Over the past 10 years, treatment of adult spinal deformity has come to focus on the assessment and correction of sagittal plane alignment. Importantly, our understanding of sagittal alignment has developed to include not only regional spinal alignment but also the critical role of the pelvis. Pelvic parameters have proved to be both an integral component of global sagittal alignment and a useful indicator of the patient’s individual sagittal profile. In this study entitled “The Influence of Pelvic Incidence and Lumbar Lordosis Mismatch on Development of Symptomatic Adjacent Level Disease Following Single-Level Transforaminal Lumbar Interbody Fusion”, Tempel et al1 attempt to apply these principles in the evaluation of adjacent level degeneration after single-level Transforaminal Lumbar Interbody Fusion (TLIF). They conclude that the risk of adjacent level degeneration correlates in a fairly linear fashion with Pelvic Incidence minus Lumbar Lordosis (PI-LL) mismatch.
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