title: Ratio of lumbar 3-column osteotomy closure: patient-specific deformity characteristics and level of resection impact correction of truncal versus pelvic compensation.
abstract: The resection point of a lumbar three-column osteotomy (3CO) creates separation of the spino-pelvic complex. This study investigates the impact of patients' baseline deformity and level of 3CO resection on the distribution of correction between the trunk and the pelvis following osteotomy closure.
  
  
  
  Patients who underwent single lumbar 3CO, upper instrumented vertebra (UIV) T1-T10, and 6 month follow-up were included. The truncal and pelvic closures were calculated based on the vertebrae adjacent to the osteotomy level and the impact of radiographic parameters and level of 3CO on the closures were analyzed.
  
  
  
  113 patients were included. Patients who experienced more pelvic correction had significantly higher Pelvic Tilt and lower Sagittal Vertical Axis at baseline. Patients who underwent more caudal osteotomies with higher pelvic compensation with modest SVA sustained more pelvic correction.
  
  
  
  The osteotomy closure is driven by patient's specific deformity. More caudal osteotomy level leads to greater pelvic tilt improvement.
  
  
  
  III.
authors.affiliation: Spine Service, Hospital for Special Surgery, 525 East 71st Street, New York, NY, 10021, USA. diebob@hss.edu.
authors.forename: Bassel G
authors.identifier: 0000-0002-7835-2263
authors.initials: BG
authors.lastname: Diebo
authors.affiliation: Spine Service, Hospital for Special Surgery, 525 East 71st Street, New York, NY, 10021, USA.
authors.forename: Renaud
authors.initials: R
authors.lastname: Lafage
authors.affiliation: Department of Neurosurgery, San Francisco Medical Center, University of California, 400 Parnassus Street, San Francisco, CA, USA.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Ames
authors.affiliation: Rocky Mountain Scoliosis and Spine Center, Denver, CO, 80205, USA.
authors.forename: Shay
authors.initials: S
authors.lastname: Bess
authors.affiliation: Department of Orthopaedics and Spine Surgery, University Hospital of Bordeaux, Bordeaux, France.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Obeid
authors.affiliation: Department of Orthopaedic Surgery, University of California, Davis, 3301 C St, Suite 1500, Sacramento, CA, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Klineberg
authors.affiliation: Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA.
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Cunningham
authors.affiliation: Department of Neurosurgery, University of Virginia Medical Center, PO Box: 800212, Charlottesville, VA, USA.
authors.forename: Justin S
authors.initials: JS
authors.lastname: Smith
authors.affiliation: Department of Orthopaedic Surgery, Baylor Scoliosis Center, 4708 Alliance Blvd, #810, Plano, TX, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Hostin
authors.affiliation: Department of Orthopaedic Surgery, Naval Medical Center, San Diego, CA, USA.
authors.forename: Shian
authors.initials: S
authors.lastname: Liu
authors.affiliation: Spine Service, Hospital for Special Surgery, 525 East 71st Street, New York, NY, 10021, USA.
authors.forename: Peter G
authors.initials: PG
authors.lastname: Passias
authors.affiliation: Spine Service, Hospital for Special Surgery, 525 East 71st Street, New York, NY, 10021, USA.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Schwab
authors.affiliation: Spine Service, Hospital for Special Surgery, 525 East 71st Street, New York, NY, 10021, USA.
authors.forename: Virginie
authors.initials: V
authors.lastname: Lafage
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D010388:Pelvis; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000503:physiopathology / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000601:surgery; D060726:Torso
keywords: Pelvic correction; Ratio of closure; Spinal osteotomy; Truncal correction