Abstract
PURPOSE: This study aimed to introduce a novel method for assessing intraoperative coronal alignment in posterior spinal deformity surgery and to investigate its feasibility and efficacy in preventing postoperative coronal imbalance (CIB). METHODS: All enrolled patients underwent posterior spinal deformity surgery, with dot-line method employed to evaluate coronal alignment intraoperatively. Preoperative and postoperative radiographic and clinical parameters were analyzed. Additionally, patients were divided into type A, B, and C preoperatively, and subgroup analysis was conducted to further assess the effectiveness of this new method. RESULTS: Of 46 patients with preoperative CIB, 16 were classified as type B and 30 as type C. The prevalence of CIB was 11.70% at the final follow-up. Preoperative main Cobb angle averaged 55.39 ± 28.22° and improved to 15.19 ± 10.65° at the final follow-up (P < 0.05). Preoperative CBD corrected from 23.06 ± 16.77 mm preoperatively to 18.77 ± 14.48 mm at the final follow-up (P < 0.05). SVA was 34.59 ± 22.66 mm before surgery and 20.12 ± 12.21 mm at the final follow-up (P < 0.05). VAS score and SRS-22 score demonstrated significant improvements had at the final follow up (P < 0.05). Subgroup analysis showed postoperative CIB in 2 patients with type A, 4 patients with type B, and 5 patients with type C. CONCLUSION: Dot-line method is a viable technique for intraoperative assessment of coronal alignment in posterior spinal deformity surgery, effectively reducing and preventing postoperative CIB.