Passive surgical correction of rigid adult spine deformities to normative alignment and balance

Realizing an age-adjusted correction in adult spine deformities (ASD) is demanding. We focus on rigid ASD patients requiring three-column osteotomies (TCO) and analyze the capability to obtain a normative alignment. Additionally, we introduce a new age-adjusted alignment parameter: the C7-SA norm. We retrospectively included 26 patients (68.2 ± 1.6 years) with rigid ASD who underwent lumbar TCO for deformity correction. All patients were positioned on a ProAxis table (Mizuho OSI, USA) with the shoulders, hips and ankles aligned for passive correction without bending the surgical table. The mean pelvic incidence—lumbar lordosis, sagittal vertical axis, T1 pelvic angle, and C7-SA norm before and after surgery were as follows: 25.7 ± 2.9° versus 10.1 ± 1.4° ( p 20.8° which confirmed the necessity to conduct a TCO. Realigning the C7-SA norm in rigid ASD by TCOs and optimal patient positioning is a simple method for age-adjusted deformity correction without the need for preoperative complex calculations, intraoperative measurements, and repositioning of the patient during surgery.