Pelvic Incidence as a Predictor of Proximal Junctional Failure in Patients undergoing Anterior Column Realignment with Anterior Longitudinal Ligament Release to Restore Lordosis in Adult Spinal Deformity - A Retrospective Cohort.
OBJECTIVE: To identify variables that may contribute to the development of proximal junctional failure (PJF) in patients with long lumbo-sacral and thoraco-lumbo-pelvic constructs undergoing ACR with ALLR.
METHODS: Data of patients with ASD who underwent ACR with ALLR at L3-4 was collected retrospectively from medical records and a prospectively maintained spine research database between 2016 and 2022.
RESULTS: Eleven (41%) developed PJF at a mean of 24 ± 21 months from the index surgery. The cohort was then divided into two groups for analysis, 13 subjects in the high PI group (defined as PI ≥55º) and 14 subjects in the low PI group (defined as PI
CONCLUSIONS: PI may be a predictor of PJF and highly correlates with ACR-ALLR levels. In patients undergoing L3-4 ACR-ALLR, a PI value of ≤53º is associated with a significantly elevated risk of PJF. Preoperative planning of ACR-ALLR level based on normal sagittal alignment in otherwise healthy individuals may mitigate the risk of PJF development in ASD patients treated with ACR-ALLR.
Published In/Presented At
Noureldine, M. H. A., McBride, P., Liaw, D., Coughlin, E., Mhaskar, R., & Alikhani, P. (2023). Pelvic Incidence as a Predictor of Proximal Junctional Failure in Patients undergoing Anterior Column Realignment with Anterior Longitudinal Ligament Release to Restore Lordosis in Adult Spinal Deformity - A Retrospective Cohort. World neurosurgery, S1878-8750(23)01755-2. Advance online publication. https://doi.org/10.1016/j.wneu.2023.12.036
Medical Education | Medicine and Health Sciences
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