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- | ====== Alignment Goals in Adult Spinal Deformity Surgery ====== | ||
- | In a narrative review | ||
- | Pizones et al. | ||
- | from La Paz Univ. Hosp, Madrid; additional centers in San Antonio, | ||
- | published in the [[Global Spine Journal]] | ||
- | to critically examine evolving strategies in [[sagittal alignment]] targets for [[adult spinal deformity surgery]], shifting focus from generic [[HRQoL]] goals to preventing mechanical [[complication]]s | ||
- | Traditional [[alignment]] [[metric]]s (PI‑LL, SVA, TK) are limited for personalized [[planning]]; | ||
- | ((Pizones J, Hills J, Kelly MP, Alavi F, Nuñez-Pereira S, Smith JS, Sardar ZM, Lenke LG, Lewis SJ, Pellisé F; [[AO Spine Knowledge Forum Deformity]]. [[Alignment]] Goals in [[Adult Spinal Deformity Surgery]]. Global Spine J. 2025 Jul; | ||
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- | ==== Critical Review ==== | ||
- | The narrative review offers a comprehensive appraisal of alignment paradigms, yet: | ||
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- | * **Strengths: | ||
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- | * **Weaknesses: | ||
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- | * **Evidence gaps:** No robust [[meta-analysis]] to support superiority of new alignment strategies; minimal discussion on age-adjusted goals (e.g., Lafage et al., 2016, 2017) and their clinical endpoints | ||
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- | ==== Verdict ==== | ||
- | The article is a well-informed narrative but falls short of high-level [[evidence]]. It’s [[hypothesis-generating]] rather than definitive in guiding surgical [[decision-making]]. | ||
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- | **Rating: 6/10** | ||
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- | ==== Takeaway for Practicing Neurosurgeon ==== | ||
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- | Use alignment strategies that respect patient-specific morphology (like [[GAP]] and [[Roussouly]]) and consider whole-body compensation. However, be cautious—this guidance is based on emerging concepts, not on strong comparative trials or comprehensive outcomes data. | ||
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- | ==== Bottom Line ==== | ||
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- | An informative review on evolving alignment goals—but lacking in solid evidence. A step forward in concept, yet insufficient as a standalone clinical guide until validated by robust comparative studies. | ||
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- | ==== Metadata ==== | ||
- | ^ [[Category: | ||
- | ^ [[Category: | ||
- | ^ Tags: ASD, sagittal_alignment, | ||
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- | ==== Citation ==== | ||
- | Alignment Goals in Adult Spinal Deformity Surgery. Pizones J et al. *Global Spine J.* 2025 Jul; | ||
- | Corresponding author: Javier Pizones, Spine Surgery Unit, La Paz University Hospital, Madrid, Spain. | ||
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Adult [[spinal deformity]] surgery is a specialized surgical procedure aimed at correcting abnormal curvatures and alignment of the spine in adults. These deformities can result from various conditions, including degenerative changes, scoliosis, kyphosis, or a combination of factors. The primary goals of adult spinal deformity surgery are to alleviate pain, improve spinal alignment, restore function, and enhance the patient' | Adult [[spinal deformity]] surgery is a specialized surgical procedure aimed at correcting abnormal curvatures and alignment of the spine in adults. These deformities can result from various conditions, including degenerative changes, scoliosis, kyphosis, or a combination of factors. The primary goals of adult spinal deformity surgery are to alleviate pain, improve spinal alignment, restore function, and enhance the patient' | ||
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===== Patient Evaluation ===== | ===== Patient Evaluation ===== |