Purpose To identify preoperative and early postoperative spinopelvic parameters associated with loss of global sagittal correction after short-segment lumbar fusion in patients with preoperative sagittal imbalance.Methods This retrospective single-center study included 124 patients aged 60 years or older with preoperative SVA of 50 mm or greater who underwent 1- to 3-level lumbar interbody fusion. Full-length standing lateral radiographs were obtained preoperatively, 4–6 weeks postoperatively, and 2 years postoperatively. Spinopelvic parameters included SVA, lumbar lordosis (LL), global tilt (GT), and lordosis distribution index (LDI). Correlation, multivariable logistic regression, and ROC analyses were performed.Results Mean SVA improved from 89.8 +/- 34.7 mm to 59.9 +/- 42.8 mm early postoperatively, but worsened to 85.7 +/- 61.1 mm at 2 years. Preoperative LDI correlated positively with delta SVA (r = 0.43, p < 0.0001). Early postoperative SVA, GT, and LDI also correlated positively, whereas postoperative LL correlated negatively (r = -0.601, p < 0.0001). Preoperative LDI remained independently associated with delta SVA of 50 mm or greater (odds ratio 2.99, 95% confidence interval 1.24–7.21, p = 0.015). ROC-derived cutoffs were 78% for preoperative LDI and 17.6 degrees for postoperative LL. Two-year SVA correlated with ODI (r = 0.536, p < 0.001).Conclusion Higher preoperative LDI and insufficient early postoperative LL restoration were associated with recurrent sagittal imbalance 2 years after short-segment lumbar fusion. These parameters may help identify patients at increased risk of loss of correction after short fusion.