Sagittal balance and intervertebral disc composition in patients with low back pain

Savarese, Leonor Garbin; Reis, Rafael de Menezes; Jorge, Maria Lucía del Rosario Castro; Salmon, Carlos Ernesto Garrido; Herrero, Carlos Fernando Pereira da Silva; Nogueira-Barbosa, Marcello Henrique

doi:10.1590/1414-431x2022e12015

Cited by 2 publications

(2 citation statements)

References 36 publications

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“…Because no standard pelvic sagittal equilibrium values have been determined for the general population, defining standard spinal physiological curves is difficult. 7,8 The most important factor seems to be compatibility between the spine curves, giving the optimal position with minimum muscle effort while the body's weight axis is in a physiological position. 8,9 Therefore, it is crucial to determine the spatial position of the pelvis.…”

Section: Discussionmentioning

confidence: 99%

“…The relative position of the pelvis to the spine is a decisive factor affecting spinal column curves. Because no standard pelvic sagittal equilibrium values have been determined for the general population, defining standard spinal physiological curves is difficult 7,8 . The most important factor seems to be compatibility between the spine curves, giving the optimal position with minimum muscle effort while the body’s weight axis is in a physiological position 8,9 .…”

Section: Discussionmentioning

confidence: 99%

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The Importance of Spinopelvic Parameters in Recurrent Lumbar Disk Herniation

Eren,

Karagoz Guzey,

Gulec

et al. 2023

Clinical Spine Surgery

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Study Design: Retrospective clinical study. Objectives: We aimed to investigate preoperative spinopelvic mismatch as a risk factor for recurrent lumbar disk herniation (RLDH) in patients undergoing lumbar disk herniation (LDH) surgery. Summary of Background Data: Spinopelvic parameters have been associated with lumbar degenerative diseases, particularly LDH. However, the relationship between these parameters and RLDH has yet to be studied. Materials and Methods: Data of 1453 patients aged ≥18 who underwent single-level, unilateral fenestration microdiscectomy for the first time in our hospital between 2013 and 2019 were reviewed. The study group comprised 88 patients who underwent surgery for RLDH. The control group comprised 101 randomly selected patients who underwent surgery for LDH but not RLDH. Age, sex, body mass index, occupational activity level, operative level, Roussouly classification type, and time to recurrence were recorded. Moreover, pelvic incidence, lumbar lordosis (LL), interverteberal disk height (IDH), segmental lordosis, sacral slope (SS), pelvic tilt (PT), and sacral table angle (ST) were measured for each patient. Pelvic mismatch was calculated. Results: Mean age was 46.5±11.4 y (range, 20–70). Both groups were similar concerning age, sex, body mass index, occupational activity level, and level of surgery. The mean time to recurrence was 167.3±36.6 d (range, 62–363). Measurements in the RLDH group were as follows: IDH=7.6±1.5 mm, pelvic incidence =54.4°±10.1°, LL=47.3°±13°, segmental lordosis =9.3°±5°, SS=35.1°±9.9°, and PT=19.3°±7.3°. Mean IDH was significantly lower in the RLDH group (P=0.02). Less LL and lower PT at L3–4 level and increased SS at L5–S1 level were considered risk factors for RLDH. Conclusion: This study showed that preoperative low IDH is at higher risk for RLDH in patients undergoing LDH surgery. LL, PT, and SS may be risk factors for specific levels.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Importance of Spinopelvic Parameters in Recurrent Lumbar Disk Herniation

Eren,

Karagoz Guzey,

Gulec

et al. 2023

Clinical Spine Surgery

View full text Add to dashboard Cite

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The Impact of Spinopelvic Alignment on the Facet Joint Degeneration

Soydan¹,

Bayramoglu²,

Altas³

2023

Global Spine Journal

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Study Design Retrospective Cohort. Objectives This study aims to evaluate the relations between facet joint degeneration (FD) and sagittal spinopelvic parameters. Second, the association of FD with degenerative disc disease (DDD) and lumbar disc herniations (LDH) was assessed. Methods The radiologic data of 192 patients was retrospectively analyzed. Total, proximal, and distal lumbar lordosis (LL, PLL, and DLL), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and sacral table angle (STA) were measured on lumbar x-ray plates. DDD and FD was graded on the MRI images. The apex of lumbar lordosis and PI-LL imbalance were noted in each patient. Correlation analyses were performed. Results Age and body mass index (BMI) were correlated with FD. LL and DLL are positively associated with upper-level FDs (L1-2 and L2-3) (P < 0,05). PLL were positively associated with lower level FD (L5-S1) (P < 0,05). A significant increase in PI was associated with FD in L2-3 and L4-5. A larger PT was found in FD in L4. The PI-LL imbalance was not correlated with the FD. Correlation between DDD and LDH and FD was observed in each level (P < 0,01). The level of FD is not affected by the apex of the curve. Conclusion Age and BMI have a direct impact on FD. However, spinopelvic parameters influence the severity of FD rather than its occurrence. In addition to the effects of lumbar lordosis as a single entity, it is essential to consider separately the effects of proximal and distal lumbar lordosis at the FD level.

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Sagittal balance and intervertebral disc composition in patients with low back pain

Cited by 2 publications

References 36 publications

The Importance of Spinopelvic Parameters in Recurrent Lumbar Disk Herniation

The Importance of Spinopelvic Parameters in Recurrent Lumbar Disk Herniation

The Impact of Spinopelvic Alignment on the Facet Joint Degeneration

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