title: Preoperative T1 Slope More Than 40° as a Risk Factor of Correction Loss in Patients With Adult Spinal Deformity.
abstract: METHODS
  A retrospective study of surgical outcomes of adult spinal deformity (ASD) cases.
  
  
  OBJECTIVE
  The aim of the study was to investigate the effects of high T1 slope (T1S) on surgical outcomes in patients with ASD.
  
  
  BACKGROUND
  Few studies have evaluated the surgical outcomes of patients with ASD with cervical deformities.
  
  
  METHODS
  Eighty-eight patients with ASD who underwent posterior spinal corrective fusion were assigned to either group A (T1S <40°) or group B (T1S ≥40°). Whole-spine standing radiographs of both groups were preoperatively assessed: at first standing after the surgery and at 1 and 2 years postoperatively.
  
  
  RESULTS
  There were 56 patients in group A and 32 in group B. The preoperative C7 sagittal vertical axis (SVA) improved from 61 to 41 mm in group A and from 161 to 64 mm in group B at first standing after the surgery. C7 SVA at 2 years after the surgery was, however, 57 mm in group A and 98 mm in group B because of correction loss (P = 0.003). T1S measurements before and immediately after the surgery and 2 years after the surgery were, however, 25°, 23°, and 27° in group A and 53°, 36°, and 41° in group B, respectively. There were no significant differences among measurements in group A. Those in group B were, however, significantly improved in the first standing, but T1S of 40° or higher deteriorated toward 2 years after the surgery.
  
  
  CONCLUSIONS
  Among patients with T1S of 40° or higher, C7 SVA improved immediately after the surgery but worsened at 2 years after the surgery. These results suggested that cervicothoracic parameters were important predictors of correction loss.
  
  
  METHODS
  4.
authors.affiliation: Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Oe
authors.affiliation: Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Yamato
authors.affiliation: Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Togawa
authors.affiliation: Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Kenta
authors.initials: K
authors.lastname: Kurosu
authors.affiliation: Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Mihara
authors.affiliation: Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Banno
authors.affiliation: Department of Orthopedic Surgery, Hamamatsu Medical Center, Hamamatsu, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Yasuda
authors.affiliation: Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Sho
authors.initials: S
authors.lastname: Kobayashi
authors.affiliation: Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Hasegawa
authors.affiliation: Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Matsuyama
mesh_terms: D000368:Aged; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000000981:diagnostic imaging* / Q000601:surgery; D008141:Lordosis / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011187:Posture; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D012600:Scoliosis / Q000000981:diagnostic imaging* / Q000601:surgery; D013123:Spinal Fusion / Q000379:methods; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery; D017211:Treatment Failure