Variability Over Time of Preoperative Sagittal Alignment Parameters: Radiographic and Clinical Considerations

STUDY DESIGN.Retrospective review. OBJECTIVE.To evaluate preoperative variability in radiographic sagittal parameters in adult spinal deformity (ASD). SUMMARY OF BACKGROUND DATA.In ASD surgical planning, deformity magnitude is determined from preoperative radiographs. There are no studies evaluating...

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Bibliographic Details
Published in:Spine (Philadelphia, Pa. 1976) Pa. 1976), 2016-12, Vol.41 (24), p.1896-1902
Main Authors: Menga, Emmanuel N., Spiegel, Matthew A., Vira, Shaleen, Lafage, Renaud, Henry, Jensen K., Liabaud, Barthelemy, Oren, Jonathan H., Worley, Nancy, Schwab, Frank J., Errico, Thomas J., Lafage, Virginie, Protopsaltis, Themistocles S.
Format: Article
Language:English
Subjects:
Adult
Aged
Female
Humans
Kyphosis - diagnostic imaging
Kyphosis - surgery
Male
Middle Aged
Postoperative Complications - prevention & control
Radiography - methods
Retrospective Studies
Scoliosis - diagnostic imaging
Scoliosis - surgery
Spinal Fusion - methods
Thoracic Vertebrae - surgery
Time Factors
Young Adult
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Summary:STUDY DESIGN.Retrospective review. OBJECTIVE.To evaluate preoperative variability in radiographic sagittal parameters in adult spinal deformity (ASD). SUMMARY OF BACKGROUND DATA.In ASD surgical planning, deformity magnitude is determined from preoperative radiographs. There are no studies evaluating the clinical relevance and timing to repeat radiographs during interval clinic visits and timing to repeat radiograph for preoperative planning. METHODS.A total of 139 patients with ASD with minimum two preoperative full-body spine x-rays were included. Cervical, thoracic, lumbar, pelvic, and hip/knee sagittal alignment parameters were analyzed using dedicated spine measurement software. Patients were grouped by time intervals between x-raysA8 weeks or lesser, B10 to 20 weeks, and C21 weeks or more. Changes in sagittal parameters were correlated to age and deformity magnitude (T1 pelvic angle or pelvic tilt [PT] >20°). RESULTS.The cohort had mean age 59 years, mean body mass index 27, 30% men, 95 patients with no prior spine surgery, and 44 patients at minimum 9 months since prior spine surgery. There were 25 patients in group A, 38 in B, and 71 in C. All radiographic measures showed good time-based consistency at intervals less than 21 weeks (groups A and B). Group C had significant increases in PT (1.5°) and hip extension (2.1°) (P 
ISSN:0362-2436
1528-1159
DOI:10.1097/BRS.0000000000001648