Sagittal spinopelvic alignment plays a crucial role in the clinical course and surgical treatment of adult spinal deformity. Knowledge pertaining to adult thoracolumbar spinal deformity and corrective surgery continues to advance. Much of this is due to recent advances in understanding in sagittal alignment. In this review article, we review standard principles related to sagittal alignment in adult thoracolumbar spinal deformity surgery. In addition, we will review recent philosophies and schools of thought.
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