Characteristics of Spinopelvic Sagittal Alignment in Lumbar Degenerative Disease

Zárate-Kalfópulos, Barón; Reyes-Tarrago, F; Navarro-Aceves, Luis Alberto; García-Ramos, C L; Reyes-Sánchez, Alejandro; Alpizar-Aguirre, A; Rosales-Olivarez, Luis Miguel

doi:10.1016/j.wneu.2019.02.067

Cited by 27 publications

(29 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, mismatch of shape and radiographic values was frequently observed in spine deformity patients, and some authors have attempted to reconstruction spine alignment according to this classi cation [7,16,17]. We found the existence of mismatch between parameters and shape in both types, which was different to ndings for degenerative lumbar disease in previous studies [4,11,12]. We speculated this was the result of regional deformity.…”

Section: Discussionmentioning

confidence: 56%

“…The Roussouly classi cation was rst established in a normal population, and its effectiveness in pathologic conditions remained ambiguous. Some authors have used it as a practical tool for lumbar degenerative disease treatment, and the shape of curvature and SS values are well-matched in these populations [4,11,12]. However, mismatch of shape and radiographic values was frequently observed in spine deformity patients, and some authors have attempted to reconstruction spine alignment according to this classi cation [7,16,17].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Analysis of Sagittal Profile and Radiographic Parameters in Symptomatic Thoracolumbar Disc Herniation Patients

Gao

Wang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Few studies describe thoracolumbar disc herniation (TLDH) as an isolated category, it is frequently classified as the lower thoracic spine or upper lumbar spine. Thus, less is known about the morphology and aetiology of TLDH compared to lumbar disc herniation (LDH)The aim of study is to investigate sagittal alignment in TLDH, and analyze sagittal profile with radiographic parameters.Methods Data from 70 patients diagnosed with TLDH were retrospectively reviewed. The thoracic-lumbar alignment was depicted by description of curvatures (the apex of lumbar curvature, the apex of thoracic curvature, and inflexion point of the two curvatures) and radiographic parameters from complete standing long-cassette spine radiographs. The rank sum test was utilised to compare radiographic parameters values in each subtype. Results We found two subtypes differentiated by the apex of thoracic kyphotic curves. The apex of the thoracic kyphotic curve located in the middle thoracic spine in type I, and the apex of the thoracic kyphotic curve located in the thoracolumbar region in type II patients. Thirty-six patients were classified as type I, and 34 patients were classified as type II. The mean sagittal vertical axis, T1 pelvic angle and L1 pelvic angle were 27.9±24.8°, 8.2±7.3° and 6.2±4.9°, respectively. There was significant difference (p<0.001) of thoracolumbar angle between type I patients (14.9±7.9°) and type II patients (29.1±13.7°).Conclusions We presented two distinctive sagittal profiles in TLDH patients, and a regional kyphotic deformity with a balanced spine was validated in both subtypes. In view of the different curvatures, different aetiologies were discovered in each subtype. Mismatch between shape and SS value was observed, and better agreement was found in Type II patients.

show abstract

Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Analysis of Sagittal Profile and Radiographic Parameters in Symptomatic Thoracolumbar Disc Herniation Patients

Gao

Wang

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Showed that spinopelvic sagittal alignment plays a predisposingrole in the pathogenesis of lumbar degeneration. [18] Even though we couldn't confirm whether these characteristics were the effect or the predictor of lumbar degeneration in the current retrospective study, they have potential clinical implications.…”

Section: Discussionmentioning

confidence: 68%

Correlation between lumbar sagittal alignment, Modic changes, and endplate erosion in patients with degenerative disease

Lv¹,

Wang²

2020

Preprint

View full text Add to dashboard Cite

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.

show abstract

“…Roussouly et al [16] proposed four types of sagittal lumbo-pelvic alignment using lateral radiography. Certain types of sagittal lumbo-pelvic alignment were more frequently associated with speci c degenerative diseases [20]. Patients with symptomatic disc herniation were most commonly classi ed as Type 1 or 2, and patients with spinal stenosis as Type 4 [16].…”

Section: Disscussionmentioning

confidence: 99%

Straighter low lumbar curvature in isthmic spondylolisthesis at L4

Zheng

Zhong

Zhu

et al. 2020

Preprint

View full text Add to dashboard Cite

Abstract Background: This study was conducted to compare differences in imaging features and clinical symptoms between patients with single-level isthmic spondylolisthesis (IS) at L4 and at L5 and to investigate the correlation between imaging and clinical parameters. Methods: This cross-sectional study evaluated patients with single-level IS who were enrolled between June 2011 and June 2018. A total of 139 patients, 44 in the L4 IS group and 95 in the L5 IS group, met the study criteria and were included. Imaging and clinical parameters obtained from the two groups were compared and analyzed.Results: Patients in the L4 IS group had smaller lower lumbar lordosis (LLL) (27.1 ± 8.2 vs. 30.9 ± 9.3, P = 0.021) and were of older age (58.5 ± 8.7 vs. 52.8 ± 10.1, P < 0.01) than those in the L5 IS group. As per the Roussouly classification system, most patients with L4 IS were classified as Type 2 (43.2%), whereas most patients with L5 IS fell under Type 3 (44.2%). In the L5 IS group, pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), and L5 incidence (L5I) were positively associated with slippage rate (SR), but the lumbosacral angle (LSA) was negatively associated with SR (P < 0.01). In the L4 IS group, only L5I showed a positive association with SR (P < 0.01). More significant associations were found among sagittal lumbo-pelvic parameters in the L5 IS group, but none were found between SR and Oswestry Disability Index (ODI) in either group.Conclusions: When compared with patients with L5 IS, patients with L4 IS were of older age and had straighter low lumbar curvature when they were obviously symptomatic. PI was an important parameter for patients with L5 IS while for those with L4 IS, L5I deserved more attention for its significantly positive correlation with the degree of slippage.

show abstract

Characteristics of Spinopelvic Sagittal Alignment in Lumbar Degenerative Disease

Cited by 27 publications

References 16 publications

Analysis of Sagittal Profile and Radiographic Parameters in Symptomatic Thoracolumbar Disc Herniation Patients

Analysis of Sagittal Profile and Radiographic Parameters in Symptomatic Thoracolumbar Disc Herniation Patients

Correlation between lumbar sagittal alignment, Modic changes, and endplate erosion in patients with degenerative disease

Straighter low lumbar curvature in isthmic spondylolisthesis at L4

Contact Info

Product

Resources

About