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Related Concept Videos

Deformations in a Transverse Cross Section01:21

Deformations in a Transverse Cross Section

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When a material is subjected to uniaxial stress, it elongates or contracts in the direction of the applied force, and also undergoes changes in the perpendicular directions. This behavior is crucial for understanding how materials behave under stress and is governed by mechanical properties such as Poisson's ratio v, which measures the ratio of transverse strain to axial strain.
As the material stretches, it expands or contracts in orthogonal directions to the load. This phenomenon varies...
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Deformation of Member under Multiple Loadings01:11

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When a rod is made of different materials or has various cross-sections, it must be divided into parts that meet the necessary conditions for determining the deformation. These parts are each characterized by their internal force, cross-sectional area, length, and modulus of elasticity. These parameters are then used to compute the deformation of the entire rod.
In the case of a member with a variable cross-section, the strain is not constant but depends on the position. The deformation of an...
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Relative pelvic version displays persistent compensatory measures with normalised sagittal vertical axis after

Derek T Cawley1,2, Louis Boissiere3, Caglar Yilgor4

  • 1Institut de la Colonne Vertébrale, Spine Unit 1, Bordeaux University Hospital, Bordeaux, France. derekcawley@hotmail.com.

Spine Deformity
|April 29, 2021
PubMed
Summary

Post-operative pelvic orientation after spinal deformity surgery can mask sagittal imbalance. Relative pelvic version (RPV) assessment at 6 weeks predicts long-term outcomes and complications in adult spinal deformity patients.

Keywords:
Adult spinal deformityAlignmentFusionKyphosisLumbar lordosisPelvic tiltRelative pelvic versionSacral slopeSagittal vertical axisSpino-pelvic

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Area of Science:

  • Spine surgery
  • Orthopedics
  • Biomechanical analysis

Background:

  • Normal sagittal vertical axis (SVA) after spinal deformity correction is associated with a significant risk of mechanical complications.
  • Post-operative compensatory pelvic orientation can normalize SVA, potentially masking underlying sagittal imbalance.
  • Relative pelvic version (RPV) is an individualized measure to assess persistent post-operative compensatory pelvic orientation.

Purpose of the Study:

  • To assess the predictive value of relative pelvic version (RPV) for persistent post-operative compensatory measures in adult spinal deformity (ASD) patients.
  • To evaluate the relationship between RPV at 6 weeks and patient-related outcome measures (PROMs), complications, and spino-pelvic sagittal parameters at 2 years.
  • To determine if RPV categorization can identify patients at higher risk for future sagittal imbalance and complications.

Main Methods:

  • Adult spinal deformity patients with normal SVA (<±50 mm) at 6-week follow-up were included.
  • Patients underwent spinal fusion of >4 vertebrae extending to L5 or below.
  • Patients were categorized into RPV subgroups (anteversion, aligned, moderate retroversion, severe retroversion) at 6 weeks and followed for 2 years.

Main Results:

  • At 6 weeks, 140 patients were analyzed: 5% anteversion, 42.1% aligned, 42.9% moderate retroversion, and 11.4% severe retroversion.
  • At 2-year follow-up, RPV increased in all groups except severe retroversion, which showed a higher likelihood of developing SVA >50 mm.
  • Complications occurred across all RPV groups, with significant 2-year differences in back pain and PROMs between moderate and severe retroversion groups.

Conclusions:

  • Normal SVA after spinal deformity surgery does not preclude progression of retroversion and potential increase in positive sagittal balance.
  • RPV categorization at 6 weeks is a valuable predictor of 2-year PROMs in adult spinal deformity patients.
  • Early identification of RPV may aid in managing long-term outcomes and preventing complications in ASD patients.