Importance of Radiological Evaluation of Global Spinal Balance Together with Lower Limb Alignment in Planning Lumbar Spine Deformity Surgery - Illustrative Case Presentation.

BACKGROUND: The presented case illustrates the critical role of a detailed preoperative radiological evaluation in complex spine surgery. CASE REPORT: A 49-year-old patient was admitted for a revision surgery after L3-L5 fusion. Preoperative assessment showed preserved sagittal balance, coronal imbalance and valgus knee deformity. The patient reported pain of 8-10 in VAS (Visual Analogue Scale) and had an ODI (Oswestry Disability Index) of 60%. The first step of the surgery was L2-S1 fusion with decompression and spine deformity correction. The second step involved anti-valgus osteotomy of the right tibial bone. CONCLUSIONS: The assessment of global spinal balance together with lower extremity alignment should be strongly recommended.