Abstract
The operative goal in the adult spine patient is to achieve and maintain coronal and sagittal balance, prevent progression of degeneration and deformity, and decompress areas of symptomatic neural element compression. When spinopelvic fixation in adult deformity is necessary, there are a wide range of possibilities. Each fixation type offers distinct advantages and disadvantages. The choice of implant depends on the relative merits of the fixation option measured against the mechanical needs for correction and corrective maintenance. One must also consider the patients pathophysiology. Advanced degenerative disease, medical co-morbidities, and osteoporosis are all factors that impact on the choice of implant and fixation. The surgical treatment of adult spine deformity often necessitates extension to the sacrum or pelvis and the relative merits of the different implant choices in sacropelvic fixation need to be understood.
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