ABSTRACT
In the spine with deformity, the vertebral column normally compensates above or below so as to maintain overall balance with the head positioned over the sacrum and pelvis. Decompensation, or spinal imbalance, is a complication after the surgical treatment of spinal deformities and represents a postsurgical loss of this ability to compensate. In the coronal plane, decompensation is most commonly associated with the surgical treatment of scoliosis, while decompensation in the sagittal plane may be seen with either scoliosis or kyphosis surgery. In general, postoperative decompression represents the iatrogenic failure to appreciate or fully understand normal alignment and compensatory mechanisms of the spine being treated.
