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Peñalver FJG, Romero de la Higuera SB, Blasco PC, Trullén EMG. Long-Term Survival Analysis of Low Back Pain Onset in Patients Undergoing Hip Prosthesis Surgery: A Kaplan-Meier Study. Orthop Traumatol Surg Res 2024:104149. [PMID: 39733994 DOI: 10.1016/j.otsr.2024.104149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2024] [Revised: 11/08/2024] [Accepted: 12/26/2024] [Indexed: 12/31/2024]
Abstract
INTRODUCTION Total hip arthroplasty has been associated with the onset of low back pain, which can significantly impact patients' quality of life. However, a detailed evaluation of the time until the onset of long-term low back pain following total hip arthroplasty remains largely unknown. This study aimed to explore the relationship between total hip arthroplasty and the development of long-term lower back pain. Through survival analysis, we examined the time of onset of low back pain in a cohort of patients who underwent the procedure, providing a detailed temporal perspective of this postoperative complication. HYPOTHESIS The onset of low back pain in patients undergoing total hip arthroplasty tends to manifest in the medium and long term. MATERIALS AND METHODS A survival study using the Kaplan-Meier method was conducted on 299 patients who underwent total hip arthroplasty between 2010 and 2020 at the Hospital Clínico Universitario Lozano Blesa in Zaragoza. The event of interest was the occurrence of low back pain during monthly follow-ups, which was subsequently stratified by sex and body mass index (BMI). Death and the end of the study follow-up were considered as censored data. RESULTS The sample comprised 67.6% men and 32.4% women. Additionally, 68.2% of patients were overweight or had grade 1 obesity. During the follow-up of the entire sample, 96 patients developed low back pain, with 28 cases occurring within the first 2 years. The 50% survival of the population without low back pain was established at 39 months, with a mean follow-up of 112.25 months (95% CI 105.87-118.62). Significant differences were observed in the onset of lower back pain in men when considering different BMI grades. However, no significant differences were found between sexes or among different BMI groups when gender was not taken into account. DISCUSSION The results of this study provide valuable information on the survival of patients undergoing total hip arthroplasty who experienced low back pain over an extensive follow-up period. These findings have significant implications for clinical practice, indicating that patients undergoing total hip arthroplasty should be informed of this potential risk. LEVEL OF EVIDENCE IV; retrospective case series study.
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Affiliation(s)
- Francisco José Gallego Peñalver
- Department of Physical Medicine and Nursing, University of Zaragoza, iHealthy Research Group, C. Domingo Miral, s/n, 50009, Zaragoza, Spain; Rehabilitation Department, Hospital Obispo Polanco, Av. Ruiz Jarabo, s/n, 44002 Teruel, Spain.
| | | | - Pedro Cía Blasco
- Paint Unit, Hospital Universitario Lozano Blesa, C. San Juan Bosco, 15, 50009, Zaragoza, Spain
| | - Eva María Gómez Trullén
- Department of Physical Medicine and Nursing, University of Zaragoza, iHealthy Research Group, C. Domingo Miral, s/n, 50009, Zaragoza, Spain
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Prost S, Ambrosino R, Pesenti S, Fuentes S, Tropiano P, Blondel B, Skalli W. Change in standing acetabular orientation 2 years postoperatively after surgical correction of adult spinal deformity. Orthop Traumatol Surg Res 2024:104087. [PMID: 39674543 DOI: 10.1016/j.otsr.2024.104087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 11/29/2024] [Accepted: 12/10/2024] [Indexed: 12/16/2024]
Abstract
INTRODUCTION Although sagittal alignment is known to influence pelvic position, few studies accurately identify the relationship between sagittal alignment and acetabular orientation. We hypothesized that postoperative PT should be correlated with acetabular change in native hips after surgical correction of adult spinal deformity. The objective of this study was therefore to describe the correlation between the change in pelvic tilt and the change in acetabular orientation two years after surgical correction of adult spinal deformity. MATERIAL AND METHOD Based on a retrospective study of a prospective mono center database, 127 acetabuli out of sixty-nine patients were analyzed preoperatively and at two years postoperatively of surgical management of sagittal imbalance by posterior