Spine deformity · 2026
The relationship between distal lumbar lordosis correction and early postoperative L1-pelvic angle changes in adult spinal deformity surgery.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
de Oliveira Rafael Garcia, Fujii Takeshi, Younus Iyan, Bansal Aiyush, Nguyen Kenneth T, Yamanouchi Kento, Louie Philip K, Sethi Rajiv K, Leveque Jean-Christophe, Nemani Venu M
Аннотация
PURPOSE: To evaluate the early postoperative relationship between changes in distal and proximal lumbar lordosis and the L1-pelvic angle in adult spinal deformity surgery.
METHODS: A retrospective review was performed of 120 adult spinal deformity patients undergoing ≥ 6-level thoracolumbar fusion to the pelvis with a UIV at T10 or higher. Spinopelvic parameters were assessed preoperatively and at an early postoperative window (minimum 6 months to maximum 1 year) to isolate initial alignment mechanics, ideal L1-pelvic angle was defined as (0.5 × pelvic incidence - 19) ± 2, and uni- and multivariable regression analyses examined associations between changes in lumbar lordosis components and L1-pelvic angle, with stratification by postoperative L1-pelvic angle deviation.
RESULTS: The cohort (mean age 65.7 years; 64.1% female) had a mean pelvic incidence of 55.2°. L1-pelvic angle improved from 13.7° preoperatively (deviation 5.1°) to 9.2° postoperatively (deviation 0.1°), with increases in distal and proximal lumbar lordosis of 10.5° and 9.5°, respectively. Change in distal lumbar lordosis strongly correlated with change in L1-pelvic angle (ΔL1PA = - 0.5ΔDLL + 0.4; r = - 0.80; p < 0.001). Patients with postoperative L1-pelvic angle increase had greater preoperative thoracic kyphosis, thoracolumbar kyphosis, and L4-S1 lordosis (all p ≤ 0.017).
CONCLUSION: Distal lumbar lordosis change is strongly associated with early postoperative L1-pelvic angle alignment in adult spinal deformity, with each 1° of L4-S1 correction producing a 0.5° L1-pelvic angle reduction. This relationship provides a descriptive framework for understanding early lumbopelvic behavior after major reconstruction, while the lack of association with proximal lordosis and ideal preoperative L1-pelvic angle suggests sagittal deformity drivers beyond the distal lumbar spine.
METHODS: A retrospective review was performed of 120 adult spinal deformity patients undergoing ≥ 6-level thoracolumbar fusion to the pelvis with a UIV at T10 or higher. Spinopelvic parameters were assessed preoperatively and at an early postoperative window (minimum 6 months to maximum 1 year) to isolate initial alignment mechanics, ideal L1-pelvic angle was defined as (0.5 × pelvic incidence - 19) ± 2, and uni- and multivariable regression analyses examined associations between changes in lumbar lordosis components and L1-pelvic angle, with stratification by postoperative L1-pelvic angle deviation.
RESULTS: The cohort (mean age 65.7 years; 64.1% female) had a mean pelvic incidence of 55.2°. L1-pelvic angle improved from 13.7° preoperatively (deviation 5.1°) to 9.2° postoperatively (deviation 0.1°), with increases in distal and proximal lumbar lordosis of 10.5° and 9.5°, respectively. Change in distal lumbar lordosis strongly correlated with change in L1-pelvic angle (ΔL1PA = - 0.5ΔDLL + 0.4; r = - 0.80; p < 0.001). Patients with postoperative L1-pelvic angle increase had greater preoperative thoracic kyphosis, thoracolumbar kyphosis, and L4-S1 lordosis (all p ≤ 0.017).
CONCLUSION: Distal lumbar lordosis change is strongly associated with early postoperative L1-pelvic angle alignment in adult spinal deformity, with each 1° of L4-S1 correction producing a 0.5° L1-pelvic angle reduction. This relationship provides a descriptive framework for understanding early lumbopelvic behavior after major reconstruction, while the lack of association with proximal lordosis and ideal preoperative L1-pelvic angle suggests sagittal deformity drivers beyond the distal lumbar spine.