Answer to the Letter to the Editor of T.A. Mattei concerning 'far lateral approaches (XLIF) in adult scoliosis' by P. Berjano and C. Lamartina (Eur Spine J. 2012 Jul 27. [Epub ahead of print])

摘要

We agree with Dr. Mattei in considering that the proposed classification [1] addresses well the cases with severe sagittal imbalance without coronal imbalance (Type IV) and those with significant coronal imbalance with moderate sagittal imbalance (Type III) but does not clearly include those cases with both significant coronal and sagittal imbalance. While recognizing that the category has not been well represented in the proposed classification, the authors consider that these patients would be better classified in the sagittal imbalance group (Type IV). The reasons for this are two: 1. sagittal imbalance is the most important predictor of HRQoL and outcomes in adult deformity patients; 2. as the classification has been proposed as a guide for treatment, sagittal plane deformity in patients with both coronal an sagittal imbalance dictates in the authors' opinion one important step in the, surgical strategy, that is the choice of the technique that allows to obtain the amount of correction needed.