Background: Sagittal alignment and coronal balance have been considered to be important in treating patients with degenerative scoliosis (DS). Previous studies have reported that Modic changes (MCs), disc degeneration (DD),and facet tropism(FT) have been considered as major factors forspinopelvic alignment parameters inpatients with DS. However, no previous study has investigated relationship between them.Methods: Our retrospective study recruited 38 DS patients and41 healthy age and sex matched individuals.The DS patientswere divided into DS group andhealthy age and sex matched individuals were divided into healthy group.Full‑length frontal and lateral views of the entire spine was measured to evaluate sagittal alignment and coronal balance. Endplate-disc-facetjoints degeneration of patients with DS were quantified using the Modic classifications, DD, and FT.The spinopelvic alignment parameters were measured, including pelvic incidence,sacral slope,lumbar lordosis, thoracic kyphosis, C7-sagittal vertical axis, L3 tilt, coronal balance distance, coronal cobb angel, thoracolumbar junctional angle, T1 pelvic angle.Results:Based on radiographic findings, the incidence of MCs at different lumbar level was higher percentage of participants showed MCsand FT in the DS group (DS group: 52.63%, healthy group: 11.24%). The coronal and sagittal parameters were significantly different between DS group and healthy group (p<0.05), except for SS (>0.05).Besides, there was significant correlation between the coronal and sagittal parameters.Conclusions: Coronal deformity has little effect on sagittal parameter sexcept for SVA, TK, and LLI. Besides, differentcoronal deformity types show weak difference on sagittal plan. The prevalence of MC in DLS group is higher than healthy group, which result in poorer clinical outcomes.
Purpose To explore the role of lumbar sagittal alignment in the occurrence of Modicchanges and endplate defects (MC&ED) development in patients with a spinal degenerative disease, and the relationship between lumbar sagittal alignment and patient-report outcomes. Background Increasing attention has been focused on MC&ED as playing a potential role in the etiopathogenesis of lumbar degeneration. The precise understanding of the mechanisms leading to progression of MC&ED is lacking. Hence, we investigated how lumbar sagittal alignment influences the MC&ED. Patients and methods Ninety-six consecutive asymptomatic or symptomatic patients with Modic changes or endplate defect were retrospectively recruited in this study from August 2016 to December 2018. MC&ED were observed in 76 patients and not observed in 20 patients, representing two groups for comparison. The lumbar sagittal parameters were measured, including lumbar lordosis (LL),pelvic incidence (PI), sacral slope (SS), and pelvic tilt (PT). The lumbar lordosis index (LLI) and idea LL were then calculated. Clinical outcomes were assessed using a visual analog scale(VAS) and a Oswestry Disability Index (ODI) before and after operation. Results There were no significant differences in the distribution of demographics and baseline clinical variables between both groups. Mean age and BMI showed a significant difference between both groups (P<0.05). There were significant correlations between LL, LLI, Lossof LL, and Level 1 (r=0.281, 0.230, and 0.284, P<0.05) Also, PI, PT were significantly correlated with Level 4 (r=0.249, 0.202, P<0.05).Compared with presurgery scores, an improvement was seen in postoperative VAS and ODI scores (P<0.05). Further, the postoperative scores at 24 months in the without Modicor end plate defect group showed greater improvements compared with the with Modic or endplate defect group (P<0.05). Conclusion This analysis indicated that maintaining lumbar sagittal alignment was related to a lower risk of Modic changes in patients with the spinal degenerative disease. The lumbar sagittal alignment might be a factor that influenced the posterior inclination of the pelvis in symptomatic lumbar disease.
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