INTRODUCTION: Sagittal plane realignment is critical to achieve desirable clinical outcomes in @entity85 ( @entity85 ). Increasingly minimally invasive (MIS) techniques are being used to treat @entity85 . This study's objective was to evaluate circumferential MIS (cMIS) techniques and their ability to treat sagittal plane imbalance. METHODS: Multicenter database was queried for the following inclusion criteria: minimum 2-year follow-up, coronal cobb = 20  , SVA > 5 cm, or PT > 25  . @entity1 were stratified by SRS-Schwab global alignment modifier (GAM) as "Scoli," "+," or "++" depending on their preoperative @entity85 , and then analyzed for demographic, radiographic, and health-related quality-of-life (HRQoL) measures. A "+" modifier denoted moderate and "++" denoted marked @entity85 whereas "Scoli" signified nonpathological sagittal alignment. RESULTS: Eighty-six of 91 potential @entity1 had complete 2-year follow-up data ("Scoli" = 51, "+" = 21, and "++" = 14). The "Scoli" group was significantly younger than "++" group (mean 57.6 vs 70.5 years). There were no differences in baseline HRQoL and operative data. Postoperatively "Scoli" and "+" had improved @entity717 Index (ODI), Visual Analog Scale (VAS) back and leg. "Scoli" group had no differences radiographically while "+" saw improvement in PI-LL mismatch (21.1  -15.4  ; P = .025) and LL (33.6  -39.9  ; P = .016). "++" had improvement in VAS back but not ODI, VAS leg, PT, PI-LL mismatch, SVA, LL. Of 51 @entity1 in "Scoli," 42 (81%) remained "Scoli," 9 (17%) deteriorated (5 to "+," 4 to "++"). Thirteen of 21 (61.9%) "+" @entity1 remained "+" while 3 changed to "++," and 5 to "Scoli." Nine of 14 (64.3%) "++" @entity1 remained "++," 3 improved to "+" and 2 to "Scoli." CONCLUSION: MIS techniques successfully treated @entity1 with Scoli and "+" deformities with improved HRQoL. @entity1 with "++" showed less improvement clinically, and, as a sequela of fusion surgery, were left with a fixed @entity85 . These results suggest that with severe @entity85 , an open rather than MIS approach should be considered.

172   A Critical Analysis of Sagittal Plane Deformity Correction With Minimally Invasive Surgery: A 2-Year Follow-up Study of Deformity XXXX Categorized by the SRS-Schwab Classification.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity717 :: ('MESH:D009069', 'Disease') :: ['Oswestry Disability'] @entity85 :: ('MESH:D009140', 'Disease') :: ['sagittal plane deformity', 'sagittal plane deformities', 'adult spinal deformity', 'ASD', 'sagittal deformity']
@entity1 :: (9606,Species) :: ['Patients']
