Effect of Spine-Pelvis Relationship in Total Hip Arthroplasty

Lee, Sang; Lim, Chae Won; Choi, Kwi Youn; Jo, Suenghwan

doi:10.5371/hp.2019.31.1.4

Cited by 27 publications

(30 citation statements)

References 32 publications

(43 reference statements)

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“…In contrast, we found that lower PIA patients may be a contributing factor to the development of ASD after long spinal fusion (Table 2). Many studies [32][33][34][35][36][37][38] have focused on how to correct the sagittal profile, including increased LLA, reduced normal C7 plumb line and PTA, but our results show that there was no significant significant difference between the incidence of ASD with preoperative and postoperative spinopelvic parameters, except for PIA. The PI, or pelvic base angle, is a useful descriptive terminology and an extremely important parameter for determining the global spinal balance of an individual [39,40].…”

Section: Discussioncontrasting

confidence: 63%

Predicting factors of adjacent segment degeneration after long-segment spinal fusion: spinopelvic parameters analysis

Chiu

Kao

Chen

et al. 2019

Preprint

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Purpose We investigated whether spinopelvic parameters are important prognostic factors for adjacent segment degeneration after long instrumented spinal fusion for degenerative spinal disease. Methods This uncontrolled, randomized, single arm retrospective study included patients who underwent long instrumented lumbar fusion (fusion levels≥ 4) in the past 5 years with follow-up for at least 2 years. The inclusion criteria included adult patients (≥40 years of age) with a diagnosis of spinal degeneration who underwent instrumented corrective surgery. The exclusion criteria included preexisting adjacent disc degeneration, combined anterior reconstructive surgery, and distal ASD. Clinical and operative characters were evaluated. Lumbar lordotic angle (LLA), sacral slope angle (SSA), pelvic tilt angle (PTA) and pelvic incidence angle (PIA) were compared preoperatively, postoperatively and at the final follow-up. Results From 2009 to 2014, 60 patients (30 ASD and 30 non-ASD patients) were enrolled. The average age was 66.82 ± 7.48 years for the study group and 67.97 ± 7.81 years for the control group. There was no statistically significant difference in clinical and operative characteristics. Among all spinopelvic parameters, only pre-, post-operative and final follow-up PIA in ASD group (53.9±10.4ﾟ, 54.6±14.0ﾟ, 54.3±14.1ﾟ) and non-ASD group (60.3±13.0ﾟ, 61.8±11.3ﾟ, 62.5±11.2ﾟ) showed statistically significant differences (p<0.05). Conclusion This study confirms that preoperative, postoperative and final follow-up PIA is a significant factor contributing to the development of adjacent segment degeneration after long instrumented spinal fusion.

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Section: Discussioncontrasting

confidence: 63%

Predicting factors of adjacent segment degeneration after long-segment spinal fusion: spinopelvic parameters analysis

Chiu

Kao

Chen

et al. 2019

Preprint

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“…The different finding maybe resulted from different diagnosis and operations. Many studies 25, [33][34][35][36][37][38] have focused on how to correct the sagittal profile, including increased LLA, reduced normal C7 plumb line and PTA, but our results showed that there was no significant significant difference between the incidence of ASD with the correction of all spinopelvic parameters (Table 3). Only preoperative, postoperative and follow-up PIA were responsible for the progression of ASD.…”

Section: Discussionmentioning

confidence: 57%

Predicting factors of adjacent segment degeneration after long-segment spinal fusion: spinopelvic parameters analysis

