For a retrospective study, researchers wanted to determine the best and ideal target values for spine balance correction in senior individuals over the age of 60 with adult spinal deformity. Many spinal reconstruction surgeries use the Scoliosis Research Society -Schwab classification goal values to achieve appropriate alignment and good outcomes. However, adopting the Scoliosis Research Society-Schwab classification to all senior individuals with sagittal malalignment who are 60 years or older may result in various inconsistencies. The study comprised 121 patients with adult spinal deformities who had long-segment fusion from T10 to sacrum (average age 70.5 years, minimum 2-year follow-up). Researchers used Pearson’s correlation coefficient to examine the relationship between clinical and radiographic parameters. In addition, used multilinear regression analysis and a multivariate logistic regression model (backward elimination method) to identify the risk factors for Post sagittal imbalance using the correlation factors of the postoperative (Post) and last follow-up (Last) sagittal vertical axes. After establishing the importance of each path, it was proven that the effects of pelvic incidence (PI)—lumbar lordosis (LL) and Post pelvic tilt ratio (PTr) were legitimate (P< 0.05) using logistic regression analysis with the correlation factors of Post and Last sagittal vertical axes. The target value of PI-LL was 1.33 after utilizing the ROC curve, and the target value of PTr was 25.95%. The Post values of PI-LL and PTr were found to be risk factors for Post sagittal imbalance in the study, with a goal value of PI-LL less than 1.33 and a target value of PTr was less than 25.95%. Based on Schwab’s model, these goal values can be helpful guidance for spine surgeons performing spine reconstruction surgery for elderly patients with a pure sagittal imbalance.
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