The correction range of lumbosacral curve vertebral body tilt in degenerative scoliosis for achieving postoperative coronal balance
Abstract Purpose To explore the relationship between lumbosacral curve vertebral body tilt correction and postoperative coronal balance in adult degenerative scoliosis to determine the ideal target values for the tilt correction. Methods We conducted a retrospective analysis of 144 patients who unde...
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BMC
2025-04-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-025-08655-3 |
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| author | Zehua Jiang Ziyang Liu Chuanxu Li Xuanhao Fu Hao Yu Xuan Wang Maosen Zhang Linyan Liu Yuelin Cheng Wenjun Du Rusen Zhu |
| author_facet | Zehua Jiang Ziyang Liu Chuanxu Li Xuanhao Fu Hao Yu Xuan Wang Maosen Zhang Linyan Liu Yuelin Cheng Wenjun Du Rusen Zhu |
| author_sort | Zehua Jiang |
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| description | Abstract Purpose To explore the relationship between lumbosacral curve vertebral body tilt correction and postoperative coronal balance in adult degenerative scoliosis to determine the ideal target values for the tilt correction. Methods We conducted a retrospective analysis of 144 patients who underwent surgery between January 2017 and December 2023. Patients were classified based on the preoperative Obeid classification and fixation segment length into Concave Long Segment (Concave-L, n = 41), Concave Short Segment (Concave-S, n = 33), Convex Long Segment (Convex-L, n = 39), and Convex Short Segment (Convex-S, n = 31). Changes in coronal and sagittal radiographic parameters and the correlation between the correction percentage of the most tilted vertebra (L4 or L5) and postoperative coronal balance distance (CBD) were assessed. Results Significant postoperative improvements in CBD, maximum coronal tilt, and Cobb angle were observed in the Concave-L, Convex-L, and Convex-S groups. The Concave-S group exhibited significant changes only in Cobb angle and maximum coronal tilt, but not CBD. A significant negative correlation existed between postoperative CBD and the correction ratio of maximum coronal tilt in the convex malalignment (r=-0.629, P < 0.001), with the regression equation: Postoperative CBD = 32.99 - (28.82 × Correction Ratio of Coronal Tilt). A correction ratio exceeding 45% at L4 or L5 tilt predicted a postoperative CBD within 20 mm. Conclusion Both short and long segment fusions effectively correct convex coronal malalignment, but concave malalignment requires long segment fusion for adequate correction. Optimal coronal balance in convex malalignment is achieved when the maximum tilt correction ratio exceeds 45%. |
| format | Article |
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| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
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| series | BMC Musculoskeletal Disorders |
| spelling | doaj-art-8a2abc3f7da2471b9d7d1d20b83ed3272025-08-20T02:30:14ZengBMCBMC Musculoskeletal Disorders1471-24742025-04-012611910.1186/s12891-025-08655-3The correction range of lumbosacral curve vertebral body tilt in degenerative scoliosis for achieving postoperative coronal balanceZehua Jiang0Ziyang Liu1Chuanxu Li2Xuanhao Fu3Hao Yu4Xuan Wang5Maosen Zhang6Linyan Liu7Yuelin Cheng8Wenjun Du9Rusen Zhu10Department of Spine Surgery, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai UniversityDepartment of Spine Surgery, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai UniversityDepartment of Spine Surgery, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai UniversityDepartment of Spine Surgery, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai UniversityDepartment of Spine Surgery, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai UniversityDepartment of Spine Surgery, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai UniversityDepartment of Spine Surgery, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai UniversityDepartment of Spine Surgery, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai UniversityDepartment of Spine Surgery, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai UniversityDepartment of Spine Surgery, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai UniversityDepartment of Spine Surgery, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai UniversityAbstract Purpose To explore the relationship between lumbosacral curve vertebral body tilt correction and postoperative coronal balance in adult degenerative scoliosis to determine the ideal target values for the tilt correction. Methods We conducted a retrospective analysis of 144 patients who underwent surgery between January 2017 and December 2023. Patients were classified based on the preoperative Obeid classification and fixation segment length into Concave Long Segment (Concave-L, n = 41), Concave Short Segment (Concave-S, n = 33), Convex Long Segment (Convex-L, n = 39), and Convex Short Segment (Convex-S, n = 31). Changes in coronal and sagittal radiographic parameters and the correlation between the correction percentage of the most tilted vertebra (L4 or L5) and postoperative coronal balance distance (CBD) were assessed. Results Significant postoperative improvements in CBD, maximum coronal tilt, and Cobb angle were observed in the Concave-L, Convex-L, and Convex-S groups. The Concave-S group exhibited significant changes only in Cobb angle and maximum coronal tilt, but not CBD. A significant negative correlation existed between postoperative CBD and the correction ratio of maximum coronal tilt in the convex malalignment (r=-0.629, P < 0.001), with the regression equation: Postoperative CBD = 32.99 - (28.82 × Correction Ratio of Coronal Tilt). A correction ratio exceeding 45% at L4 or L5 tilt predicted a postoperative CBD within 20 mm. Conclusion Both short and long segment fusions effectively correct convex coronal malalignment, but concave malalignment requires long segment fusion for adequate correction. Optimal coronal balance in convex malalignment is achieved when the maximum tilt correction ratio exceeds 45%.https://doi.org/10.1186/s12891-025-08655-3Coronal balance distanceFractional curveCoronal TiltDegenerative scoliosis |
| spellingShingle | Zehua Jiang Ziyang Liu Chuanxu Li Xuanhao Fu Hao Yu Xuan Wang Maosen Zhang Linyan Liu Yuelin Cheng Wenjun Du Rusen Zhu The correction range of lumbosacral curve vertebral body tilt in degenerative scoliosis for achieving postoperative coronal balance BMC Musculoskeletal Disorders Coronal balance distance Fractional curve Coronal Tilt Degenerative scoliosis |
| title | The correction range of lumbosacral curve vertebral body tilt in degenerative scoliosis for achieving postoperative coronal balance |
| title_full | The correction range of lumbosacral curve vertebral body tilt in degenerative scoliosis for achieving postoperative coronal balance |
| title_fullStr | The correction range of lumbosacral curve vertebral body tilt in degenerative scoliosis for achieving postoperative coronal balance |
| title_full_unstemmed | The correction range of lumbosacral curve vertebral body tilt in degenerative scoliosis for achieving postoperative coronal balance |
| title_short | The correction range of lumbosacral curve vertebral body tilt in degenerative scoliosis for achieving postoperative coronal balance |
| title_sort | correction range of lumbosacral curve vertebral body tilt in degenerative scoliosis for achieving postoperative coronal balance |
| topic | Coronal balance distance Fractional curve Coronal Tilt Degenerative scoliosis |
| url | https://doi.org/10.1186/s12891-025-08655-3 |
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