Clinical study on Roussouly classification to evaluate sagittal morphology and predict mechanical complications after surgery for degenerative scoliosis
ZHU Yu
WANG Hong-qiang
LI Ang
ZHAO Hong-jian
ZHAO Qiong-rui
GAO Zhi-xiang
GUO Tian-ze
GAO Yan-zheng
Abstract：Objective To evaluate the clinical efficacy and imaging parameters of postoperative degenerative scoliosis fixed to the sacrum/pelvis using Roussouly classification,analyze the risk factors for mechanical complications,and explore the significance of Roussouly classification in lumbar long-segment fixation surgery.Methods A retrospective analysis was conducted on 45 patients who underwent long-segment lumbar sacral/pelvic fusion surgery for degenerative scoliosis at Henan Provincial People's Hospital from December 2017 to December 2020.Among them,7 were males and 38 were females,aged 55-85 years with an average age of(70.84±8.52)years.According to whether they met the Roussouly classification,they were divided into the Roussouly classification(RG)group(n=10)and the non-Roussouly classification(NRG)group(n=35);General data including visual analog scale(VAS),lumbar Oswestry disability index(ODI),health-related quality of life(QOL),and the occurrence of mechanical complications were compared between the two groups.Parameters related to spinal pelvic imaging,such as coronal Cobb's angle,pelvic incidence angle(PI)sacral slope angle(SS),lumbar lordosis angle(LL),lumbar lordosis distribution index(LDI),the number of vertebrae included in the lordosis(NVL),the lumbar sagittal apex(LA),and inflection point(IP)were compared between the two groups.Based on whether mechanical complications occurred after surgery,the Roussouly classification related sagittal parameters were included in univariate analysis and multivariate binary Logistic regression analysis to determine independent risk factors for mechanical complications.Results The baseline levels of RG and NRG were consistent before surgery;The postoperative VAS score for low back pain in the RG group(1.20±0.92)was lower than that in the NRG group(1.97±0.79),and the differences were statistically significant(P=0.01);The postoperative ODI score in the RG group was(13.40±3.69),while in the NRG group was(21.40±7.66),with statistically significant differences(P=0.003);The postoperative SF-36 score in the RG group(75.68±4.81)was higher than that in the NRG group(68.25±6.30),with statistically significant differences(P=0.001);The LL(48.20±8.48)° in the RG group was greater than that in the NRG group(40.33±5.22)°,with statistically significant differences(P=0.001).The SVA(24.55 mm)in the RG group was smaller than the 40.84 mm in the NRG group,with statistically significant differences(P=0.03).There were statistically significant differences in the incidence of mechanical complications between the two groups(P=0.04);Postoperative PI(OR=0.797;95%CI=0.657-0.968;P=0.022)and LA(OR=0.027;95%CI=0.002-0.438;P=0.011)are independent risk factors for postoperative mechanical complications.Conclusions Patients with DS who meet the ideal Roussouly classification after surgery can achieve better clinical efficacy,while having fewer mechanical complications.A smaller pelvic PI value and a higher anterior convex vertex position can increase the occurrence of mechanical complications after DS surgery.
Keywords：ScoliosisSpinal diseasesRoussouly classification
Publication Date：2024-07-19
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：9( 498-506 )