A current concepts review synthesizing normative spinopelvic data and outcomes literature to define three practical radiographic targets for adult spinal deformity correction surgery — SVA, pelvic tilt, and the PI–LL relationship — and to explain how each parameter drives patient-reported disability.
When evaluating an adult deformity patient or planning correction, check all three parameters together: if SVA is corrected but PT remains >20°, the pelvis is still retroverted to compensate for residual deformity and outcomes will suffer — target LL within 9° of that patient's PI to address the root morphologic mismatch rather than chasing an absolute lordosis number.
A current concepts review synthesizing normative spinopelvic data and outcomes literature to define three practical radiographic targets for adult spinal deformity correction surgery — SVA, pelvic tilt, and the PI–LL relationship — and to explain how each parameter drives patient-reported disability.
When evaluating an adult deformity patient or planning correction, check all three parameters together: if SVA is corrected but PT remains >20°, the pelvis is still retroverted to compensate for residual deformity and outcomes will suffer — target LL within 9° of that patient's PI to address the root morphologic mismatch rather than chasing an absolute lordosis number.