Lumbar Spine Surgery. Importance of Sagittal Balance in the Quality of Life of Patients

Abstract

Objective: To evaluate whether performing surgery in degenerative diseases of the lumbar spine modify the spinopelvic balance and influences the clinical outcome and the quality of life of patients. Methods: The spinopelvic balance was evaluated in 25 patients using plain radiographs of the lumbosacral region including the proximal femur, as well as evaluating the quality of life on two separated occasions. Results: The measure of spinopelvic balance was obtained by averaging the angles of sacral slope, pelvic version and pelvic incidence. Mean preoperative angles were 59.88º, 22.84º, and 37.44º, respectively, and the mean postoperative values were 61.56º, 24.64º, and 37.32º, respectively. Regarding the questionnaires on quality of life, the Oswestry index showed mean preoperative values of 46.24, characterized as severe disability and mean postoperative values of 13.29 denoting satisfactory response after surgical treatment. The SF-36 questionnaire showed important and significant improvement in quality of life in different domains, with the exception of physical limitation and social aspects, with a p-value of 0.02 and 0.025, respectively. Conclusion: Patients undergoing surgical treatment of degenerative lumbar diseases showed no significant changes in the spinopelvic balance, but showed significant improvement in quality of life after surgery.

Reproducibility and Equivalence of Cobbmeter Application in the Sagittal Evaluation of the Spine

“…The spino-pelvic parameters are key components in the evaluation and treatment of sagittal deformities 9 and also of degenerative pathologies of the spine, as correct sagittal alignment directly impacts the quality of life of these patients. 13,14 The current standard for acquiring the measurements uses manual measuring of these parameters with a goniometer, a process that requires a dermatograph pencil for drawing lines on the radiographic film, as well as the goniometer itself, which the clinician many times does not have on hand. 15 Recently, with the inclusion of technological tools in medical practice, these technologies can be used to assist physicians in clinical practice.…”