Sagittal Balance Correction in Lateral Interbody Fusion for Degenerative Scoliosis

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Figure 1
Pre-operative standing lateral radiograph depicting a sagittal balance of +7.1 cm. (B) Post-operative radiograph depicting an improvement in sagittal balance to +4.1 cm.
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Figure 2
Case example demonstrating mild loss of correction over time. (A) Pre-operative standing lateral radiograph depicting a sagittal balance of +18.5 cm. (B) Post-operative radiograph at 6-weeks depicting an improvement in sagittal balance to +6.0 cm. (C) Post-operative radiograph at 6-months depicting a mild loss of correction to a sagittal balance of 7.9cm.

Table 3

Radiographic measures. Mean values at each time point.

Measures	Time	Mean	SE
SVA	Pre-operative	5.79 cm	0.85 cm
	First post-operative	5.60 cm	0.79 cm
	Final post-operative	3.81 cm	0.99 cm
Cobb	Pre-operative	21.6°	2.4°
	First post-operative	6.9°	1.8°
	Final post-operative	8.0°	2.3°
GLL	Pre-operative	28.9°	2.3°
	First post-operative	35.2°	2.2°
	Final post-operative	32.0°	2.8°
LSL	Pre-operative	40.0°	2.2°
	First post-operative	46.7°	2.0°
	Final post-operative	45.9°	2.6°
SL	Pre-operative	33.6°	2.2°
	First post-operative	37.0°	2.0°
	Final post-operative	38.6°	2.5°

Table 4

Post-hoc differences at each time point.

Measures	Time	Difference	SE of difference	p-value
SVA	First post-operative -pre-operative	- 0.99 cm	0.77 cm	0 .40
	Final post-operative -pre-operative	-1.98 cm	0.97 cm	0.10
	Final - first post-operative	- 0.99 cm	0.97 cm	0.56
Cobb	First post-operative -pre-operative	-14.7°	1.7°	< 0.001
	Final post-operative -pre-operative	-13.6°	2.2°	< 0.001
	Final - first post-operative	1.1°	2.2°	0.88
GLL	First post-operative -pre-operative	6.3°	2.2°	0.01
	Final post-operative -pre-operative	3.1°	2.8°	0.50
	Final - first post-operative	-3.2°	2.8°	0.47
LSL	First post-operative -pre-operative	6.7°	2.0°	0.002
	Final post-operative -pre-operative	5.9°	2.5°	0.05
	Final - first post-operative	-0.7°	2.5°	0.95
SL	First post-operative -pre-operative	3.4°	1.9°	0.18
	Final post-operative -pre-operative	5.0°	2.4°	0.10
	Final- first post-operative	1.6°	2.4°	0.78

Table 5

Patient-reported outcome measures.

Outcome	Time	Mean	SE	Lower 95% CI	Upper 95% CI	p-value	95% CI of difference
ODI	Baseline	50.6	4.1	42.0	59.2	0.003	-26.3	-6.9
ODI	Follow-up	34	4.8	24.0	44.0	0.003	-26.3	-6.9
SF-36 Mental	Baseline	40.9	3.1	34.4	47.4	0.01	2.2	13.0
SF-36 Mental	Follow-up	48.5	2.6	43.0	54.0	0.01	2.2	13.0
SF-36 Physical	Baseline	31.2	2.0	26.9	35.5	0.41	-3.0	7.1
SF-36 Physical	Follow-up	33.2	2.4	28.1	38.3	0.41	-3.0	7.1
Back pain	Baseline	7.4	0.6	6.1	8.7	<0.001	-5.6	-2.6
Back pain	Follow-up	3.3	0.7	1.8	4.8	<0.001	-5.6	-2.6
Right leg pain	Baseline	5.2	0.7	3.7	6.7	<0.001	-3.9	-1.3
Right leg pain	Follow-up	2.5	0.6	1.2	3.8	<0.001	-3.9	-1.3
Left leg pain	Baseline	4.9	0.7	3.4	6.4	<0.001	-5.2	-1.8
Left leg pain	Follow-up	1.4	0.8	-0.3	3.1	<0.001	-5.2	-1.8