Scholarlink

Purpose <p>Achieving target L1-pelvic-angle (L1PA) is heavily influenced by segmental lordosis changes during adult spinal deformity (ASD) surgery. Understanding the effect of changing each lordotic segmental level on L1PA will aid in preoperative planning and intraoperative alignment assessment in ASD. In patients undergoing ASD surgery, we aimed to evaluate the impact of segmental lordosis changes on postoperative L1PA.</p> Methods <p>A retrospective cohort study (2009-24) was performed for ASD surgery patients. Inclusion criteria were: ≥5-level fusion and sagittal/coronal deformity. Primary exposure variable was change in segmental lordosis at each lumbar level. Primary outcome was the change in L1PA. Multivariable regression controlling for preoperative and change in segmental lordosis at each level was performed.</p> Results <p>Of 180 patients (mean age:59 ± 19 years, 32% males), mean preoperative/postoperative L1PA were 14 ± 11° and 12 ± 9°, respectively. <b>L1/2</b>: Mean change in lordosis was 7 ± 6°. For a 10° increase in L1/2 lordosis, the L1PA increased by 0.33° (β = -0.03, <i>p</i> = 0.684). <b>L2/3</b>: Mean change in lordosis was 8 ± 8°. For a 10° increase in L2/3 lordosis, the L1PA decreased by 0.01° (β = 0.00, <i>p</i> = 0.991). <b>L3/4</b>: Mean change in lordosis was 9 ± 8°. For a 10° increase in L3/4 lordosis, the L1PA decreased by 1.05° (β = 0.10, <i>p</i> = 0.086). <b>L4/5</b>: Mean change in lordosis was 9 ± 8°. For a 10° increase in L4/5 lordosis, the L1PA decreased by 1.78° (β = 0.18, <i>p</i> = 0.001). <b>L5/S1</b>: Mean change in lordosis was 11 ± 12°. For a 10° increase in L5/S1 lordosis, the L1PA decreased by 1.41° (β = 0.14, <i>p</i> = 0.002).</p> Conclusion <p>Changes in segmental lordosis at the L4/5 level were associated with greatest decrease in L1PA following ASD surgery, followed by L5/S1 and L3/4. Changes at L5/S1 influenced the L1PA slightly less than L4/5. These findings suggest that focusing on adding lordosis at the L4/5 and L5/S1 level will result in the greatest improvement in L1PA.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

How changes in segmental lordosis impact L1-pelvic-angle after adult spinal deformity surgery: Which lumbar levels matter most?

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月19日

查看全文
  • Harsh Jain,
  • Advith Sarikonda,
  • Tyler Zeoli,
  • Omar Zakieh,
  • Anthony Bishay,
  • Jeremia Williams,
  • Austin Montgomery,
  • Walter Navid,
  • Alan Tang,
  • Keyan Peterson,
  • Iyan Younus,
  • Ranbir Ahluwalia,
  • Soren Jonzzon,
  • Hani Chanbour,
  • Hui Nian,
  • Adam Wegner,
  • Julian Lugo-Pico,
  • Amir Abtahi,
  • Byron Stephens,
  • Scott Zuckerman

摘要

Purpose

Achieving target L1-pelvic-angle (L1PA) is heavily influenced by segmental lordosis changes during adult spinal deformity (ASD) surgery. Understanding the effect of changing each lordotic segmental level on L1PA will aid in preoperative planning and intraoperative alignment assessment in ASD. In patients undergoing ASD surgery, we aimed to evaluate the impact of segmental lordosis changes on postoperative L1PA.

Methods

A retrospective cohort study (2009-24) was performed for ASD surgery patients. Inclusion criteria were: ≥5-level fusion and sagittal/coronal deformity. Primary exposure variable was change in segmental lordosis at each lumbar level. Primary outcome was the change in L1PA. Multivariable regression controlling for preoperative and change in segmental lordosis at each level was performed.

Results

Of 180 patients (mean age:59 ± 19 years, 32% males), mean preoperative/postoperative L1PA were 14 ± 11° and 12 ± 9°, respectively. L1/2: Mean change in lordosis was 7 ± 6°. For a 10° increase in L1/2 lordosis, the L1PA increased by 0.33° (β = -0.03, p = 0.684). L2/3: Mean change in lordosis was 8 ± 8°. For a 10° increase in L2/3 lordosis, the L1PA decreased by 0.01° (β = 0.00, p = 0.991). L3/4: Mean change in lordosis was 9 ± 8°. For a 10° increase in L3/4 lordosis, the L1PA decreased by 1.05° (β = 0.10, p = 0.086). L4/5: Mean change in lordosis was 9 ± 8°. For a 10° increase in L4/5 lordosis, the L1PA decreased by 1.78° (β = 0.18, p = 0.001). L5/S1: Mean change in lordosis was 11 ± 12°. For a 10° increase in L5/S1 lordosis, the L1PA decreased by 1.41° (β = 0.14, p = 0.002).

Conclusion

Changes in segmental lordosis at the L4/5 level were associated with greatest decrease in L1PA following ASD surgery, followed by L5/S1 and L3/4. Changes at L5/S1 influenced the L1PA slightly less than L4/5. These findings suggest that focusing on adding lordosis at the L4/5 and L5/S1 level will result in the greatest improvement in L1PA.