adult_spinal_deformity_surgery

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adult_spinal_deformity_surgery [2025/07/10 06:21] administradoradult_spinal_deformity_surgery [2025/07/10 06:22] (current) administrador
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 {{rss>https://pubmed.ncbi.nlm.nih.gov/rss/search/1NGmwZeh8JwXIzruhIPaXrHY4vAtO01ESFM_T-5mx5oKPotQx0/?limit=15&utm_campaign=pubmed-2&fc=20230321164733}} {{rss>https://pubmed.ncbi.nlm.nih.gov/rss/search/1NGmwZeh8JwXIzruhIPaXrHY4vAtO01ESFM_T-5mx5oKPotQx0/?limit=15&utm_campaign=pubmed-2&fc=20230321164733}}
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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, San Diego, Toronto, Barcelona, Charlottesville, New York   
-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]]; compensatory strategies (pelvic retroversion, knee flexion) are essential; individualized, structure-shape–based alignment (e.g., GAP, Roussouly, T4‑L1‑Hip‑Axis) reduces mechanical failure risk, though reoperation rates remain high   
-((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;15(3_suppl):108S-122S. doi: 10.1177/21925682251331048. Epub 2025 Jul 9. PMID: 40632289.)). 
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-==== Critical Review ==== 
-The narrative review offers a comprehensive appraisal of alignment paradigms, yet: 
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-* **Strengths:** Integrates key classification systems; emphasizes pelvic and lower-extremity compensation; aligns recent evidence on shape-based vs. quality-of-life–based targets; timely discussion given recent advances (e.g., T4‑L1‑Hip‑Axis)  
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-* **Weaknesses:** Lacks systematic methodology or quantitative synthesis; conclusions primarily descriptive; limited [[critical appraisal]] of conflicting literature; evidence grade unclear   
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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:Adult_Spinal_Deformity]]   
-^ [[Category:Spinal_Surgery_Alignment]]   
-^ Tags: ASD, sagittal_alignment, mechanical_complications, GAP_score, Roussouly, T4-L1-Hip-Axis 
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-==== Citation ==== 
-Alignment Goals in Adult Spinal Deformity Surgery. Pizones J et al. *Global Spine J.* 2025 Jul;15(3_suppl):108S‑122S. doi:10.1177/21925682251331048. Published July 9, 2025.   
-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's quality of life. 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's quality of life.
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 ===== Patient Evaluation ===== ===== Patient Evaluation =====
  • adult_spinal_deformity_surgery.txt
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