{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T02:19:44Z","timestamp":1785809984699,"version":"3.56.0"},"reference-count":17,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Achieving appropriate spinopelvic alignment in deformity surgery has been correlated with improvement in pain and disability. Minimally invasive surgery (MIS) techniques have been used to treat adult spinal deformity (ASD); however, there is concern for inadequate sagittal plane correction. Because age can influence the degree of sagittal correction required, the purpose of this study was to analyze whether obtaining optimal spinopelvic alignment is required in the elderly to obtain clinical improvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>A multicenter database of ASD patients was queried. Inclusion criteria were age \u2265 18 years; an MIS component as part of the index procedure; at least one of the following: pelvic tilt (PT) &gt; 20\u00b0, sagittal vertical axis (SVA) &gt; 50 mm, pelvic incidence to lumbar lordosis (PI-LL) mismatch &gt; 10\u00b0, or coronal curve &gt; 20\u00b0; and minimum follow-up of 2 years. Patients were stratified into younger (&lt; 65 years) and older (\u2265 65 years) cohorts. Within each cohort, patients were categorized into aligned (AL) or mal-aligned (MAL) subgroups based on postoperative radiographic measurements. Mal-alignment was defined as a PI-LL &gt; 10\u00b0 or SVA &gt; 50 mm. Pre- and postoperative radiographic and clinical outcomes were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Of the 185 patients, 107 were in the younger cohort and 78 in the older cohort. Based on postoperative radiographs, 36 (33.6%) of the younger patients were in the AL subgroup and 71 (66.4%) were in the MAL subgroup. The older patients were divided into 2 subgroups based on alignment; there were 26 (33.3%) patients in the AL and 52 (66.7%) in the MAL subgroups. Overall, patients within both younger and older cohorts significantly improved with regard to postoperative visual analog scale (VAS) scores for back and leg pain and Oswestry Disability Index (ODI) scores. In the younger cohort, there were no significant differences in postoperative VAS back and leg pain scores between the AL and MAL subgroups. However, the postoperative ODI score of 37.9 in the MAL subgroup was significantly worse than the ODI score of 28.5 in the AL subgroup (p = 0.019). In the older cohort, there were no significant differences in postoperative VAS back and leg pain score or ODI between the AL and MAL subgroups.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>MIS techniques did not achieve optimal spinopelvic alignment in most cases. However, age appears to impact the degree of sagittal correction required. In older patients, optimal spinopelvic alignment thresholds did not need to be achieved to obtain similar symptomatic improvement. Conversely, in younger patients stricter adherence to optimal spinopelvic alignment thresholds may be needed.<\/jats:p><jats:p>https:\/\/thejns.org\/doi\/abs\/10.3171\/2018.4.SPINE171153<\/jats:p><\/jats:sec>","DOI":"10.3171\/2018.4.spine171153","type":"journal-article","created":{"date-parts":[[2018,8,10]],"date-time":"2018-08-10T14:01:27Z","timestamp":1533909687000},"page":"560-564","source":"Crossref","is-referenced-by-count":22,"title":["The impact of age on surgical goals for spinopelvic alignment in minimally invasive surgery for adult spinal deformity"],"prefix":"10.3171","volume":"29","author":[{"given":"Paul","family":"Park","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai-Ming","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cornell Medical Center, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praveen V.","family":"Mummaneni","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of California, San Francisco, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan S.","family":"Uribe","sequence":"additional","affiliation":[{"name":"Barrow Neurological Institute, Phoenix, Arizona;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Y.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Miami, Florida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacie","family":"Tran","sequence":"additional","affiliation":[{"name":"San Diego Center for Spinal Disorders, San Diego, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam S.","family":"Kanter","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierce D.","family":"Nunley","sequence":"additional","affiliation":[{"name":"Spine Institute of Louisiana, Shreveport, Louisiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David O.","family":"Okonkwo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher I.","family":"Shaffrey","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory M.","family":"Mundis","sequence":"additional","affiliation":[{"name":"Scripps Clinic, La Jolla, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dean","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of California, San Francisco, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Eastlack","sequence":"additional","affiliation":[{"name":"Scripps Clinic, La Jolla, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neel","family":"Anand","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Cedars-Sinai Medical Center, Los Angeles, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khoi D.","family":"Than","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph M.","family":"Zavatsky","sequence":"additional","affiliation":[{"name":"Spine and Scoliosis Specialists, Tampa, Florida; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard G.","family":"Fessler","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Rush University Medical Center, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"_","family":"_","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"547","DOI":"10.3171\/2012.2.SPINE11320","article-title":"Impact of spinopelvic alignment on decision making in deformity surgery in adults: a review","volume":"16","author":"Ames CP","year":"2012","unstructured":"Ames CP, Smith JS, Scheer JK, Bess S, Bederman SS, Deviren V, : Impact of spinopelvic alignment on decision making in deformity surgery in adults: a review. 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