Spinopelvic balance evaluation of patients with degenerative spondylolisthesis L4L5 and L4L5 herniated disc who underwent surgery

Nunes, V.R.H.; Jacob, Charbel; Cardoso, Igor Machado; Batista, José Lucas; Brazolino, Marcus Alexandre Novo; Maia, Thiago Cardoso

doi:10.1016/j.rboe.2016.09.003

Cited by 4 publications

(5 citation statements)

References 14 publications

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“…Spinopelvic parameters of importance such as pelvic incidence (PI) are known to vary with age and their value reflects the anatomy of the pelvis, not the values of sacral slope (SS), pelvic incidence (PI) that derive directly from the position of the pelvis. In the same way, the increase in PI after a surgical procedure for degenerative deformity leads to an increase in lumbar lordosis [39,40,41] .…”

Section: Discussionmentioning

confidence: 89%

“…Loss of LL has been shown to be closely related to clinical symptom operative complications such as subsequent intervertebral disc degeneration and cororal and sagittal imbalance [40,41] .…”

Section: Discussionmentioning

confidence: 99%

“…The lumbosacral morphology and the global sagittal balance are the main factors of the biomechanical pathogenesis of the sagittal balance disorders, consequently the mechanical tension of the lumbosacral junction translated into pain and future deformation [39,40,41] . The objective of this work is to identify the modifications of the spinopelvic balance posterior to the ALIF and therefore its clinical repercussion.…”

Section: Introductionmentioning

confidence: 99%

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Spinopelvic Parameters in Anterior Lumbar Interbody Fusion, the First Follow-Up Study of Three Years in Mexican Population

Quillo-Olvera

Quillo-Olvera²,

Quillo-Reséndiz³

et al. 2019

ijirms

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Objective: The objective of this work is to identify the modifications of the spinopelvic balance posterior to the ALIF and therefore its clinical repercussion. Methods: A retrospective study of 20 patients were included, patients treated with ALIF was performed by 2 neurosurgeons and 1 vascular surgeon in 1 medical center in 2015, clinical data and radiographic measurements pre and postoperative at 3 years follow-up were studied. Results: The number of patients was 20;16 females (80%) and 4 males (20%), with a follow-up 36 months, the mean age of the studied group was 50.1 ± 8.5years (range 35-67 years), body mass index (BMI) was 29± 3.5, two of the 20 patients (10%) had undergone prior spine surgery, a total of 26 ALIF levels were treated in 20 patients, fourteen patients (70%) underwent 1 level L5-S1 and six patients (6%) underwent 2 level L4-L5,L5-S1. All ALIF cages were supplemented with anterior integrated fixation, Eigth(40%) of 20 patients were treated with posterior spinal fixation in addition to their ALIF procedure, Twelve (60%) of 20 patients were standalone ALIF. The mean hospital stay after ALIF procedure were 4.05± 1.87 days (range 2-9 days). PI,SS,PT and LL were measures pre and the postoperative was the last reported during the 3 years follow up, PI and SS has statistically significant (p= 0.008 and 0.012)correspondingly. visual analog scale (VAS) was the measure preoperative and the postoperative was the last reported getting statistically significant (p= 0.001) and the complications obtained in 4 cases were persistent pain, bleeding, intestinal pseudoclusion and retrograde ejaculation. Conclusions: The interaction between the anatomy of the pelvis and the paravertebral muscles have a direct influence on the stress of the intervertebral discs, improving the posture of the spine and minimizing energy expenditure. In this work performed the changes in the espinopelvic parameters that are described in the literature were obtained; we know that the ALIF improves the pelvic incidence and therefore the lumbar lordosis postoperative. Here we could verify that the modification of spinopelvic balances is related to the clinical improvement of the patient in the follow-up after his surgery, however is necessary to demonstrate quantitatively the modification of these parameters in our population to justify that the surgery is a satisfactory result for the patient.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Spinopelvic Parameters in Anterior Lumbar Interbody Fusion, the First Follow-Up Study of Three Years in Mexican Population

Quillo-Olvera

Quillo-Olvera²,

Quillo-Reséndiz³

et al. 2019

ijirms

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“…Previously, a decreased PI was noted with degenerative disc disease, lumbar disc displacement, and chronic LBP. 17,26,27 Therefore, spinopelvic balance disruption can alter biomechanical stresses at the lumbo-sacral junction and also in the compensation mechanisms used to maintain an adequate posture, 28 leading to aforementioned spinal and disc changes as well as LBP. However, not all disc degeneration on MRI may lead to lumbar disc displacement and/or MCs, and that potential sub-variants in the etiologies of these phenotypes may exist.…”

