{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T05:51:18Z","timestamp":1725256278509},"reference-count":25,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,7]]},"abstract":"OBJECTIVE<\/jats:title>Pedicle subtraction osteotomy (PSO) is commonly performed for correction of spinal sagittal plane deformities. The PSO results in complex, multiple changes of the spinopelvic alignment. The influence of the variability of individual pelvic morphology has not been fully analyzed in previous outcome studies of sagittal imbalance. The aim of this study was to define radiological variables affecting the outcome after PSO in adult spinal deformities, with special emphasis on the variability of pelvic morphology.<\/jats:p><\/jats:sec>METHODS<\/jats:title>Clinical and radiographic outcomes were analyzed in a retrospective analysis of 104 patients who underwent a PSO at a single center. The radiographic variables studied were sagittal vertical axis (SVA), T1SPI (T-1 spinopelvic inclination), lumbar lordosis (LL), thoracic kyphosis (TK), pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS). To control for the individual variation of pelvic morphology, the LL\/PI, PT\/PI, and SS\/PI ratios were calculated. Clinical outcome was assessed using the visual analog scale for pain, Oswestry Disability Index, and EQ-5D preoperatively and at a minimum 1-year follow-up. Correlation coefficients were calculated between each individual radiographic variable and the outcome measures. The importance of LL mismatch to TK, reflecting the importance of a harmonious spine, was analyzed by comparing the outcome of patients with a TK+LL+PI \u2264 45\u00b0 to those with a sum > 45\u00b0.<\/jats:p><\/jats:sec>RESULTS<\/jats:title>SVA and T1SPI demonstrated the strongest correlation with the clinical outcome scores (r = 0.4\u20130.5, p < 0.001). LL correlated weakly with the clinical outcome (r = 0.2\u20130.3, p < 0.003). Mismatch of LL to PI, however, did not correlate significantly with the outcome. Similarly, only weak and inconsistent correlation was observed between PT, SS, PT\/PI, SS\/PI, and functional outcome. Patients with a TK+LL+PI \u2264 45\u00b0 had a significantly lower ODI score (33 vs 44) and a significantly higher EQ-5D score (0.64 vs 0.40) than patients with a sum > 45\u00b0 (LL is a negative value).<\/jats:p><\/jats:sec>CONCLUSIONS<\/jats:title>PSO resulted in a substantial correction of sagittal imbalance and improved outcome in most patients in this study. Correction of the global sagittal balance appears to be a necessary precondition for a good outcome. A harmonious spine with a TK and an LL of similar magnitude seems to add to a positive outcome.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2016.11.spine16601","type":"journal-article","created":{"date-parts":[[2017,4,28]],"date-time":"2017-04-28T14:02:22Z","timestamp":1493388142000},"page":"74-80","source":"Crossref","is-referenced-by-count":10,"title":["The impact of spinopelvic morphology on the short-term outcome of pedicle subtraction osteotomy in 104 patients"],"prefix":"10.3171","volume":"27","author":[{"given":"Karin","family":"Eskilsson","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Institute for Clinical Sciences, Sahlgrenska University Hospital, Gothenburg University, Gothenburg, Sweden; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deep","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christer","family":"Johansson","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Institute for Clinical Sciences, Sahlgrenska University Hospital, Gothenburg University, Gothenburg, Sweden; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rune","family":"Hedlund","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Institute for Clinical Sciences, Sahlgrenska University Hospital, Gothenburg University, Gothenburg, Sweden; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-spine16601","series-title":"Neurosurg Clin N Am","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1016\/j.nec.2012.12.007","article-title":"Use of Surgimap Spine in sagittal plane analysis, osteotomy planning, and correction calculation","volume":"24","author":"Akbar M,","year":"2013","unstructured":"Akbar M, Terran J, Ames CP, Lafage V, Schwab F: Use of Surgimap Spine in sagittal plane analysis, osteotomy planning, and correction calculation. 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