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Journal of Orthopaedics and Traumatology

Official Journal of the Italian Society of Orthopaedics and Traumatology

Fig. 3 | Journal of Orthopaedics and Traumatology

Fig. 3

From: Validation of Roussouly classification in predicting the occurrence of adjacent segment disease after short-level lumbar fusion surgery

Fig. 3

A case with mismatched Roussouly type. A 59-year-old female with lumbar degenerative spondylolisthesis and spinal stenosis at L3–4 and L4–5, the theoretical Roussouly shape was type 3 based on the PI of 55° (A, B). She underwent pedicle screw fixation from L3 to L5, and TLIF at L3–4 and L4–5. The upright lateral radiograph showed that PT was 22°, SS was 33°, LL was 37°, DL was 16°, LDI was 43%, lumbar apex was L3, inflexion point was T10 (indicating the retroverted type 2), and the sagittal profile did not match the ideal Roussouly type (C). At 5-year follow-up, she complained of recurrent low back pain and leg pain and numbness. The upright lateral radiograph showed hypertension and retrolisthesis at the adjacent segment, and MRI detected occurrence of L2–3 spinal stenosis (D, E). PI pelvic incidence, PT pelvic tilt. SS sacral slope, LL lumbar lordosis, DL distal lordosis, LDI lordosis distribution index, TLIF transforaminal lumbar interbody fusion, MRI magnetic resonance imaging

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