"Shafaq","year":"2012"},{"key":"b19-spine15805","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"E344","DOI":"10.1097\/BRS.0b013e3181c91121","article-title":"Total sagittal spinal alignment in patients with lumbar canal stenosis accompanied by intermittent claudication","volume":"35","author":"Suzuki","year":"2010"},{"key":"b20-spine15805","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"650","DOI":"10.1097\/00007632-199503150-00003","article-title":"Epidural pressure measurements. Relationship between epidural pressure and posture in patients with lumbar spinal stenosis","volume":"20","author":"Takahashi","year":"1995"},{"key":"b21-spine15805","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1317","DOI":"10.1097\/00007632-198811000-00019","article-title":"Lumbar degenerative kyphosis. Clinical, radiological and epidemiological studies","volume":"13","author":"Takemitsu","year":"1988"},{"key":"b22-spine15805","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1097\/BRS.0b013e3181d25829","article-title":"Clinical outcome of microsurgical bilateral decompression via unilateral approach for lumbar canal stenosis: minimum five-year follow-up","volume":"36","author":"Toyoda","year":"2011"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/25\/1\/article-p39.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/25\/1\/article-p39.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/25\/1\/article-p39.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T22:00:01Z","timestamp":1681596001000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/25\/1\/article-p39.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,7]]},"references-count":22,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/2015.12.spine15805","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2016,7]]}}}