arthrodesis extended to the pelvis. The analysis was based on bi-planar EOS radiographs with 3D reconstructions of the pelvis and spine using SterEOS 3D software. The following specific parameters were analyzed: sacral slope, pelvic tilt, lumbar lordosis, SVA, acetabulum tilt (AT), anteversion (AA) (orientation of the acetabulum in the axial plane), abduction (AAbd) (orientation of the acetabulum in the frontal plane), inclination (AI) (orientation of the acetabulum in the sagittal plane), and anterior acetabulum coverage (ACA). A Pearson correlation was performed between the pre-and postoperative change in acetabular parameters (right and left) and pelvic parameters. Linear regressions were performed to identify the most relevant pelvic and spinal parameters. A subgroup analysis was performed to identify a difference between distal sacral and distal ilium fixations. RESULTS All measured acetabular parameters were significantly different two years after surgery. Changes in AT (p = 0.03), AI (p = 0.03) and ACA (p = 0.05) were significantly greater in the ilium fixation group. Postoperative PT reduction was strongly correlated with the decrease of AT and AA ( = 0.61 and = 0.57, p < 0.001), it was also correlated with the increase of AI and ACA and the decrease of AAbd. The entire cohort linear regression analysis revealed that a 1 ° decrease in PT resulted in a 0.4 ° decrease in AA and a 0.6 ° decrease in AT (R2 = 0.45 and = 0.38). CONCLUSION Our study highlights the significant influence of the change in sagittal alignment on acetabular orientation in standing position. This correlation explains the increased risk of anterior hip impingement, the change in acetabular load distribution that might lead to early hip osteoarthritis, and the overall change in the subjects' gait pattern. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Solène Prost
- Aix-Marseille Université, APHM, CNRS, ISM, CHU Timone, Unité de Chirurgie Rachidienne, 264 rue Saint-Pierre, 13005 Marseille, France; Arts et Métiers ParisTech, 151 Boulevard de l'Hôpital, 75013 Paris, France
| | - Romain Ambrosino
- Aix-Marseille Université, APHM, CNRS, ISM, CHU Timone, Unité de Chirurgie Rachidienne, 264 rue Saint-Pierre, 13005 Marseille, France
| | - Sébastien Pesenti
- Aix-Marseille Université, APHM, CNRS, ISM, CHU Timone, Unité de Chirurgie Rachidienne, 264 rue Saint-Pierre, 13005 Marseille, France
| | - Stéphane Fuentes
- Aix-Marseille Université, APHM, CNRS, ISM, CHU Timone, Unité de Chirurgie Rachidienne, 264 rue Saint-Pierre, 13005 Marseille, France
| | - Patrick Tropiano
- Aix-Marseille Université, APHM, CNRS, ISM, CHU Timone, Unité de Chirurgie Rachidienne, 264 rue Saint-Pierre, 13005 Marseille, France
| | - Benjamin Blondel
- Aix-Marseille Université, APHM, CNRS, ISM, CHU Timone, Unité de Chirurgie Rachidienne, 264 rue Saint-Pierre, 13005 Marseille, France.
| | - Wafa Skalli
- Arts et Métiers ParisTech, 151 Boulevard de l'Hôpital, 75013 Paris, France
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Aubert T, Hallé A, Gerard P, Butnaru M, Graff W, Rigoulot G, Auberger G, Aubert O. Archetype analysis of the spine-hip relationship identifies distinct spinopelvic profiles. Orthop Traumatol Surg Res 2024; 110:103944. [PMID: 39048457 DOI: 10.1016/j.otsr.2024.103944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 02/26/2024] [Accepted: 03/08/2024] [Indexed: 07/27/2024]
Abstract
INTRODUCTION The position of the pelvis in the sagittal plane can vary considerably between different functional positions. Adapting the position of the acetabular cup in relation to the alignment between the spine and the hip of each individual, prior to prosthesis placement, can prevent the risk of prosthetic impingement. Taken individually, risk factors for unfavorable spinopelvic kinematics can be difficult to interpret when trying to precisely predict which patients are at risk. Furthermore, the use of classifications or algorithms can be complex, most often associated with limited values and often difficult to apply in current practices of risk assessment. HYPOTHESIS We hypothesized that the deconstruction of the data matrix including age and spinopelvic parameters (SPT, LL, PI, LF and PI-LL) correlated with the analysis of spinopelvic kinematics could be used to define an individualized hip-spine relationship. MATERIAL AND METHOD We applied archetypal analysis, which is a probabilistic, data-driven and unsupervised approach, to a complete phenotype cohort of 330 patients before total hip arthroplasty to define the spinopelvic profile of each individual using the spinopelvic parameters without threshold value. For each archetype, we analyzed the spinopelvic kinematics, not implemented in the creation of the archetypes. RESULTS An unsupervised learning method revealed seven archetypes with distinct spinopelvic kinematic profiles ranging from -8.9 ° to 13.15 ° (p = 0.0001) from standing to sitting and -5. 