Anterior column realignment (ACR) technique for correction of sagittal imbalance

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  1. 1.

    Lamartina C, Berjano P, Petruzzi M, Sinigaglia A, Casero G, Cecchinato R et al (2012) Criteria to restore the sagittal balance in deformity and degenerative spondylolisthesis. Eur Spine J 21 Suppl 1:S27–S31

  2. 2.

    Deukmedjian A, Le TV, Baaj AA, Dakwar E, Smith DA, Uribe JS (2012) Anterior longitudinal ligament release using the minimally invasive lateral retroperitoneal transpsoas approach: a cadaveric feasibility study and report of 4 clinical cases. Laboratory investigation. J Neurosurg Spine 17:530–539

  3. 3.

    Berjano P, Langella F, Ismael MF, Damilano M, Scopetta S, Lamartina C (2014) Successful correction of sagittal imbalance can be calculated on the basis of pelvic incidence and age. Eur Spine J 23(Suppl 6):587–596

  4. 4.

    Lamartina C, Berjano P (2014) Classification of sagittal imbalance based on spinal alignment and compensatory mechanisms. Eur Spine J 23(6):1177–1189

  5. 5.

    Cho KJ, Bridwell KH, Lenke LG, Berra A, Baldus C (2005) Comparison of Smith-Petersen versus pedicle subtraction osteotomy for the correction of fixed sagittal imbalance. Spine 30:2030–2038

  6. 6.

    Auerbach JD, Lenke LG, Bridwell KH, Sehn JK, Milby AH, Bumpass D et al (2012) Major complications and comparison between 3-column osteotomy techniques in 105 consecutive spinal deformity procedures. Spine 37:1198–1210

  7. 7.

    Deukmedjian AR, Dakwar E, Ahmadian A, Smith DA, Uribe JS (2012) Early outcomes of minimally invasive anterior longitudinal ligament release for correction of sagittal imbalance in patients with adult spinal deformity. Sci World J 2012:789698. doi:10.1100/2012/789698

  8. 8.

    Uribe JS, Smith DA, Dakwar E, Baaj AA, Mundis GM, Turner AWL, Cornwall GB, Akbarnia BA (2012) Lordosis restoration after anterior longitudinal ligament release and placement of lateral hyperlordotic interbody cages during the minimally invasive lateral transpsoas approach: a radiographic study in cadavers. J Neurosurg Spine 17:476–485

  9. 9.

    Akbarnia BA, Mundis GM, Moazzaz P, Kabirian N, Bagheri R, Eastlack RK, Pawelek JB (2014) Anterior column realignment (ACR) for focal kyphotic spinal deformity using a lateral transpsoas approach and ALL release. J Spinal Disord Tech 27(1):29–39

  10. 10.

    Marchi L, Oliveira L, Amaral R, Castro C, Coutinho T, Coutinho E, Pimenta L (2012) Anterior elongation as a minimally invasive alternative for sagittal imbalance—a case series. HSS J 8(2):122–127

  11. 11.

    Lamartina C, Berjano P (2014) Spine alignment in adult trauma, degeneration and deformity. Eur Spine J 23(Suppl 6):585–586

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Correspondence to Pedro Berjano.

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Berjano, P., Damilano, M., Ismael, M. et al. Anterior column realignment (ACR) technique for correction of sagittal imbalance. Eur Spine J 24, 451–453 (2015) doi:10.1007/s00586-015-3962-6

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  • Anterior column realignment
  • ACR
  • Anterior vertebral release
  • XLIF
  • Interbody lumbar fusion
  • Pedicle subtraction osteotomy
  • Sagittal imbalance
  • Minimally invasive spine surgery