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Sagittal lumbar apex has been demonstrated to be a key parameter in sagittal plane morphology. Our aim was to understand its behavior with postural changes, analyzing two different concepts of lumbar apex. Prospective observational study with a cohort of patients presenting sagittal malalignment identified from a monocenter database of adult spinal deformities (ASD). Inclusion criteria were age 30years, SVA 40mm, and/or PT 20. All patients had full-spine EOS radiographs in 2 different positions (P1 natural position) and posi
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