Chiu

Kao

Chen

et al. 2020

Preprint

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Background We investigated whether spinopelvic parameters are important prognostic factors causing adjacent segment degeneration (ASD) after long instrumented spinal fusion for degenerative spinal disease. Methods This uncontrolled, randomized, single arm retrospective study included patients who underwent long instrumented lumbar fusion (fusion levels≥ 4) in the past 5 years with follow-up for at least 2 years. The inclusion criteria included adult patients (≥40 years of age) with a diagnosis of spinal degeneration who underwent instrumented corrective surgery. The exclusion criteria included preexisting adjacent disc degeneration, combined anterior reconstructive surgery, and distal ASD. Clinical and operative characters were evaluated. Angle of lumbar lordosis (LLA), sacral slope (SSA), pelvic tilt (PTA) and pelvic incidence (PIA) were compared preoperatively, postoperatively and at the final follow-up. Results From 2009 to 2014, 60 patients (30 ASD and 30 non-ASD) were enrolled. The average age was 66.82 ± 7.48 years for the study group and 67.97 ± 7.81 years for the control group. There was no statistically significant difference in clinical and operative characteristics. Among all spinopelvic parameters, only pre-, post-operative and final follow-up PIA in ASD group (53.9±10.4ﾟ, 54.6±14.0ﾟ, 54.3±14.1ﾟ) and non-ASD group (60.3±13.0ﾟ, 61.8±11.3ﾟ, 62.5±11.2ﾟ) showed statistically significant differences ( p <0.05). Conclusion This study confirms that preoperative, postoperative and final follow-up PIA is a significant factor contributing to the development of ASD after long instrumented spinal fusion.

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“…Implant dislocation tends to occur during changes in posture, most commonly when rising from a chair [1]. Thus, a comprehensive understanding of THA stability includes examining alignment not only during standing positions but also during postural changes.…”

Section: Conflict Of Interestsmentioning

confidence: 99%

“…Changes in spinopelvic alignment may be attributed to multiple causes. Owing to the coordinated nature of spinopelvic motions, a limit in motion on one spine segment tends to increase mobility in other spine segments and in pelvic tilt to maintain spinopelvic "balance" [1]. Spine diseases, including degenerative disc disease (DDD), degenerative spondylolisthesis, and lumbar fusion, have been associated with abnormal spinopelvic alignment and mobility [9,11,12].…”

Section: Conflict Of Interestsmentioning

confidence: 99%

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Obesity Alters Spinopelvic Alignment Changes From Standing to Relaxed Sitting: the Influence of the Soft-tissue Envelope

et al. 2020

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Background: Changes in spinopelvic and lower extremity alignment between standing and relaxed sitting have important clinical implications with regard to stability of total hip arthroplasty. This study aimed to analyze the effect of body mass index (BMI) on lumbopelvic alignment and motion at the hip joint. Methods: A retrospective review of patients who underwent full-body stereoradiographs in standing and relaxed sitting for total hip arthroplasty planning was conducted. Spinopelvic parameters measured included spinopelvic tilt (SPT), pelvic incidence (PI), lumbar lordosis (LL), PI minus LL (PI-LL), proximal femoral shaft angle (PFSA), and standing-to-sitting hip range of motion. Propensity score matching controlled for age, gender, PI, and hip ostoarthritis grade. Patients were stratified into normal (NORMAL; BMI, 18.5-24.9), overweight (OW; 25.0-29.9), and obese (OB; 30.0-34.9) groups. Alignment parameters were compared using one-way analysis of variance. Results: There were 84 patients in each group after propensity score matching. Standing alignment between BMI groups was similar for all parameters (P > .05) except for PFSA (P < .001). Significant differences were noted for sitting alignment between patients who are NORMAL, OW, and OB in: SPT (P ¼ .007), PILL (P ¼ .018), and LL (P ¼ .029). PFSA between groups was not significantly different (P > .05). Significant differences were found for sitting-to-standing alignment across groups in PFSA change (P < .001), SPT change (P ¼ .006), PILL change (P ¼ .005), LL change (P ¼ .037), and hip flexion (P < .001). Conclusions: Significant differences in sitting and standing-to-sitting change in lumbopelvic alignment based on BMI suggest obese patients recruit more posterior spinopelvic tilt when sitting to compensate for soft-tissue impingement that occurs anterior to the hip joint and limiting hip flexion.

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Effect of Spine-Pelvis Relationship in Total Hip Arthroplasty

Cited by 27 publications

References 32 publications

Predicting factors of adjacent segment degeneration after long-segment spinal fusion: spinopelvic parameters analysis

Predicting factors of adjacent segment degeneration after long-segment spinal fusion: spinopelvic parameters analysis

Predicting factors of adjacent segment degeneration after long-segment spinal fusion: spinopelvic parameters analysis

Obesity Alters Spinopelvic Alignment Changes From Standing to Relaxed Sitting: the Influence of the Soft-tissue Envelope

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