Javier Pizones1, Montserrat Baldan Martin1, Francisco Javier Sánchez Perez-Grueso1, Caglar Yilgor2, Alba Vila-Casademunt3, Miquel Serra-Burriel4, Ibrahim Obeid5, Ahmet Alanay2, Emre R Acaroglu6, Ferran Pellisé7. 1. Spine Unit, Department of Orthopedic Surgery, Hospital Universitario La Paz, Madrid, Spain. 2. Acibadem Mehmet Ali Aydinlar University, Department of Orthopedics and Traumatology, Istanbul, Turkey. 3. Spine Research Unit, Vall d'Hebron Institute of Research, Barcelona, Spain. 4. Center for Research in Health and Economics CRES-UPF, Barcelona, Spain. 5. Spine Surgery Unit, Pellegrin University Hospital, Bordeaux, France. 6. Orthopedic Spine Unit, Ankara Spine Center, Ankara, Turkey. 7. Spine Surgery Unit, Hospital Universitario Vall d'Hebron, Barcelona, Spain.
Abstract
STUDY DESIGN: A retrospective analysis of data collected prospectively in an adult spine deformity multicenter database. OBJECTIVE: The aim of this study was to determine the impact of adult scoliosis (AS) on the type of Roussouly sagittal shape in terms of classification applicability, scoliosis modification of a patient theoretical sagittal shape, and coronal-sagittal deformity associations. SUMMARY OF BACKGROUND DATA: Roussouly described a four-type sagittal shape classification in healthy individuals, which has been also applied to patients with degenerative spinal disease. However, it remains uncertain if its principles can be applied to AS patients. METHODS: AS patients recorded in a prospective multicenter database of adult spinal deformity were included. Preoperative sagittal radiographs were analyzed using the KEOPS software to measure pelvic parameters, global sagittal alignment, and the various criteria used for the Roussouly classification. The different sagittal shape types were compared using the Chi-square and McNemars tests, and analysis of variance with Bonferroni correction. RESULTS: The classification was applicable to all of the 190 analyzed AS patients. In addition to Roussouly criteria, two parameters helped differentiate the different shapes: T10-L2 angle (24° ± 19 type-1; 14° ± 15 type-2; 3° ± 15 type-3; 0.4° ± 14 type-4; P < 0.001), and lordosis distribution index (90% ± 17 type-1; 83% ± 16 type-2; 73% ± 21 type-3; 63% ± 16 type-4; P < 0.001). AS changed the theoretical shape in 34% of the patients (P < 0.001). Curve etiology and curve pattern were not associated with any particular type of sagittal shape (P > 0.05). Type-1 was associated with older patients (P = 0.02), degenerative curves (P = 0.02), and greater PI-LL mismatch (P = 0.012). Types 3 to 4 were associated with younger age and idiopathic etiology (P < 0.001). CONCLUSION: Roussouly four-type sagittal shape classification could be applied to AS patients. AS modified the theoretical type in one of every three patients. No particular association was found between the sagittal types and specific coronal deformities. Sagittal shape recognition in patients with AS will help restore the appropriate theoretical shape through surgery, which can eventually lead to better surgical outcomesLevel of Evidence: 2.
STUDY DESIGN: A retrospective analysis of data collected prospectively in an adult spine deformity multicenter database. OBJECTIVE: The aim of this study was to determine the impact of adult scoliosis (AS) on the type of Roussouly sagittal shape in terms of classification applicability, scoliosis modification of a patient theoretical sagittal shape, and coronal-sagittal deformity associations. SUMMARY OF BACKGROUND DATA: Roussouly described a four-type sagittal shape classification in healthy individuals, which has been also applied to patients with degenerative spinal disease. However, it remains uncertain if its principles can be applied to AS patients. METHODS: AS patients recorded in a prospective multicenter database of adult spinal deformity were included. Preoperative sagittal radiographs were analyzed using the KEOPS software to measure pelvic parameters, global sagittal alignment, and the various criteria used for the Roussouly classification. The different sagittal shape types were compared using the Chi-square and McNemars tests, and analysis of variance with Bonferroni correction. RESULTS: The classification was applicable to all of the 190 analyzed AS patients. In addition to Roussouly criteria, two parameters helped differentiate the different shapes: T10-L2 angle (24° ± 19 type-1; 14° ± 15 type-2; 3° ± 15 type-3; 0.4° ± 14 type-4; P < 0.001), and lordosis distribution index (90% ± 17 type-1; 83% ± 16 type-2; 73% ± 21 type-3; 63% ± 16 type-4; P < 0.001). AS changed the theoretical shape in 34% of the patients (P < 0.001). Curve etiology and curve pattern were not associated with any particular type of sagittal shape (P > 0.05). Type-1 was associated with older patients (P = 0.02), degenerative curves (P = 0.02), and greater PI-LL mismatch (P = 0.012). Types 3 to 4 were associated with younger age and idiopathic etiology (P < 0.001). CONCLUSION: Roussouly four-type sagittal shape classification could be applied to AS patients. AS modified the theoretical type in one of every three patients. No particular association was found between the sagittal types and specific coronal deformities. Sagittal shape recognition in patients with AS will help restore the appropriate theoretical shape through surgery, which can eventually lead to better surgical outcomesLevel of Evidence: 2.
Authors: Javier Pizones; Lucía Moreno-Manzanaro; Francisco Javier Sánchez Pérez-Grueso; Alba Vila-Casademunt; Caglar Yilgor; Ibrahim Obeid; Ahmet Alanay; Frank Kleinstück; Emre R Acaroglu; Ferran Pellisé Journal: Eur Spine J Date: 2019-10-22 Impact factor: 3.134
Authors: Juan I Cirillo Totera; José G Fleiderman Valenzuela; Jorge A Garrido Arancibia; Samuel T Pantoja Contreras; Lyonel Beaulieu Lalanne; Facundo L Alvarez-Lemos Journal: EFORT Open Rev Date: 2021-12-10
Authors: Peter G Passias; Haddy Alas; Renaud Lafage; Bassel G Diebo; Irene Chern; Christopher P Ames; Paul Park; Khoi D Than; Alan H Daniels; D Kojo Hamilton; Douglas C Burton; Robert A Hart; Shay Bess; Breton G Line; Eric O Klineberg; Christopher I Shaffrey; Justin S Smith; Frank J Schwab; Virginie Lafage Journal: J Craniovertebr Junction Spine Date: 2019 Jul-Sep