STUDY DESIGN: Retrospective study of consecutive @entity1 series. OBJECTIVES: To review the radiographic and clinical results of @entity1 with preoperative fixed sagittal imbalance treated with combined anterior and posterior arthrodesis, and to determine factors that predict clinical outcome. SUMMARY OF BACKGROUND DATA: Combined anterior and posterior arthrodesis of the spine is useful in the management of fixed @entity85 involving the coronal and sagittal planes. The specific indications for combined surgery in the @entity1 with regional and global imbalance have not been well defined. METHODS: Retrospective review of 25 consecutive @entity1 treated with combined anterior and posterior spinal arthrodesis. Inclusion criteria included a preoperative global sagittal imbalance of at least 5 cm. Outcome variables included radiographic measures of preoperative, postoperative, and follow-up films, and a clinical assessment using the Modified SRS Outcomes Instrument and a review of @entity260 . RESULTS: Twenty-five consecutive cases were reviewed. Mean age was 58 years (range 38-77), and mean follow-up was 55 months (range 24-81) for clinical and 44.5 (range 24-81) months for radiographic outcome variables. The mean preoperative sagittal imbalance was 10.5 cm (range 5.2-23.3), which improved to 2.9 cm (range 0-12.6) after surgery, and was maintained as 3.3 cm (range 0-13.5) at follow-up. @entity1515 was -23 degrees (range +40 to -47) before surgery, and increased to -42 degrees at follow-up (range -20 degrees to -60 degrees ), an increase of 19 degrees. @entity1 with preoperative regional hypolordosis in the lumbar spine that was corrected surgically had the highest postoperative scores. The mean score for @entity1 satisfaction with surgical management was 4.45 (range 2.5-5). Correlation analysis of clinical outcome domains demonstrated that @entity1 satisfaction correlated poorly with domains of @entity158 (r = 0.37, P = 0.1) and function (r = 0.4, P = 0.09). Within the domains, self-image showed highest correlation with @entity1 satisfaction (r = 0.65, P = 0.006) and total score (r = 0.89, P = 0.0001). CONCLUSIONS: @entity1 with global sagittal imbalance of the spine were effectively treated with a combined anterior and posterior arthrodesis as measured by radiographic parameters. @entity1 satisfaction with surgery, and overall clinical outcomes were best in cases that resulted in an @entity1515 . The subset of @entity1 with preoperative regional hypolordosis of the lumbar spine has better outcomes than those with @entity1515 in the physiologic range.

Management of fixed XXXX : outcome of combined anterior and posterior surgery.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient', 'Patient'] @entity260 :: ('MESH:D011183', 'Disease') :: ['postoperative complications'] @entity1515 :: ('MESH:D008141', 'Disease') :: ['preoperative lumbar lordosis', 'increase in lumbar lordosis', 'Mean lumbar lordosis'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain'] @entity85 :: ('MESH:D009140', 'Disease') :: ['deformity']
@entity85 :: (MESH:D009140,Disease) :: ['sagittal plane deformity']
