Correlation between symptoms and sagittal alignment parameters in patients with lumbar canal stenosis: a case-control study

Abstract

Objective: To examine the relationship between sagittal balance parameters and different symptoms of spinal disease in patients with lumbar canal stenosis (LCS) and controls. Methods: In this prospective, diagnostic, case-control study, we included all patients consecutively admitted to a public teaching hospital for surgical treatment of LCS between July 2010 and October 2011, aged more than 40 years, with back pain plus radiculopathy or neurogenic claudication, and controls without LCS. Magnetic resonance and x-rays allowed the measurement of sagittal axis parameters. Clinical data, the Oswestry Disability Index and the visual analogue scale of pain were assessed. Results: 23 patients were in the Stenosis group, and 17 were controls. The Stenosis group presented lower values of total lumbopelvic lordosis and regional lordosis L1, L2 and L3. In LCS patients and back pain, total lumbopelvic and regional lordosis at L1, L2 and L3 were smaller. Those with stenosis and radiculopathy had higher values of pelvic tilt and lower total lumbopelvic lordosis and regional lordosis in L1 and L2. In patients with claudication, regional lumbopelvic lordosis in L1 and L2 and the T9 sagittal offset were smaller. All patients with pain had higher values of thoracic kyphosis, regional lumbopelvic lordosis in L1, lower values for pelvic tilt, sagittal T1 offset, sacro-femoral distance and overhang compared to patients without pain. Conclusions: This study shows significant correlations between symptoms and sagittal axis parameters between patients with and without spinal canal stenosis and also in subgroups of the patients with stenosis with different complaints. correlAtion between symptoms And sAgittAl Alignment pArAmeters in pAtients with lumbAr cAnAl stenosis: A cAse-control study

Natural History of Lumbar Canal Stenosis: Clinical Aspects and Sagittal Balance

“…Of the 58 individuals had TK T4-T12 measured, 4 were hypokyphotic, 47 had normal kyphosis, and 7 were hyperkyphotic, considering normal to be between 20 and 40. 19 Table 5 shows the mean TK, ODI, VAS, and EQ-5D by TK classification group.…”

“…The same authors also found that the population of DLS patients was older than the randomly selected control group. 19 Several studies argue that an increase in SVA is associated with a poorer quality of life and an increase in axial pain. [23][24][25] In 2013, Schwab concluded that serious clinical disability (ODI > 40) is associated with an increase in SVA, PI-LL mismatch, and PT.…”

Pre- And Postoperative Comparative Analysis of the Spinopelvic and Global Sagittal Parameters of Patients With Adolescent Idiopathic Scoliosis

“…21,22 Rod molding, together with spinal fixation, influences the pelvic parameters. 23,24 The objective of our study was to evaluate pre-and postoperative parameters to determine whether the normal spinopelvic parameter and sagittal balance values were maintained. Comparing the mean variation in kyphosis became relevant, since there was a great variation in the range of the variable in both the pre-(6.6° -86.2°) and postoperative (18.2° -59.7°) periods; and, consequently, so did determining what type of influence this variation has on overall sagittal alignment with each group and in the comparison among them.…”

Avaliação dos parâmetros espinopélvicos pelo posicionamento intra-operatório na artrodese de coluna lombo-sacra

“…This change in the sacral slope, showing decreased values, negatively influences the clinical pain of the patients. 15 The decreased sacral slope, referring to the sacral standard similar to when we are seated, causes more pain post-surgery. 16 Therefore, we should be concerned with maintaining the sacral parameters within appropriate values.…”

“…19 The molding of rods, along with the fixation of the spine, influences the pelvic parameters. 15 Another factor that can influence the pelvic parameters is the angle resulting from the positioning of the pelvis with the surgical pads, since the pelvic values are directly influenced by the positioning of the hip (center of the femoral head). 1…”