35 ° to -10.81 ° (p = 0.0001) from supine to standing. Archetype 1 represents the "ideal" patient (A1); young patients without spinopelvic anomaly and the least at risk of mobility anomaly. Followed by 3 archetypes without sagittal imbalance according to their lumbar lordosis and pelvic incidence, from the highest to the lowest (archetypes 2-4), archetype 4 exposing a greater risk of spinopelvic kinematic anomaly compared to others. Then 2 archetypes with sagittal imbalance: archetype 5, with an immobile pelvis in the horizontal plane from standing to sitting position in anterior tilt and archetype A6, with significant posterior pelvic tilt standing, likely compensating for the imbalance and associated with the greatest anomaly of spinopelvic kinematics. Finally, archetype 7 with the stiffest lumbar spine without sagittal imbalance and significant unfavorable kinematics from standing to sitting. CONCLUSION An archetypal approach to patients before hip replacement can refine diagnostic and prognostic features associated with the hip-spine relationship and reduced heterogeneity, thereby improving spinopelvic characterization. This risk stratification of spinopelvic kinematic abnormalities could make it possible to target patients who require adapted positioning or types of implants before prosthetic surgery. LEVEL OF EVIDENCE IV retrospective study.
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Affiliation(s)
- Thomas Aubert
- Groupe Hospitalier Diaconesses Croix Saint Simon, 125 Rue d'Avron, Paris 75020, France.
| | - Aurélien Hallé
- Groupe Hospitalier Diaconesses Croix Saint Simon, 125 Rue d'Avron, Paris 75020, France
| | - Philippe Gerard
- Groupe Hospitalier Diaconesses Croix Saint Simon, 125 Rue d'Avron, Paris 75020, France
| | - Michael Butnaru
- Groupe Hospitalier Diaconesses Croix Saint Simon, 125 Rue d'Avron, Paris 75020, France
| | - Wilfrid Graff
- Groupe Hospitalier Diaconesses Croix Saint Simon, 125 Rue d'Avron, Paris 75020, France
| | | | - Guillaume Auberger
- Groupe Hospitalier Diaconesses Croix Saint Simon, 125 Rue d'Avron, Paris 75020, France
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Aubert T, Gerard P, Galanzino G, Marmor S. In silico analysis of the patient-specific acetabular cup anteversion safe zone. Orthop Traumatol Surg Res 2024; 110:103940. [PMID: 39043498 DOI: 10.1016/j.otsr.2024.103940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 02/26/2024] [Accepted: 03/12/2024] [Indexed: 07/25/2024]
Abstract
INTRODUCTION Various computer-assisted surgical systems claim to improve the accuracy of cup placement in total hip arthroplasties after assessing spinopelvic mobility to prevent prosthetic impingement. However, no study has yet analyzed the extent of the patient-specific cup anteversion safe zones. HYPOTHESIS We hypothesized that most patients have a safe zone >10 °, except those with abnormal spinopelvic mobility, who have a much narrower safe zone. MATERIALS AND METHODS We simulated the risks of prosthetic impingement using the planned cup anteversion. The consecutive cohort included 341 patients who underwent total hip arthroplasty. Our primary endpoint was the patient-specific impingement-free zone for cup anteversion, which was then divided into four subgroups: 0 °, 1 ° to 5 °, 6 ° to 10 °, and >10 °. This data was then secondarily analyzed for abnormal spinopelvic mobility (the difference in the spinopelvic tilt [ΔSPT] from a standing to a flexed seated position >20 °). RESULTS The mean anteversion safe zone was 22.8 ° with 82.4% (281/341) of patients with a zone strictly >10 °. The mean safe zone was 8.9 ° (+/- 9 °) in patients with an ΔSPT ≥20 ° (18.2%), with 37.1% of these patients having a zone of 0 °, 16.13% a zone between 1 ° and 5 °, 8.06% a zone between 6 ° and 10 ° and 38.71% a zone >10 °. The mean safe zone was 25.9 ° (+/- 9 °) in patients with an ΔSPT <20 ° (81.8%), and the proportion of cases in each zone was 2.51%, 1.08%, 4.3%, and 92.11%, respectively (p < 0.001). CONCLUSION The safe zone for anteversion appears to be fairly wide in most patients. However, identifying patients at risk of abnormal spinopelvic mobility seems necessary to identify the two-thirds of patients with a narrow safe zone. LEVEL OF EVIDENCE IV; retrospective study.
