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Coronal imbalance
6%
273/4270
Sagittal imbalance
82%
3487/4270
Magnitude of coronal Cobb angle
9%
365/4270
Number of spine levels involved in the deformity
1%
62/4270
Level of the apex of the curve
2%
65/4270
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Sagittal balance is the most reliable radiographic predictor of clinical health status in adults with spinal deformity. Glassman et al evaluated 752 patient of which a positive sagittal imbalance was identified in 352 patients. As the C7 plumb line deviation increased, poorer results were found in all measures of health status. In addition, patients in this study with lumbar kyphosis had more overall measured disability compared to controls. Schwab et al as a method of classifying adult scoliosis, define criteria based on radiographic markers of disability which ultimately showed correlation with patient-reported disability and need for operative treatment. Kim et al analyzed the causes, prevalence, and risk factors for sagittal thoracic decompensation in patients post lumbar spinal instrumentation and found that postoperative sagittal imbalance, smaller lumbar lordosis, preoperative sagittal imbalance and age at surgery > 55yrs were risk factors for thoracic decompensation. Illustration A demonstrated how sagittal imbalance is measured.
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