ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2014
Pelvic incidence-lumbar lordosis mismatch results in increased segmental joint loads in the unfused and fused lumbar spine.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 2 of them syntheses that pooled it.
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Who cites it
47 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Clinical effectiveness of reduction and fusion versus in situ fusion in the management of degenerative lumbar spondylolisthesis: a systematic review and meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Pooled it
- Relationship between sagittal balance and adjacent segment disease in surgical treatment of degenerative lumbar spine disease: meta-analysis and implications for choice of fusion technique.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2018Pooled it
- Influence of pelvic incidence-lumbar lordosis mismatch on surgical outcomes of short-segment transforaminal lumbar interbody fusion.BMC musculoskeletal disorders · 2015Trial
- Full versus partial correction of pelvic incidence-lumbar lordosis mismatch in lumbar fusion: a systematic review and meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Review
- Quantitative Assessment of Postoperative Lumbar Morphology Using Geometric Morphometrics: Within-Subject Changes Following TLIF and Decompression.Diagnostics (Basel, Switzerland) · 2026Article
- Impact of "Asymptomatic," Radiographic Foraminal Stenosis on Lumbar Spine Surgery Outcomes: A Systematic Review.Global spine journal · 2026Review
- Changes in low back pain, global sagittal alignment, and spinopelvic parameters following primary total hip arthroplasty: results of a prospective observational study with two-year follow-up.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Does spinopelvic imbalance after minimally invasive lower lumbar fusion predispose patients to subsequent minimally invasive sacroiliac joint fusions? a case-control study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- Influence of pelvic incidence-lumbar lordosis mismatch on surgical outcomes of total hip arthroplasty: a retrospective cohort study.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Biomechanical Evaluation of the Effect of MIS and COS Surgical Techniques on Patients with Spondylolisthesis using a Musculoskeletal Model.Journal of biomedical physics & engineering · 2025Article
- The triadic relationship between spinal posture, loading, and degeneration.Frontiers in bioengineering and biotechnology · 2025Article
- Risk factors and clinical significance of posterior slip of the proximal vertebral body after lower lumbar fusion.World journal of clinical cases · 2024Article
- Changes in Alignment at Untreated Vertebral Levels Following Short-Segment Fusion Using Personalized Interbody Cages: Leveraging Personalized Medicine to Reduce the Risk of Reoperation.International journal of spine surgery · 2024Article
- Sagittal spinopelvic alignment in ambulatory persons with cerebral palsy.Spine deformity · 2024Article
- Long-term efficacy of Waveflex semi-rigid-dynamic-internal-fixation system in delaying intervertebral disc degeneration at adjacent segments and improving spinal sagittal imbalance.Scientific reports · 2024Article
- Lumbar lordosis and sacral slope do not differ in two types of postoperative lumbar disc re-herniation: a cross-sectional observational study.BMC musculoskeletal disorders · 2024Observational
- Development of End-to-End Artificial Intelligence Models for Surgical Planning in Transforaminal Lumbar Interbody Fusion.Bioengineering (Basel, Switzerland) · 2024Article
- Validation of Roussouly classification in predicting the occurrence of adjacent segment disease after short-level lumbar fusion surgery.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2024Article
- Comparison of short-segment and long-segment fixation in treatment of degenerative scoliosis and analysis of factors associated with adjacent spondylolisthesis.Open medicine (Warsaw, Poland) · 2024Article
- Risk Factors and Three Radiological Predictor Models for the Progression of Proximal Junctional Kyphosis in Adult Degenerative Scoliosis Following Posterior Corrective Surgery: 113 Cases With 2-years Minimum Follow-Up.Global spine journal · 2023Article
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4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
purposeSymptomatic adjacent segment disease (ASD) has been reported to occur in up to 27 % of lumbar fusion patients. A previous study identified patients at risk according to the difference of pelvic incidence and lordosis. Patients with a difference between pelvic incidence and lumbar lordosis >15° have been found to have a 20 times higher risk for ASD. Therefore, it was the aim of the present study to investigate forces acting on the adjacent segment in relation to pelvic incidence-lumbar lordosis (PILL) mismatch as a measure of spino-pelvic alignment using rigid body modeling to decipher the underlying forces as potential contributors to degeneration of the adjacent segment.
methodsSagittal configurations of 81 subjects were reconstructed in a musculoskeletal simulation environment. Lumbar spine height was normalized, and body and segmental mass properties were kept constant throughout the population to isolate the effect of sagittal alignment. A uniform forward/backward flexion movement (0°-30°-0°) was simulated for all subjects. Intervertebral joint loads at lumbar level L3-L4 and L4-L5 were determined before and after simulated fusion.
resultsIn the unfused state, an approximately linear relationship between sagittal alignment and intervertebral loads could be established (shear: 0° flexion r = 0.36, p < 0.001, 30° flexion r = 0.48, p < 0.001; compression: 0° flexion r = 0.29, p < 0.01, 30° flexion r = 0.40, p < 0.001). Additionally, shear changes during the transition from upright to 30° flexed posture were on average 32 % higher at level L3-L4 and 14 % higher at level L4-L5 in alignments that were clinically observed to be prone to ASD. Simulated fusion affected shear forces at the level L3-L4 by 15 % (L4-L5 fusion) and 23 % (L4-S1 fusion) more for alignments at risk for ASD.
conclusionHigher adjacent segment shear forces in alignments at risk for ASD already prior to fusion provide a mechanistic explanation for the clinically observed correlation between PILL mismatch and rate of adjacent segment degeneration.
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