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Affiliation(s)
- Thomas Aubert
- Orthopedic Department, Croix St Simon Hospital 125 rue d'Avron, 75020 Paris, France.
| | - Philippe Gerard
- Orthopedic Department, Croix St Simon Hospital 125 rue d'Avron, 75020 Paris, France
| | - Giacomo Galanzino
- Orthopedic Department, Croix St Simon Hospital 125 rue d'Avron, 75020 Paris, France
| | - Simon Marmor
- Orthopedic Department, Croix St Simon Hospital 125 rue d'Avron, 75020 Paris, France
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Kobayashi T, Morimoto T, Mawatari M. Factors influencing the measurement of sagittal spinopelvic alignment in patients with vertebral fractures. Osteoporos Int 2024; 35:1103. [PMID: 38551722 DOI: 10.1007/s00198-024-07063-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/08/2024] [Indexed: 05/30/2024]
Affiliation(s)
- Takaomi Kobayashi
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
| | - Tadatsugu Morimoto
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Masaaki Mawatari
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
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Kouyoumdjian P. How the hip-spine relationship influences total hip arthroplasty. Orthop Traumatol Surg Res 2024; 110:103773. [PMID: 38000509 DOI: 10.1016/j.otsr.2023.103773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 06/30/2023] [Indexed: 11/26/2023]
Abstract
INTRODUCTION Motion in the spine, pelvis and hips which make up the spinopelvic femoral complex (SPFC) implies mechanical relationships that help maintain trunk balance and optimize hip functionThe aim of this study was to understand the physiology of the SPFC and evaluate the dysfunctions of the SPFC and their implications for total hip arthroplasty considering the hip-spine relationship. METHODS A review of relevant and comprehensive studies on this subject is reported in order to highlight a pathophysiology that integrates the description of the evaluations of the spine-pelvic and hip parameters and recommendations for the kinematic planning of the THA procedure. The primary objective was to determine which type of hip-spine relationship has the highest risk for THA complications and to become proficient in selecting the priority surgical intervention when both the hip and spine are affected. Finally, this review attempted to assist hip surgeons with surgical technique, tools, implant selection, and goals of planning a THA that requires personalized kinematic alignment. Determine the influence of THA on these kinematics and the effect of stiffness of the lumbopelvic complex on the risk of THA failure. RESULTS When a person sits, the pelvis goes into retroversion and the acetabulum opens forward. This frees the femoral head and neck to allow hip flexion. The opposite - pelvic anteversion - occurs when a person stands. When pelvic mobility is limited, the hip must increase its range of motion to accommodate these posture changes. Disturbances in spinal and pelvic kinematics lead to abnormal hip function, which may contribute to complications following total hip arthroplasty (THA). CONCLUSION A precise evaluation of the parameters governing the SPFC must be taken into account in order to best optimize the placement and choice of THA implants. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Pascal Kouyoumdjian
- CHU de Nîmes, Faculté de Médecine Montpellier-Nîmes, Université Montpellier, Hôpital Carémeau, 4, place du Professeur-Robert-Debré, 30900 Nîmes, France.
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Soydan Z, Bayramoglu E, Altas O, Şen C. Revealing the Effect of Spinopelvic Alignment on Hip Disorders. CLINICAL MEDICINE INSIGHTS. ARTHRITIS AND MUSCULOSKELETAL DISORDERS 2023; 16:11795441231191790. [PMID: 37701625 PMCID: PMC10493047 DOI: 10.1177/11795441231191790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 07/14/2023] [Indexed: 09/14/2023]
Abstract
Background Hip osteoarthritis (HOA) is a growing burden and one of the leading causes of hip pain. The relationship between the HOA and the alignment of the spinopelvic region has been intensively studied, however the issue remains controversial. Spinopelvic imbalance, HOA, and dysplasia were investigated in relation to sagittal spinopelvic parameters in this study. Methods We collected computerized tomography (CT) topograms of the pelvis or abdomen from 380 patients. In antero-posterior (AP) topograms, Tonnis grading, center-edge angle (CEA) and Sharp's acetabular angle (AA) measurements were performed on each patient. Lateral topograms were used to evaluate the following spinopelvic parameters for each patient: pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), sacral table angle (STA), lumbar lordosis (LL), proximal lumbar lordosis (PLL), distal lumbar lordosis (DLL), and PI-LL difference. Initially, the cohort was divided into two subgroups based on whether or not they had HOA. Then, they were divided into two subgroups based on whether or not they had dysplasia. Ultimately, it was divided in half based on the PI-LL imbalance. Statistical analyses were conducted to determine the likely correlations between the spinopelvic parameters of these subgroups. In addition, the correlations between spinopelvic parameters were investigated. Results There were 380 patients evaluated. We found no association between HOA or dysplasia and spinopelvic parameters. In addition, there was no association between PI-LL imbalance and HOA or dysplasia. Conclusion There was no difference in constant PI and STA angle, besides other variable parameters, between groups having HOA and dysplasia or not. PI-LL imbalance has no effect on HOA and dysplasia.
