Which is more predictive value for mechanical complications: Fixed thoracolumbar alignment (t1 pelvic angle) versus dynamic global balance parameter (odontoid-hip axis angle)

Kwang Ryeol Kim, Jean Charles Le Huec, Hyun Jun Jang, Sung Hyun Noh, Jeong Yoon Park, Yoon Ha, Sung Uk Kuh, Dong Kyu Chin, Keun Su Kim, Byung Ho Jin, Yong Eun Cho, Kyung Hyun Kim

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

Objective: In this study, we investigate about relationship between postoperative global sagittal imbalance and occurrence of mechanical complications after adult spinal deformity (ASD) surgery. In global sagittal balance parameters, odontoid-hip axis (OD-HA) angle and T1 pelvic angle (TPA) were analyzed. Methods: Between January 2009 and December 2016, 199 consecutive patients (26 males and 173 females) with ASD underwent corrective fusion of more than 4 levels and were followed up for more than 2 years. Immediate postoperative and postoperative 2 years whole spine x-rays were checked for evaluating immediate postoperative OD-HA, TPA, and other parameters. In clinical outcomes, back and leg pain visual analogue scale, Scoliosis Research Society-22 spinal deformity questionnaire (SRS-22), Oswestry Disability Index (ODI), 36-item Short Form Health Survey (SF-36) were evaluated. Results: Based on the occurrence of mechanical complications, a comparative analysis was performed for each parameter. In univariable analysis, mechanical complications were significantly much more occurred in OD-HA abnormal group (odds ratio [OR], 3.296; p < 0.001; area under the curve [AUC] = 0.645). In multivariable analysis, the result was much more related (OR, 2.924; p = 0.001; AUC = 0.727). In contrast, there was no significant difference between normal and the occurrence of mechanical complications in TPA. In clinical outcomes (normal vs. abnormal), the differences of SRS-22 (0.88 ± 0.73 vs. 0.68 ± 0.64, p = 0.042), ODI (-24.72 ± 20.16 vs.-19.01 ± 19.95, p = 0.046), SF-36 physical com-posite score (19.33 ± 18.55 vs. 12.90 ± 16.73, p = 0.011) were significantly improved in OD-HA normal group. Conclusion: The goal of ASD surgery is to improve patient life quality through correction. In our study, TPA was associated with spinopelvic parameter and OD-HA angle was associated with health-related quality of life and complications. OD-HA angle is predictable factor for mechanical complications after ASD surgery.

Original languageEnglish
Pages (from-to)597-607
Number of pages11
JournalNeurospine
Volume18
Issue number3
DOIs
Publication statusPublished - 2021 Sept

Bibliographical note

Publisher Copyright:
© 2021 by the Korean Spinal Neurosurgery Society.

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

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