{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:07:47Z","timestamp":1790798867218,"version":"4.1.0"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Several studies have examined the relationship between sagittal spinopelvic alignment and clinical outcomes after spinal surgery. However, the long-term reciprocal changes in sagittal spinopelvic alignment in patients with lumbar spinal stenosis after decompression surgery remain unclear. The aim of this study was to investigate radiographic changes in sagittal spinopelvic alignment and clinical outcomes at the 2-year and 5-year follow-ups after minimally invasive lumbar decompression surgery.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The authors retrospectively studied the medical records of 110 patients who underwent bilateral decompression via a unilateral approach for lumbar spinal stenosis. Japanese Orthopaedic Association (JOA) and visual analog scale (VAS) scores for low-back pain (LBP), leg pain, leg numbness, and spinopelvic parameters were evaluated before surgery and at the 2-year and 5-year follow-ups. Sagittal malalignment was defined as a sagittal vertical axis (SVA) \u2265 50 mm.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Compared with baseline, lumbar lordosis significantly increased after decompression surgery at the 2-year (30.2\u00b0 vs 38.5\u00b0, respectively; p &lt; 0.001) and 5-year (30.2\u00b0 vs 35.7\u00b0, respectively; p &lt; 0.001) follow-ups. SVA significantly decreased at the 2-year follow-up compared with baseline (36.1 mm vs 51.5 mm, respectively; p &lt; 0.001). However, there was no difference in SVA at the 5-year follow-up compared with baseline (50.6 mm vs 51.5 mm, respectively; p = 0.812). At the 5-year follow-up, 82.5% of patients with preoperative normal alignment maintained normal alignment, whereas 42.6% of patients with preoperative malalignment developed normal alignment. Preoperative sagittal malalignment was associated with the VAS score for LBP at baseline and 2-year and 5-year follow-ups and the JOA score at the 5-year follow-up. Postoperative sagittal malalignment was associated with the VAS score for LBP at the 2-year and 5-year follow-ups and the VAS score for leg pain at the 5-year follow-up. There was a trend toward deterioration in clinical outcomes in patients with persistent postural malalignment compared with other patients.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>After minimally invasive surgery, spinal sagittal malalignment can convert to normal alignment at both short-term and long-term follow-ups. Sagittal malalignment has a negative impact on the VAS score for LBP and a weakly negative impact on the JOA score after decompression surgery.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2020.11.spine201552","type":"journal-article","created":{"date-parts":[[2021,6,11]],"date-time":"2021-06-11T07:24:25Z","timestamp":1623396265000},"page":"177-184","source":"Crossref","is-referenced-by-count":9,"title":["The effect of minimally invasive lumbar decompression surgery on sagittal spinopelvic alignment in patients with lumbar spinal stenosis: a 5-year follow-up study"],"prefix":"10.3171","volume":"35","author":[{"given":"Hamidullah","family":"Salimi","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka; and"}],"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; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kentaro","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Fuchu Hospital, Osaka, Japan"}],"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; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatoshi","family":"Hoshino","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka; and"}],"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; and"}],"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; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Tamai","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Hori","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akito","family":"Yabu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka; and"}],"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; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"24","key":"r1","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"2764","DOI":"10.1097\/BRS.0b013e31815a7644","article-title":"The impact of perioperative complications on clinical outcome in adult deformity surgery","volume":"32","author":"Glassman SD","year":"2007","unstructured":"Glassman SD, Hamill CL, Bridwell KH,  The impact of perioperative complications on clinical outcome in adult deformity surgery. 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