| Objective:To investigate whether the sagittal plane of the spine matches the correlation between ideal Roussouly classification and the incidence of mechanical complications and clinical outcomes after posterior long segment fixation for adult degenerative scoliosis（ADS）.Methods:A total of 54 patients with ADS who underwent posterior long segment fixation surgery in the spine surgery department of the First Affiliated Hospital of Xinjiang Medical University from January 2015 to January 2021were retrospectively analyzed for clinical relevant data.The radiographic data for the primary measurements were:Cobb angle（CA）,Pelvic incidence（PI）,Pelvic tilt（PT）,Sacral slope（SS）,Lumbar lordosis（LL）,Sagittal vertical axis（SVA）,Global tilt（GT）,The number of vertebrae included in the lordosis（NVL）,The lumbar sagittal apex（LA）,Inflexion point（IP）,and the patients’preoperative,postoperative,and at last follow-up Oswestry disability index（ODI）scores,Japanese orthopaedic association（JOA）scores,as well as Visual analogue scale（VAS）scores were collected.Patients were divided into mechanical complication（MC）group versus non mechanical complication（NMC）group according to whether or not mechanical complication occurred in postoperative period,the analysis was performed to compare the two groups of patient related data,and the metrology data that conformed to normal distribution were analyzed by independent samples t-test,the measurement data that skewed distribution were analyzed by rank sum test,and the counting data were analyzed by Pearsontest.Results:1.Ten patients（18.5%）developed mechanical complications postoperatively and 44（81.5%）did not;Postoperative matching for ideal Roussouly classification was done in 34 patients（63%）,of whom 3（8.8%）developed mechanical complications;Mismatch was present in 20 patients（37%）,7 of whom（35%）developed mechanical complications（P=0.02）.2.The overall radiographic parameters and clinical efficacy scores were improved postoperatively compared with preoperatively（all P<0.01）.3.The MC group was older（P=0.03）,had greater PT（P=0.01）and GT（P<0.01）scores at last follow-up,and worse JOA scores at last follow-up（P=0.04）,as well as had worse VAS scores of the period of postoperation（P=0.01）and last follow-up（P=0.03）.4.There was no correlation between the position of UIV,LIV and IP after operation and mechanical complications（P>0.05）.Patients with LA in non-ideal position after operation were more prone to mechanical complications（P=0.03）.Conclusion:The incidence of mechanical complications is lower and the clinical effect is better in patients with ideal Roussouly classification of spinal sagittal plane matching after ADS.Roussouly classification can be used to guide the surgical treatment of ADS.According to the patient’s personal situation,it should be corrected to the ideal classification during the operation. |
