术后冠状失衡的风险因素fter surgical correction of adult spinal deformities: a systematic review with pooled analysis
Francesca Barile
Francesca BarileDepartment of Biomedical and Neuromotor Science (DIBINEM), University of Bologna, Bologna; 1st Orthopaedic and Traumatologic Clinic, IRCCS Rizzoli Orthopaedic Institute, Bologna, Italy
Alberto RuffilliDepartment of Biomedical and Neuromotor Science (DIBINEM), University of Bologna, Bologna; 1st Orthopaedic and Traumatologic Clinic, IRCCS Rizzoli Orthopaedic Institute, Bologna, Italy
Azzurra PaolucciDepartment of Biomedical and Neuromotor Science (DIBINEM), University of Bologna, Bologna; 1st Orthopaedic and Traumatologic Clinic, IRCCS Rizzoli Orthopaedic Institute, Bologna, Italy
Giovanni ViroliDepartment of Biomedical and Neuromotor Science (DIBINEM), University of Bologna, Bologna; 1st Orthopaedic and Traumatologic Clinic, IRCCS Rizzoli Orthopaedic Institute, Bologna, Italy
Marco ManzettiDepartment of Biomedical and Neuromotor Science (DIBINEM), University of Bologna, Bologna; 1st Orthopaedic and Traumatologic Clinic, IRCCS Rizzoli Orthopaedic Institute, Bologna, Italy
Matteo TraversariDepartment of Biomedical and Neuromotor Science (DIBINEM), University of Bologna, Bologna; 1st Orthopaedic and Traumatologic Clinic, IRCCS Rizzoli Orthopaedic Institute, Bologna, Italy
Marco IalunaDepartment of Biomedical and Neuromotor Science (DIBINEM), University of Bologna, Bologna; 1st Orthopaedic and Traumatologic Clinic, IRCCS Rizzoli Orthopaedic Institute, Bologna, Italy
Cesare FaldiniDepartment of Biomedical and Neuromotor Science (DIBINEM), University of Bologna, Bologna; 1st Orthopaedic and Traumatologic Clinic, IRCCS Rizzoli Orthopaedic Institute, Bologna, Italy
The aim of this study was to identify preoperative risk factors for postoperative coronal imbalance (CIB) in patients undergoing surgical correction for adult spinal deformity (ASD).
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A systematic search of articles about risk factors for postoperative CIB was conducted on electronic databases (PubMed, EMBASE, and Cochrane Library) according to the PRISMA guidelines. The methodological quality of the included articles was assessed using the Institute of Health Economics Quality Appraisal Checklist for Case Series Studies. Data regarding the patient population (demographics, diagnosis, and follow-up), pre- and postoperative radiographic and clinical data, surgical procedure details, and complications were extracted and summarized. Meta-analyses were performed when possible.
RESULTS
Nine studies comprising 838 patients were included. The pooled incidence of postoperative CIB was 26%; preoperative sagittal vertical axis (SVA) and type C imbalance (trunk shifted toward the convexity) were found to be the only primary risk factors for iatrogenic CIB (p < 0.001 and p = 0.012, respectively).
CONCLUSIONS
Baseline evaluation of a patient’s global alignment is of outmost importance when planning surgery for ASD. Type C coronal imbalance (trunk shifted toward the convexity of the main curve) and increased preoperative SVA put the patient at risk of postoperative CIB. Intraoperatively, care should be taken to properly correct the lumbosacral fractional curve.
AcarogluE,GulerUO,OlgunZD,et al.Multiple regression analysis of factors affecting health-related quality of life in adult spinal deformity.Spine Deform.2015;3(4):360–366.
DaubsMD,LenkeLG,BridwellKH,et al.Does correction of preoperative coronal imbalance make a difference in outcomes of adult patients with deformity?Spine (Phila Pa 1976).2013;38(6):476–483.
Daubs
MD
,
Lenke
LG
,
Bridwell
KH
,
Does correction of preoperative coronal imbalance make a difference in outcomes of adult patients with deformity?Spine (Phila Pa 1976)
.
2013
;
38
(
6
):
476
–
483
.
