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Improved function outcomes
4%
181/4344
Decreased pseudoarthosis rates
25%
1066/4344
Decreased major medical complications
1%
39/4344
Improved correction and maintenance of sagittal balance
67%
2901/4344
Improved curve correction in the coronal plane
3%
134/4344
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In adult patients with spinal deformity, extension of a long fusion to the sacrum is associated with improved correction and maintenance of sagittal balance. Edwards et al did a retrospective cohort study looking at patients with fusion to L5 versus those fused to the sacrum. Patients fused to the sacrum showed improved correction and maintenance of their sagittal balance. However patients fused to the sacrum also had an increased rate of pseudoarthosis and major medical complications. There was no difference in functional outcomes or degree of coronal correction between the two groups. The study by Kuhns et al is an extension of the Edwards study with longer term follow-up. They found that advanced degeneration at L5-S1 occurred in 69% of deformity patients after long fusions to L5 with 5 to 20 year follow-up. The development of advanced degeneration at L5-S1 was highly correlated with the development of positive sagittal balance.
3.3
(32)
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