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Related Experiment Video

Updated: May 29, 2026

Clinical Efficacy of an Innovative Multidimensional Traction Therapy in Moderate Adolescent Idiopathic Scoliosis
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Clinical Efficacy of an Innovative Multidimensional Traction Therapy in Moderate Adolescent Idiopathic Scoliosis

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Multicenter validation of a formula predicting postoperative spinopelvic alignment.

Virginie Lafage1, Neil J Bharucha, Frank Schwab

  • 1Department of Orthopedic Surgery, New York University Langone Medical Center-Hospital for Joint Diseases, New York, New York, USA. virginie.lafage@gmail.com

Journal of Neurosurgery. Spine
|September 28, 2011
PubMed
Summary

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New formulas accurately predict unsuccessful outcomes for adult spinal deformity (ASD) surgery, but are less reliable for successful results. Surgeons should adjust plans for predicted failures and carefully review predicted successes to improve surgical planning.

Area of Science:

  • Spine surgery
  • Adult spinal deformity (ASD)
  • Orthopedic surgery

Background:

  • Sagittal spinopelvic imbalance significantly impacts pain and disability in adult spinal deformity (ASD) patients.
  • Accurate preoperative planning is crucial for pedicle subtraction osteotomy (PSO) but current methods lack formulas to predict both sagittal balance and pelvic alignment post-surgery.

Purpose of the Study:

  • To evaluate the accuracy of two novel formulas in predicting postoperative spinopelvic alignment following PSO.
  • To assess the formulas' ability to identify successful (sagittal vertical axis [SVA] ≤ 50 mm and pelvic tilt [PT] ≤ 25°) and unsuccessful (SVA > 50 mm or PT > 25°) surgical outcomes.

Main Methods:

  • A multicenter retrospective study of consecutive adult patients (>21 years) undergoing single-level lumbar PSO for sagittal imbalance.

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  • Preoperative and minimum 6-month postoperative radiography were analyzed.
  • Two novel formulas predicted postoperative spinopelvic alignment (PT and SVA), compared against actual radiographic values.

    • Main Results:

    • Ninety-nine patients were included. Median absolute error for PT prediction was 4.1°, and for SVA prediction was 27 mm.
    • The formulas demonstrated high accuracy for predicting unsuccessful outcomes (negative predictive value = 0.98).
    • The formulas were less reliable for predicting successful outcomes (positive predictive value = 0.76).

    Conclusions:

    • The developed formulas accurately predict unsuccessful spinopelvic alignment outcomes after PSO but are less reliable for successful outcomes.
    • Surgical plans should be modified if an unsuccessful result is predicted; predicted successful outcomes require careful review to avoid borderline results.
    • These formulas are anticipated to enhance surgical planning and improve outcomes for complex ASD patients.