Transiency of postoperative cervical kyphosis seen after surgical correction of sagittal malalignment in adult spinal deformity patients

In this study, we evaluated factors affecting changes in cervical lordosis after deformity correction and during follow-up period in adult spinal deformity (ASD) patients with severe sagittal imbalance. Seventy-nine patients, with an average age of 71.6 years, who underwent long-segment fixation fro...

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Bibliographic Details
Published in:PloS one 2021-07, Vol.16 (7), p.e0254381-e0254381
Main Authors: Lee, Ki Young, Lee, Jung-Hee, Im, Sang Kyu, Lim, Hae Sung, Han, Gil
Format: Article
Language:English
Subjects:
Biology and Life Sciences
Bone surgery
Care and treatment
Comparative analysis
Correlation coefficient
Correlation coefficients
Fixation
Kyphosis
Lee, Sang
Lordosis
Mathematical analysis
Medical schools
Medicine
Medicine and Health Sciences
Orthopedics
Parameters
Patients
People and Places
Physical Sciences
Regression analysis
Research and Analysis Methods
Spine
Statistical analysis
Surgery
Thorax
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Summary:In this study, we evaluated factors affecting changes in cervical lordosis after deformity correction and during follow-up period in adult spinal deformity (ASD) patients with severe sagittal imbalance. Seventy-nine patients, with an average age of 71.6 years, who underwent long-segment fixation from T10 to S1 with sacropelvic fixation were included. We performed a comparative analysis of the radiographic parameters after surgery (Post) and at the last follow-up (Last). We calculated the Pearson's correlation coefficient and performed multilinear regression analysis to predict independent parameters for Post and Last cervical lordosis (CL), T1 slope (T1S), and thoracic kyphosis (TK). Hyperlordotic changes of -23.3° in CL before surgery was reduced to -7° after surgery, and Last CL had increased to -15.3°. T1S was reduced from 27° before surgery to 14.4° after surgery and had increased to 18.8° at the last follow-up. Through multilinear regression analysis, we found that Post CL and T1S were more significantly affected by the amount of LL correction (p = .045 and .049). The effect of Last T1S was significantly associated with the Last CL; the effect of Last TK, with the Last T1S; and the effect of Post PI-LL, with the Last TK (p < .05). The postoperative kyphotic change in CL in ASD patients with preoperative cervical hyperlordosis is not permanent and is affected by drastic LL correction and SVA restoration. To achieve spinopelvic harmony proportional to the difference in LL relative to PI, TK becomes modified over time to increase T1S and CL, in an effort to achieve optimal spine curvature.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0254381