ReviewEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
Full versus partial correction of pelvic incidence-lumbar lordosis mismatch in lumbar fusion: a systematic review and meta-analysis.
Review 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, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
10 authors.
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Abstract
purposeRestoration of sagittal balance, specifically the mismatch between pelvic incidence and lumbar lordosis (PI-LL), is an important objective in lumbar fusion, particularly for degenerative deformity correction. While a postoperative PI-LL of ≤ 10° is generally considered optimal, the clinical necessity of achieving this threshold versus partial correction (PI-LL > 10°) remains uncertain. This study aimed to systematically review the differences in disability outcomes and mechanical complications between "full" (≤ 10°) versus "partial" (> 10°) PI-LL correction.
methodsOvid Embase, Ovid MEDLINE, PubMed, Scopus, and Cochrane CENTRAL were searched from database inception to May 9, 2025. Studies were included if they compared full and partial PI-LL correction in adults undergoing lumbar fusion due to degenerative spinal conditions. Correction status was defined by a fixed PI-LL threshold only; the full SRS-Schwab classification was not applied. Using random-effects models, continuous outcomes were pooled as mean differences (MD) in pre-post change and dichotomous outcomes as odds ratios (ORs), both with 95% CIs. Risk of bias was assessed using ROBINS-I.
resultsTwenty-seven studies involving 3,682 patients met the inclusion criteria. Patients who achieved full correction had a modestly greater ODI improvement than patients with partial correction (MD - 2.21; 95% CI [- 4.21, - 0.21]; I
conclusionsPostoperative PI-LL ≤ 10° ("full" correction) is associated with a small improvement in ODI that falls below established minimal clinically important difference thresholds. In short-segment degenerative cohorts, full correction is associated with reduced odds of ASD. However, these findings are associational, and PI-LL should be treated as an important guidepost within an individualized alignment strategy that accounts for patient-specific factors and global sagittal balance, rather than as a universal numeric target.
Indexed as
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.