Evaluation of sagittal balance in preoperative and postoperative periods in patients who had surgery due to neuromuscular type scoliosis

Objective: Our aim in this study is to compare preoperative and postoperative sagital balance in patients with neuromuscular scoliosis who apply to our clinic and to reveal the importance of sagittal balance to improve the quality of life and minimize postural imbalances in patients. It is also aimed to present general information about neuromuscular scoliosis, its history, etiology, classification, sagital balance parameters, surgery and vertebral anatomy. Material and Method: 24 patients who applied to our spine polyclinic with suspicion of scoliosis and underwent surgery due to neuromuscular scoliosis at Bolu Abant İzzet Baysal University Faculty of Medicine Training and Research Hospital Orthopedics and Traumatology Clinic between 2015 and 2024 were included in the study. The patients consisted of 17 women and 7 men. Preoperative and postoperative sagittal balance parameters, Cobb angle and coronal balance distance of the patients were evaluated. Findings: Significant changes were observed in Sacral Slope, Cobb, Thoracic Kyphosis, Coronal Balance and Sagittal Balance values after the surgery. Particularly, there was a significant decrease in Cobb, Thoracic Kyphosis, Coronal Balance and Sagittal Balance values according to the dependent sample t- test and Wilcoxon signed-rank test results. These decreases show that the surgery creates positive changes by creating a corrective effect on these values. These statistically significant decreases concluded that the surgery had a curative effect vii on these parameters (p < 0.05). No statistically significant difference was found in the pre- and postoperative change statistics based on gender and disease type. The type of surgery performed and the choice of pelvic fixation, and the change in preoperative and postoperative values were evaluated with the Mann-Whitney U test. The p value for changes in sacral slope, pelvic tilt, lumbar lordosis and coronal balance values was less than 0.005 depending on the type of surgery performed. According to this value, there is a significant postoperative change in sacral slope, pelvic tilt, lumbar lordosis and coronal balance values depending on the type of surgery performed. It seems that these values did not develop by chance. Lumbar lordosis and pelvic tilt increased in patients who underwent posterior instrumentation and fusion, and this value decreased in patients who underwent magnetic rod. Results: In our study, sagittal balance parameters in patients who underwent surgery for neuromuscular type scoliosis gave significant postoperative results when evaluated compared to preoperative results. To ensure ideal posture, sagittal balance and coronal balance must work together in harmony. We think that more patients and a sufficient number of studies are needed on sagittal balance for ideal balance. Keywords: Neuromuscular scoliosis, sagittal balance, pelvic tilt