23492973)| false
BarreyC,RoussoulyP,PerrinG,Le HuecJC.Sagittal balance disorders in severe degenerative spine. Can we identify the compensatory mechanisms?Eur Spine J.2011;20(5 suppl):626–633.
Barrey
C
,
Roussouly
P
,
Perrin
G
,
Le Huec
JC
.
Sagittal balance disorders in severe degenerative spine. Can we identify the compensatory mechanisms?Eur Spine J
.
2011
;
20
(
5 suppl
):
626
–
633
.
21796393)| false
BaghdadiYM,LarsonAN,DekutoskiMB,et al.Sagittal balance and spinopelvic parameters after lateral lumbar interbody fusion for degenerative scoliosis: a case-control study.Spine (Phila Pa 1976).2014;39(3):E166–E173.
PaulJC,ViraS,QuirnoM,ProtopsaltisT.Importance of the sagittal plane in understanding adult spinal deformities.Bull Hosp Jt Dis (2013).2018;76(1):80–84.
Paul
JC
,
Vira
S
,
Quirno
M
,
Protopsaltis
T
.
Importance of the sagittal plane in understanding adult spinal deformities
.Bull Hosp Jt Dis (2013)
.
2018
;
76
(
1
):
80
–
84
.
29537961)| false
KollerH,PfanzC,MeierO,et al.Factors influencing radiographic and clinical outcomes in adult scoliosis surgery: a study of 448 European patients.Eur Spine J.2016;25(2):532–548.
Koller
H
,
Pfanz
C
,
Meier
O
,
Factors influencing radiographic and clinical outcomes in adult scoliosis surgery: a study of 448 European patients
.Eur Spine J
.
2016
;
25
(
2
):
532
–
548
.
25917822)| false
PloumisA,LiuH,MehbodAA,TransfeldtEE,WinterRB.A correlation of radiographic and functional measurements in adult degenerative scoliosis.Spine (Phila Pa 1976).2009;34(15):1581–1584.
Ploumis
A
,
Liu
H
,
Mehbod
AA
,
Transfeldt
EE
,
Winter
RB
.
A correlation of radiographic and functional measurements in adult degenerative scoliosis
.Spine (Phila Pa 1976)
.
2009
;
34
(
15
):
1581
–
1584
.
19564768)| false
SchwabFJ,LafageV,FarcyJP,BridwellKH,GlassmanS,ShainlineMR.Predicting outcome and complications in the surgical treatment of adult scoliosis.Spine (Phila Pa 1976).2008;33(20):2243–2247.
MogaC,GuoB,SchopflocherD,HarstallC.Development of a Quality Appraisal Tool for Case Series Studies Using a Modified Delphi Technique.Institute of Health Economics;2012.
Moga
C
,
Guo
B
,
Schopflocher
D
,
Harstall
C
.
Development of a Quality Appraisal Tool for Case Series Studies Using a Modified Delphi Technique
.
Institute of Health Economics
;
2012
.)| false
ZuckermanSL,LaiCS,ShenY,et al.Incidence and risk factors of iatrogenic coronal malalignment after adult spinal deformity surgery: a single-center experience.J Neurosurg Spine.2022;36(4):585–594.
Zuckerman
SL
,
Lai
CS
,
Shen
Y
,
Incidence and risk factors of iatrogenic coronal malalignment after adult spinal deformity surgery: a single-center experience
.J Neurosurg Spine
.
2022
;
36
(
4
):
585
–
594
.)| false
MatsumuraA,NamikawaT,KatoM,HoriY,HidakaN,NakamuraH.Factors related to postoperative coronal imbalance in adult lumbar scoliosis.J Neurosurg Spine.2021;34(2):66–72.
Matsumura
A
,
Namikawa
T
,
Kato
M
,
Hori
Y
,
Hidaka
N
,
Nakamura
H
.
Factors related to postoperative coronal imbalance in adult lumbar scoliosis
.J Neurosurg Spine
.
