{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:53:03Z","timestamp":1787028783179,"version":"build-2736575974"},"reference-count":58,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T00:00:00Z","timestamp":1747872000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>For the past two decades, the consideration of spinopelvic parameters, sagittal balance, and spine shape has gained importance in the diagnosis and optimal surgical management of painful adult spinal deformity. These principles are used with increasing frequency in the surgical planning and treatment of degenerative mechanical lower back pain. Several parameters exist to analyze both global and regional spinal balance. Chronic lower back pain due to degenerative disc disease, degenerative spondylolisthesis, or adult spinal deformity can be surgically managed in a multitude of ways ranging from simple decompression to multilevel arthrodesis with or without corrective osteotomies, depending on the presumed etiology of the pain, surgical planning, and the surgical goal. In surgical candidates, preoperative evaluation of spinopelvic parameters is paramount, as increasing evidence shows that restoration of the shape of the spine while respecting these parameters improves patient-reported outcome measures (PROMs), decreases re-operation rates, and reduces mechanical complications such as proximal junctional kyphosis\/failure (PJK\/PJF), distal junctional kyphosis\/failure (DJK\/DJF), adjacent segment disease (ASD), and rod fracture. This review provides a conceptual analysis of spinopelvic alignment, global and regional sagittal balance, and the restoration of the spine\u2019s shape in relation to patient outcomes during surgical treatment of degenerative spine disorders.<\/jats:p>","DOI":"10.3390\/life15060833","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T08:49:57Z","timestamp":1747903797000},"page":"833","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Surgical Management of Lower Back Pain: Is Optimizing Spinopelvic Alignment Beneficial for Patient Outcomes?"],"prefix":"10.3390","volume":"15","author":[{"given":"Dieter","family":"Thijs","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Antwerp University Hospital, Drie Eikenstraat 655, 2650 Edegem, Belgium"},{"name":"Faculty of Medicine, and Health Sciences, University of Antwerp, Universiteitsplein 1, 2600 Wilrijk, Belgium"},{"name":"Department of Neurosurgery, Vitaz, Moerlandstraat 1, 9100 Sint-Niklaas, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9342-7112","authenticated-orcid":false,"given":"Ardavan","family":"Kashtiara","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Antwerp University Hospital, Drie Eikenstraat 655, 2650 Edegem, Belgium"},{"name":"Faculty of Medicine, and Health Sciences, University of Antwerp, Universiteitsplein 1, 2600 Wilrijk, Belgium"},{"name":"Department of Neurosurgery, Vitaz, Moerlandstraat 1, 9100 Sint-Niklaas, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8915-1424","authenticated-orcid":false,"given":"Sarah","family":"Beld\u00e9","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, and Health Sciences, University of Antwerp, Universiteitsplein 1, 2600 Wilrijk, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Van de Kelft","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, and Health Sciences, University of Antwerp, Universiteitsplein 1, 2600 Wilrijk, Belgium"},{"name":"Department of Neurosurgery, Vitaz, Moerlandstraat 1, 9100 Sint-Niklaas, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,22]]},"reference":[{"key":"ref_1","first-page":"21","article-title":"Lumbar disc disorders and low-back pain: Socioeconomic factors and consequences","volume":"88","author":"Katz","year":"2006","journal-title":"J. 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