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Relationships between lumbar lordosis correction and the change in global tilt (GT) in adult spinal deformity

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Abstract

Purpose

This study aimed to explore the relationships between lumbar lordosis (LL) correction and improvement of postoperative global sagittal alignment and to establish corresponding linear regressions to predict the change in global tilt (GT) based on the corrected LL following adult spinal deformity (ASD) surgery.

Methods

A total of 240 ASD patients who underwent lumbar correction were enrolled in this multicentre study. The following sagittal parameters were measured pre- and postoperatively: thoracic kyphosis (TK), LL, upper and lower LL (ULL and LLL), pelvic tilt (PT), sagittal vertical axis (SVA) and GT. The correlations among the changes in GT (△GT), SVA (△SVA), PT (△PT), TK (△TK), LL (△LL), ULL (△ULL) and LLL (△LLL) were assessed, and linear regressions were conducted to predict △GT, △SVA, △PT and △TK from △LL, △ULL and △LLL.

Results

△LL was statistically correlated with △GT (r = 0.798, P < 0.001), △SVA (r = 0.678, P < 0.001), △PT (r = 0.662, P < 0.001) and △TK (r = − 0.545, P < 0.001), and the outcomes of the linear regressions are: △GT = 3.18 + 0.69 × △LL (R2 = 0.636), △SVA = 4.78 + 2.57 × △LL (R2 = 0.459), △PT = 2.57 + 0.34 × △LL (R2 = 0.439), △TK = 7.06–0.43 × △LL (R2 = 0.297). In addition, △LLL had more correlations with △GT, △SVA and △PT, while △ULL had more correlations with △TK.

Conclusion

Surgical correction of LL could contribute to the restoration of global sagittal morphology following ASD surgery. These models were established to predict the changes in sagittal parameters, in particular △GT, determined by △LL, which has not been previously done and may help to customize a more precise correction plan for ASD patients.

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Acknowledgements

The authors thank the Department of Spine Surgery in Shandong Provincial Hospital and Chinese PLA General Hospital for providing the image data and thank the China Scholarship Council for providing the chance of cooperation.

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Authors and Affiliations

  1. Department of Spine Surgery, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China

    Changyu Pan, Yue Yang, Lei Li, Lei Kuang, Bing Wang & Guohua Lv

  2. Spine Surgery Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

    Bourghli Anouar

  3. Orthopedic Spinal Surgery Unit 1, Pellegrin Hospital, Place Amélie Raba-Léon, 33076, Bordeaux Cedex, France

    Ibrahim Obeid

Authors
  1. Changyu Pan
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  2. Bourghli Anouar
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  3. Yue Yang
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  4. Lei Li
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  5. Lei Kuang
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  6. Bing Wang
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  7. Guohua Lv
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  8. Ibrahim Obeid
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Contributions

CP and GL conceived the study design. LL, LK and BW supervised the data collection and analysis. CP and YY drafted the manuscript. BA and IO contributed to the revision. YY and IO are responsible for this article.

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Correspondence to Yue Yang or Ibrahim Obeid.

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Pan, C., Anouar, B., Yang, Y. et al. Relationships between lumbar lordosis correction and the change in global tilt (GT) in adult spinal deformity. Eur Spine J 33, 610–619 (2024). https://doi.org/10.1007/s00586-023-08066-9

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  • DOI: https://doi.org/10.1007/s00586-023-08066-9

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