Dynamic Changes of the Pelvis and Spine Are Key to Predicting Postoperative Sagittal Alignment After Pedicle Subtraction Osteotomy: A Critical Analysis of Preoperative Planning Techniques

Spine, 05/02/2012

Preoperative planning for pedicle subtraction osteotomy (PSO) is essential to optimize postoperative spinal alignment. Mathematical models that do not consider pelvic parameters and changes in unfused spinal segments poorly predict optimal postoperative alignment and may predispose to poor clinical outcomes. The Lafage formulas, which incorporated pelvic tilt and spinal compensatory changes, best predicted optimal sagittal vertical axis (SVA).

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