• Alberto Di Martino, Carlo Cosimo Quattrocchi, Laura Scarciolla, Nicola Papapietro, Beomonte ZobelBrunoB, and Vincenzo Denaro.
• Department of Orthopaedics and Trauma Surgery, Center of Integrated Research, CIR, University Campus Bio-Medico of Rome, Via Alvaro del Portillo, 200, 00128, Rome, Italy, dimartino.cbm@gmail.com.
• Eur Spine J. 2014 Oct 1; 23 Suppl 6: 693-8.

PurposeAim of this study is to estimate the risk for symptomatic adjacent segment degeneration (ASD) and examine the association between spino-pelvic parameters and ASD.Methods22 patients operated upon by instrumented lumbar or lumbosacral spinal fusion and re-operated upon for ASD were enrolled in the study. 83 consecutive patients with the same surgery and never re-operated upon were the controls. Pelvic incidence, sacral slope (SS), pelvic tilt (PT), and lumbar lordosis were calculated.ResultsPatients with ASD had significantly lower SS (p = 0.005) and higher PT values (p < 0.001). Patients with SS <39° or PT >21°, were at higher risk for symptomatic ASD (relative risk 1.73 for SS and 3.663 for PT).ConclusionsIn patients re-operated upon for ASD, pelvic retroversion and hyperlordosis are the main mechanisms of compensation for the unbalanced spine. Patients with PT above 21° and SS below 39° are at higher risk for symptomatic ASD.

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