Change in acetabular version after lumbar pedicle subtraction osteotomy to correct post-operative flat back: EOS® measurements of 38 acetabula

Abstract

Changing the sagittal spinal alignment modifies both the pelvic and the acetabular parameters. PSO significantly increases sacral slope, thus inducing anterior pelvic tilt with significant acetabular retroversion. The measurements obtained using sterEOS(®) showed good inter-observer and intra-observer reproducibility. To our knowledge, this is the first study of changes in acetabular version after PSO.

Spine–hip relations in patients with hip osteoarthritis

“…SHS patients, by contrast, may benefit from corrective spinal surgery before the hip replacement. 34 - 36 Patients with SHS usually present with a stiffer LPC, which makes those patients mainly ‘hip users’ in situations of aberrant functional acetabular orientation, 10 , 12 increasing the risk of edge-loading and articular impingement (on a native or prosthetic hip). In order to face this aberrant functional acetabular orientation and prevent those complications happening, it seems reasonable to first use a higher tolerance implant (larger diameter head, dual mobility) 25 and second, to determine a personalised cup orientation.…”

Spine‐Pelvis‐Hip Alignments in Degenerative Spinal Deformity Patients and Associated Procedure of One‐Stage Long‐Fusion with Multiple‐Level PLIF or Apical‐Vertebra Three Column Osteotomy–a Clinical and Radiographic Analysis Study

“…There were significant connections among spine, pelvis, and hip joints during position changes in healthy human beings 10 , 11 and patients with spine or hip joints disorders 33 , 34 , 35 . A previous study 16 demonstrated that sagittal acetabular version would change significantly after PSO at lumbar spine. Both SAA and PFA of patients in our study had significant changes ( P < 0.001) during surgery, and the PFA in the LLL group was much larger ( P = 0.02) at post‐operation.…”

“…There were kinds of operative procedures for the patients with variable symptoms respectively 2 , 15 , however, the procedure of long‐segments with instrumentation and fusion was an effective treatment for the patients suffered global spine imbalance. Furthermore, the procedure of long‐fusion with three‐column osteotomy would reconstruct spinal alignment and acetabular orientation more effectively 15 , 16 , which have always borne the greatest risk to both surgeons and patients alike 2 , 17 , 18 . Therefore, there have been plenty of studies on surgical procedure of long‐fusion without advanced osteotomy for DSD patients 19 , 20 .…”

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Objective: To explore the spine-pelvis-hip alignments in degenerative spinal deformity (DSD) patients, and compare the outcomes in the procedure of long-fusion with posterior lumbar inter-body fusion (PLIF) or single-level three-column osteotomy (STO) at lower lumbar level (LLL, L 3 -S 1 ) and thoracolumbar levels (TLL, T 10 -L 2 ) for those patients.Methods: This is a retrospective study. Following institutional ethics approval, a total of 83 patients (Female, 67; Male,16) with DSD underwent long-fusion with PLIF or STO surgery between March 2015 and December 2017 were reviewed. All of those patients were assigned into LLL and TLL groups.

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“…Methods: This is a retrospective study. Following institutional ethics approval, a total of 83 patients (Female, 67; Male,16) with DSD underwent long-fusion with PLIF or STO surgery between March 2015 and December 2017 were reviewed. All of those patients were assigned into LLL and TLL groups.…”