Section: Pi Is Essentially Anmentioning

confidence: 99%

“…Association of increased PI with spondylolisthesis and facet joint degeneration has been reported by several studies. Previously, a decreased PI was noted with degenerative disc disease, lumbar disc displacement, and chronic LBP . Therefore, spinopelvic balance disruption can alter biomechanical stresses at the lumbo‐sacral junction and also in the compensation mechanisms used to maintain an adequate posture, leading to aforementioned spinal and disc changes as well as LBP.…”

Section: Introductionmentioning

confidence: 99%

Spinopelvic alignment predicts disc calcification, displacement, and Modic changes: Evidence of an evolutionary etiology for clinically‐relevant spinal phenotypes

et al. 2020

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Lumbar disc‐displacement, Modic changes (MCs), and UTE Disc Sign (UDS) on MRI are clinically relevant spinal phenotypes that can lead to sciatica/LBP. Not all degenerated discs result in disc‐displacement, MCs and UDS, suggesting varied etiologies. Spinopelvic parameters have been implicated in various spinal disorders. Pelvic incidence (PI) is “fixed parameter” since skeletal maturity. No study has addressed disc‐displacement, MCs and UDS in context of spinopelvic parameters. Therefore, the aim of study was to determine if spinopelvic parameters are associated and predict clinically‐relevant MRI‐phenotypes. One hundred and eight population‐based subjects (mean age: 52.3 years) were recruited. Spondylolisthesis and scoliosis individuals were excluded. Lumbar lordosis (LL), PI, sacral slope (SS), and pelvic tilt (PT) were assessed on lateral plain radiographs. Disc degeneration was assessed and summated, and presence or not of disc‐displacement and MCs were noted on T2W MRI. UDS was detected on UTE. Following exclusion criteria, 95 subjects were assessed. Disc‐displacement (82.1%), MCs (52.6%), and UDS (37.9%) were associated with lower PI, SS, LL, and LL/PI index. On multivariate analyses, lower PI was significantly related to development of these MRI phenotypes (adjusted OR range:0.95‐0.92; P < .05), with critical PI value of 42° or lower exhibiting fourfold increase risk of combined phenotypes (P = .020). Of UDS discs, 39.3% had adjacent MCs and 83.6% had disc‐displacement. 87.5% of MC had directly adjacent UDS. The first study to note that PI may “predict” the development of disc‐displacement, MCs and UDS, suggesting potential sub‐variants and mechanistic susceptibility that may be grounded in spinopelvic evolution. An “evolutionary etiological pathway” of spinal phenotype development is proposed.

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Patients with Modic type 2 change have a severe radiographic representation in the process of lumbar degeneration: a retrospective imaging study

Lan

Wang

et al. 2019

J Orthop Surg Res

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Background There are few studies to investigate changes in imaging parameters of Modic changes (MCs). The imaging studies examining the distinctions in the lumbar sagittal parameters between MCs and lumbar disc degeneration (LDD) are still lacking. The purpose of this study was to identify the differences in the lumbar sagittal parameters among patients for LDD with/without Modic type 2 change (MII). Methods A total of 208 patients with lumbar degenerative disease from January 2017 to August 2018 volunteered for this study. Sixty-two patients with MII were used as the MC group. The other 146 patients served as the disc degeneration (DD) group. The DD scores and sagittal parameters were measured on magnetic resonance imaging (MRI) and X-ray by using Surgimap software. Results The prevalence of MII for patients with degenerative lumbar diseases in this study was 29.81%, primarily located at L5/S1. There were significant differences in lumbar lordosis (LL) and sacral slope (SS) between these two groups ( P < 0.05). Similarly, the significant decrease in intervertebral height index (IHI) was found at L3-S1 in the MC group, compared with the DD group ( P < 0.05). However, a significant difference in intervertebral angle (IVA) was observed only at L5/S1 ( P < 0.05). The MC group had the smaller endplate concave angle (ECA) than the DD group from L3 caudal endplate to S1 cranial endplate ( P < 0.05). Conclusions MII has a severe radiographic representation in the process of lumbar degeneration than patients without MII, and the overconcentration of load caused by the smaller LL, SS, and IVA may be a reasonable explanation to answer why MCs are more common at the L5/S1.

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Spinopelvic balance evaluation of patients with degenerative spondylolisthesis L4L5 and L4L5 herniated disc who underwent surgery

Cited by 4 publications

References 14 publications

Spinopelvic Parameters in Anterior Lumbar Interbody Fusion, the First Follow-Up Study of Three Years in Mexican Population

Spinopelvic Parameters in Anterior Lumbar Interbody Fusion, the First Follow-Up Study of Three Years in Mexican Population

Spinopelvic alignment predicts disc calcification, displacement, and Modic changes: Evidence of an evolutionary etiology for clinically‐relevant spinal phenotypes

Patients with Modic type 2 change have a severe radiographic representation in the process of lumbar degeneration: a retrospective imaging study

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