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Affiliation(s)
- Zafer Soydan
- Department of Orthopaedics and Traumatology, BHT Clinic Istanbul Tema Hospital, Nişantaşı University, Istanbul, Turkey
| | - Emru Bayramoglu
- Department of Orthopaedics and Traumatology, Bursa City Hospital, Bursa, Turkey
| | - Okyar Altas
- Department of Orthopaedics and Traumatology, Basaksehir Cam Sakura City Hospital, Istanbul, Turkey
| | - Cengiz Şen
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Aytekin K, Balta O. Dimple of Venus Is Associated with the Increased Pelvic Incidence Angle and More Sagittally Oriented Facet Joint. Med Princ Pract 2023; 32:209-216. [PMID: 37285829 PMCID: PMC10601671 DOI: 10.1159/000531413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 05/30/2023] [Indexed: 06/09/2023] Open
Abstract
OBJECTIVES The present study aims to investigate whether the dimple of Venus affects the anatomy of spinopelvic junction. SUBJECTS AND METHODS Inclusion criteria were having a lumbar MRI examination in the last 1 year, being older than 18 years of age and being able to radiologically evaluate the whole vertebral colon and pelvic girdle. Exclusion criteria were having congenital diseases of the pelvic girdle/hip/vertebral column and history of fracture or previous surgery in the same anatomic regions. The patients' demographic data and low back pain were noted. At radiological examination, the pelvic incidence angle was measured by lateral lumbar X-ray. The facet joint angle, tropism, facet joint degeneration, intervertebral disc degeneration, and intervertebral disc herniation at the level of L5-S1 were examined on lumbar MRIs. RESULTS We included 134 male and 236 female patients with a mean age of 47.86 ± 14.50 years and 48.49 ± 13.49 years, respectively. We found that the patients with the dimple of Venus had higher pelvic incidence angle (p < 0.001) and more sagittally oriented facet joint (right facet joint p = 0.017, left facet joint p = 0.001) compared to those without the dimple of Venus. There was no statistically significant relationship between low back pain and the presence of the dimple of Venus. CONCLUSIONS The dimple of Venus affects the anatomy of the spinopelvic junction and is associated with an increased pelvic incidence angle and a more sagittally oriented facet joint angle.
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Affiliation(s)
- Kürşad Aytekin
- Department of Orthopedics and Traumatology, Department of Anatomy, School of Medicine, University of Giresun, Giresun, Turkey
| | - Orhan Balta
- Department of Orthopaedics and Traumatology, Gaziosmanpasa University Hospital, Tokat, Turkey
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Hip-Spine Syndrome: A Focus on the Pelvic Incidence in Hip Disorders. J Clin Med 2023; 12:jcm12052034. [PMID: 36902823 PMCID: PMC10004570 DOI: 10.3390/jcm12052034] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 02/15/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023] Open
Abstract
Since Offierski and MacNab reported a close association between the hip and spine as hip-spine syndrome in 1983, many studies on spinal alignment in hip disorders have been conducted. Notably, the pelvic incidence angle (PI) is the most important parameter and is determined by the anatomical variations in the sacroiliac joint and hip. Studies on the association of the PI with hip disorders can help in understanding the pathophysiology of hip-spine syndrome. A PI increase has been observed during the evolution of bipedal locomotion in humans and in the acquisition of gait during child development. Although the PI is a fixed parameter that is stable and unaffected by posture from adulthood onwards, it has become clear that it increases in the standing position in older people. While it may be associated with a greater risk of developing or progressing to spinal disorders, the association between the PI and hip disorders remains controversial because of the multifactorial nature of hip osteoarthritis (HOA) and the wide range of PIs in HOA (18-96°), making the interpretation of results difficult. However, several hip disorders (i.e., femoroacetabular impingement and rapid destructive coxarthrosis) have been shown to be associated with the PI. Further investigation on this topic is, therefore, warranted.
