Prevalence and Type of Cervical Deformity Among 470 Adults With Thoracolumbar Deformity

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Abstract

Multicenter, prospective, consecutive case series.

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Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity: a prospective multicenter analysis.

Frank J Schwab, Benjamin Blondel, Shay Bess … (2013)

Prospective multicenter study evaluating operative (OP) versus nonoperative (NONOP) treatment for adult spinal deformity (ASD).

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The SRS-Schwab adult spinal deformity classification: assessment and clinical correlations based on a prospective operative and nonoperative cohort.

Gregory Mundis, Eric Klineberg, Peter J S Smith … (2013)

The SRS-Schwab classification of adult spinal deformity (ASD) is a validated system that provides a common language for the complex pathology of ASD. Classification reliability has been reported; however, correlation with treatment has not been assessed. To assess the clinical relevance of the SRS-Schwab classification based on correlations with health-related quality of life (HRQOL) measures and the decision to pursue operative vs nonoperative treatment. Prospective analysis of consecutive ASD patients (18 years of age and older) collected through a multicenter group. The SRS-Schwab classification includes a curve type descriptor and 3 sagittal spinopelvic modifiers (sagittal vertical axis, pelvic tilt, pelvic incidence/lumbar lordosis mismatch). Differences in demographics, HRQOL (Oswestry Disability Index, SRS-22, Short Form-36), and classification between operative and nonoperative patients were evaluated. A total of 527 patients (mean age, 52.9 years; range, 18.4-85.1 years) met inclusion criteria. Significant differences in HRQOL were identified based on SRS-Schwab curve type, with thoracolumbar and primary sagittal deformities associated with greater disability and poorer health status than thoracic or double curve deformities. Operative patients had significantly poorer grades for each of the sagittal spinopelvic modifiers, and progressively higher grades were associated with significantly poorer HRQOL (P < .05). Patients with worse sagittal spinopelvic modifier grades were significantly more likely to require major osteotomies, iliac fixation, and decompression (P ≤ .009). The SRS-Schwab classification provides a validated language to describe and categorize ASD. This study demonstrates that the SRS-Schwab classification reflects severity of disease state based on multiple measures of HRQOL and significantly correlates with the important decision of whether to pursue operative or nonoperative treatment.

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Standing balance and sagittal plane spinal deformity: analysis of spinopelvic and gravity line parameters.

W Skalli, Marie Gagey, Jean Farcy … (2008)

Prospective study of 131 patients and volunteers recruited for an analysis of spinal alignment and gravity line (GL) assessment by force plate analysis. To determine relationships between GL, foot position, and spinopelvic landmarks in subjects with varying sagittal alignment. Additionally, the study sought to analyze the role of the pelvis in the maintenance of GL position. Force plate technology permits analysis of foot position and GL in relation to radiographically obtained landmarks. Previous investigation noted fixed GL-heel relationship across a wide age range despite changes in thoracic kyphosis. The pelvis as balance regulator has not been studied in the setting of sagittal spinal deformity. The 131 subjects were grouped by sagittal vertical axis (SVA) offset from the sacrum: sagittal forward (>2.5 cm), neutral (-2.5 cm