Hip-Spine Syndrome, Radiographic Evaluation of the Sagittal Balance

Abstract

Objectives The hip-spine syndrome (HSS) is defined as the simultaneous degeneration of the hip and lumbar spine. The objective of this study is to quantify the sagittal balance values in the population with HSS and to compare them with the normal sagittal balance parameters. Methods A retrospective study was conducted in which 30 patients with HSS who were waiting for total hip arthroplasty (THA) were evaluated. The lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI) and spinopelvic harmony (SH) angles and the BMI of these patients were measured. Results Seventeen women and 13 men participated in the study, with a mean LL of 39.55°, a mean SS of 36.92°, a mean PT of 25.77°, a mean PI of 62.72°, a mean SH of 23.17° and a mean BMI of 25.55. Only the SS did not present a changed value when compared to the normal values of the population. Conclusions HSS is increasingly present in our environment due to the aging population. Sagittal balance is gaining more and more attention in studies related to spinal pathologies. All the parameters measured in this study, except for SS, presented altered values when compared to the populational means. Evidence Level II. Observational and retrospective study.

Effects of Hip Flexion Contracture on Sagittal Spinopelvic Parameters

“…Total hip arthroplasty restores the movements of the hip joint and the anterior pelvic rotation in the orthostatic position, corresponding to the increased PT and reduced SS observed. The literature has widely reported on the readaptation of the pelvic parameters after THA 11,19,20 , usually showing how limited hip movement hinders posterior pelvic rotation, reducing PT. 5,7,9 However, few studies have assessed the effects of hip flexion contracture on these parameters.…”