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Rivière C. Reply to the letter by Daniele Vanni, Domenico Compagnone, Matteo Ponzo, Francesco Langella and Pedro Berjano. Orthop Traumatol Surg Res 2023; 109:103580. [PMID: 36787817 DOI: 10.1016/j.otsr.2023.103580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 02/07/2023] [Indexed: 02/16/2023]
Affiliation(s)
- Charles Rivière
- Clinique du Sport Bordeaux Mérignac, 04, rue Georges-Negrevergne, 33700 Mérignac, France; Bordeaux Arthroplasty Research Institute (BARI), 06, rue Georges-Negrevergne, 33700 Mérignac, France.
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Quantitative evaluation of correlation between lumbosacral lordosis and pelvic incidence in standing position among asymptomatic Asian adults: a prospective study. Sci Rep 2022; 12:18965. [PMID: 36347920 PMCID: PMC9643535 DOI: 10.1038/s41598-022-21840-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 10/04/2022] [Indexed: 11/11/2022] Open
Abstract
The determination of lumbopelvic alignment is essential for planning adult spinal deformity surgery and for ensuring favorable surgical outcomes. This prospective study investigated the correlation between the lumbar section of lumbar spine lordosis and increasing pelvic incidence in 324 Asian adults with a mean age of 55 ± 13 years (range: 20-80 years), comprising 115 male and 209 female volunteers. Participants were divided into three groups based on pelvic incidence (G1, G2, and G3 had pelvic incidence of < 45°, 45-55°, and ≥ 55°, respectively). We determined that distal and proximal lumbar lordosis contributed differentially to the increase in pelvic incidence, whereas the lordosis ratio of the L3-L4 and L4-L5 segments mostly remained constant. The mean contribution ratio of the segmental lordosis from L1 to S1 was as follows: L1-L2, 2.3%; L2-L3, 11.7%; L3-L4, 18.1%; L4-L5, 25.2%; and L5-S1, 42.7%. Pelvic incidence had a stronger correlation with proximal lumbar lordosis than did distal lumbar lordosis. The ratios of proximal lumbar lordosis to distal lumbar lordosis were 37.8% in G1, 45.8% in G2, and 55.9% in G3. These findings serve as a reference for future lumbar spine correction or fusion surgery for Asian adults.
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Kobayashi T, Morimoto T, Otani K, Mawatari M. Locomotive Syndrome and Lumbar Spine Disease: A Systematic Review. J Clin Med 2022; 11:jcm11051304. [PMID: 35268395 PMCID: PMC8911455 DOI: 10.3390/jcm11051304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/21/2022] [Accepted: 02/25/2022] [Indexed: 02/04/2023] Open
Abstract
Locomotive syndrome (LS) is defined based on the Loco-Check, 25-question Geriatric Locomotive Function Scale (GLFS-25), 5-question Geriatric Locomotive Function Scale (GLFS-5), Stand-Up Test, Two-Step Test, or a total assessment (i.e., positive for one or more of the GLFS-25, Stand-Up Test, and Two-Step Test). Lumbar spine disease has been reported to be one of the most common musculoskeletal disorders leading to LS. We therefore conducted a systematic review via PubMed, Google Scholar, Cochrane Library, Web of Science, and MEDLINE, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 26 studies were considered to be eligible for inclusion in this systematic review. The GLFS-25 showed an association with low back pain, sagittal spinopelvic malalignment, and lumbar spinal stenosis but not vertebral fracture. The GLFS-5 showed an association with low back pain and lumbar spinal stenosis. The Loco-Check and Two-Step Test showed an association with low back pain, sagittal spinopelvic malalignment, and lumbar spinal stenosis. The Stand-Up Test showed no association with lumbar spinal stenosis. The total assessment showed an association with low back pain and lumbar spinal stenosis. Furthermore, the GLFS-25, Two-Step Test, and total assessment were improved by spinal surgery for lumbar spinal stenosis. The current evidence concerning the relationship between LS and lumbar spine disease still seems insufficient, so further investigations are required on this topic.
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Affiliation(s)
- Takaomi Kobayashi
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga 849-8501, Japan; (T.K.); (M.M.)
| | - Tadatsugu Morimoto
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga 849-8501, Japan; (T.K.); (M.M.)
- Correspondence: ; Tel.: +81-952-34-2343; Fax: +81-952-34-2059
| | - Koji Otani
- Department of Orthopaedic Surgery, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan;
| | - Masaaki Mawatari
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga 849-8501, Japan; (T.K.); (M.M.)
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