2021
;
34
(
2
):
66
–
72
.)| false
TheologisAA,LertudomphonwanitT,LenkeLG,BridwellKH,GuptaMC.The role of the fractional lumbosacral curve in persistent coronal malalignment following adult thoracolumbar deformity surgery: a radiographic analysis.Spine Deform.2021;9(3):721–731.
Theologis
AA
,
Lertudomphonwanit
T
,
Lenke
LG
,
Bridwell
KH
,
Gupta
MC
.
The role of the fractional lumbosacral curve in persistent coronal malalignment following adult thoracolumbar deformity surgery: a radiographic analysis
.Spine Deform
.
2021
;
9
(
3
):
721
–
731
.
33651338)| false
BaoH,YanP,QiuY,LiuZ,ZhuF.Coronal imbalance in degenerative lumbar scoliosis: prevalence and influence on surgical decision-making for spinal osteotomy.Bone Joint J.2016;98-B(9):1227–1233.
Bao
H
,
Yan
P
,
Qiu
Y
,
Liu
Z
,
Zhu
F
.
Coronal imbalance in degenerative lumbar scoliosis: prevalence and influence on surgical decision-making for spinal osteotomy
.Bone Joint J
.
2016
;
98-B
(
9
):
1227
–
1233
.
27587525)| false
ZhangZ,SongK,WuB,ChiP,WangZ,WangZ.Coronal imbalance in adult spinal deformity following posterior spinal fusion with instrument: a related parameters analysis.Spine (Phila Pa 1976).2019;44(8):550–557.
Zhang
Z
,
Song
K
,
Wu
B
,
Chi
P
,
Wang
Z
,
Wang
Z
.
Coronal imbalance in adult spinal deformity following posterior spinal fusion with instrument: a related parameters analysis
.Spine (Phila Pa 1976)
.
2019
;
44
(
8
):
550
–
557
.
30312273)| false
TanakaN,EbataS,OdaK,ObaH,HaroH,OhbaT.Predictors and clinical importance of postoperative coronal malalignment after surgery to correct adult spinal deformity.Clin Spine Surg.2020;33(7):E337–E341.
Tanaka
N
,
Ebata
S
,
Oda
K
,
Oba
H
,
Haro
H
,
Ohba
T
.
Predictors and clinical importance of postoperative coronal malalignment after surgery to correct adult spinal deformity
.Clin Spine Surg
.
2020
;
33
(
7
):
E337
–
E341
.
31996535)| false
ZhangJ,WangZ,ChiP,ChiC.Orientation of L4 coronal tilt relative to C7 plumb line as a predictor for postoperative coronal imbalance in patients with degenerative lumbar scoliosis.Sci Rep.2020;10(1):16148.
Zhang
J
,
Wang
Z
,
Chi
P
,
Chi
C
.
Orientation of L4 coronal tilt relative to C7 plumb line as a predictor for postoperative coronal imbalance in patients with degenerative lumbar scoliosis
.Sci Rep
.
2020
;
10
(
1
):
16148
.)| false
PloumisA,SimpsonAK,ChaTD,HerzogJP,WoodKB.Coronal spinal balance in adult spine deformity patients with long spinal fusions: a minimum 2- to 5-year follow-up study.J Spinal Disord Tech.2015;28(9):341–347.
BaoH,LiuZ,ZhangY,et al.Sequential correction technique to avoid postoperative global coronal decompensation in rigid adult spinal deformity: a technical note and preliminary results.Eur Spine J.2019;28(9):2179–2186.
Bao
H
,
Liu
Z
,
Zhang
Y
,
Sequential correction technique to avoid postoperative global coronal decompensation in rigid adult spinal deformity: a technical note and preliminary results
.Eur Spine J
.
2019
;
28
(
9
):
2179
–
2186
.
31240438)| false
PlaisN,BaoH,LafageR,et al.The clinical impact of global coronal malalignment is underestimated in adult patients with thoracolumbar scoliosis.Spine Deform.2020;8(1):105–113.
Plais
N
,
Bao
H
,
Lafage
R
,
The clinical impact of global coronal malalignment is underestimated in adult patients with thoracolumbar scoliosis
.Spine Deform
.
2020
;
8
(
1
):
105
–
113
.
31981146)| false
