SynthesisEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025
The predictive power of the Roussouly classification on mechanical complications after surgery for adult spinal deformity: systematic review and meta-analysis.
Synthesis 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, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Comparative analysis between mono-axial and poly-axial screws and their effect on rod and spine curvature mismatch in treatment of adult spinal deformity.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Article
- Fusion level selection in posterior hemivertebra resection for congenital scoliosis: clinical effect size driven feature selection and multi-criteria optimization decision model.Frontiers in medicine · 2026Article
- Reoperation risk by subtype in proximal junctional kyphosis and the impact of osteoporosis treatment in adult spinal deformity surgery.North American Spine Society journal · 2025Article
Corrections and comments
- Erratum issued
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWith the increasing prevalence of adult spinal deformity (ASD) in the aging population, the need for corrective surgery has surged, highlighting the importance of preventing mechanical complications (MC) such as junctional kyphosis/failure and rod breakage. The Roussouly classification, which categorizes natural variations in spinal posture, may hold predictive value in assessing the risk of these complications, as it guides the restoration of sagittal alignment based on a patient's preoperative spinal shape.
methodsPubMed, Cochrane, and Google Scholar (pages 1-20) were searched through August 2024 to find articles comparing the incidence of mechanical complications between patients who were matched and mismatched to their ideal Roussouly shape after surgery for ASD. Extracted data consisted of the risk of mechanical complications, and the risk of reoperations.
results10 retrospective studies were included in this meta-analysis, with 1454 patients divided into 2 groups, the first group matching Roussouly classification (716 patients, 49%) and the second unmatched (738 patients, 51%). A 5-times lower rate of mechanical complication (Odds-Ratio = 0.22; 95% CI: 0.12-0.41, p < 0.001) was found in the matched group at an average follow-up of 3.6 years. Furthermore, when examining specific mechanical complications, there were higher rates of both PJK (Odds-Ratio = 1.59; 95% CI: 1.07-2.38, p = 0.02) and rod breakages (Odds-Ratio = 1.75; 95% CI: 1.15-2.66, p = 0.01) in the unmatched group. However, no difference in the rate of reoperations was observed between the two groups (Odds-Ratio = 0.48; 95% CI: 0.18-1.28, p = 0.14).
conclusionMatching patients to their ideal Roussouly type in adult spinal deformity surgery significantly reduces mechanical complications making it a secure and efficient method. Future studies should compare the Roussouly classification to other alignment models to determine optimal alignment for ASD correction surgery. LEVEL OF EVIDENCE: III.
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