Bassel G Diebo1, Renaud Lafage2, Christopher P Ames3, Shay Bess4, Ibrahim Obeid5, Eric Klineberg6, Matthew E Cunningham7, Justin S Smith8, Richard Hostin9, Shian Liu10, Peter G Passias2, Frank J Schwab2, Virginie Lafage2. 1. Spine Service, Hospital for Special Surgery, 525 East 71st Street, New York, NY, 10021, USA. diebob@hss.edu. 2. Spine Service, Hospital for Special Surgery, 525 East 71st Street, New York, NY, 10021, USA. 3. Department of Neurosurgery, San Francisco Medical Center, University of California, 400 Parnassus Street, San Francisco, CA, USA. 4. Rocky Mountain Scoliosis and Spine Center, Denver, CO, 80205, USA. 5. Department of Orthopaedics and Spine Surgery, University Hospital of Bordeaux, Bordeaux, France. 6. Department of Orthopaedic Surgery, University of California, Davis, 3301 C St, Suite 1500, Sacramento, CA, USA. 7. Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA. 8. Department of Neurosurgery, University of Virginia Medical Center, PO Box: 800212, Charlottesville, VA, USA. 9. Department of Orthopaedic Surgery, Baylor Scoliosis Center, 4708 Alliance Blvd, #810, Plano, TX, USA. 10. Department of Orthopaedic Surgery, Naval Medical Center, San Diego, CA, USA.
Abstract
PURPOSE: The resection point of a lumbar three-column osteotomy (3CO) creates separation of the spino-pelvic complex. This study investigates the impact of patients' baseline deformity and level of 3CO resection on the distribution of correction between the trunk and the pelvis following osteotomy closure. METHODS: Patients who underwent single lumbar 3CO, upper instrumented vertebra (UIV) T1-T10, and 6 month follow-up were included. The truncal and pelvic closures were calculated based on the vertebrae adjacent to the osteotomy level and the impact of radiographic parameters and level of 3CO on the closures were analyzed. RESULTS: 113 patients were included. Patients who experienced more pelvic correction had significantly higher Pelvic Tilt and lower Sagittal Vertical Axis at baseline. Patients who underwent more caudal osteotomies with higher pelvic compensation with modest SVA sustained more pelvic correction. CONCLUSIONS: The osteotomy closure is driven by patient's specific deformity. More caudal osteotomy level leads to greater pelvic tilt improvement. LEVEL OF EVIDENCE: III.
PURPOSE: The resection point of a lumbar three-column osteotomy (3CO) creates separation of the spino-pelvic complex. This study investigates the impact of patients' baseline deformity and level of 3CO resection on the distribution of correction between the trunk and the pelvis following osteotomy closure. METHODS:Patients who underwent single lumbar 3CO, upper instrumented vertebra (UIV) T1-T10, and 6 month follow-up were included. The truncal and pelvic closures were calculated based on the vertebrae adjacent to the osteotomy level and the impact of radiographic parameters and level of 3CO on the closures were analyzed. RESULTS: 113 patients were included. Patients who experienced more pelvic correction had significantly higher Pelvic Tilt and lower Sagittal Vertical Axis at baseline. Patients who underwent more caudal osteotomies with higher pelvic compensation with modest SVA sustained more pelvic correction. CONCLUSIONS: The osteotomy closure is driven by patient's specific deformity. More caudal osteotomy level leads to greater pelvic tilt improvement. LEVEL OF EVIDENCE: III.
Entities:
Keywords:
Pelvic correction; Ratio of closure; Spinal osteotomy; Truncal correction
Authors: Shayan Fakurnejad; Justin K Scheer; Virginie Lafage; Justin S Smith; Vedat Deviren; Richard Hostin; Gregory M Mundis; Douglas C Burton; Eric Klineberg; Munish Gupta; Khaled Kebaish; Christopher I Shaffrey; Shay Bess; Frank Schwab; Christopher P Ames Journal: J Neurosurg Spine Date: 2015-06-19
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