The relationship between global spinal alignment and pelvic orientation from standing to sitting following pedicle subtraction osteotomy in ankylosing spondylitis patients with thoracolumbar kyphosis

Zhao, Shi-Zhou; Qian, Bangping; Qiu, Yong; Qiao, Mu; Liu, Zhuo-jie; Huang, Jiannan

doi:10.1007/s00402-018-03107-1

Cited by 11 publications

(9 citation statements)

References 23 publications

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“…Three articles compared PI change between pre- and post-operative patient data, and seven studies assessed PI change with different postures (Table 2). 7,28–36 In a study of PI change using adult patients with spine deformity, there was 9.4° PI change between pre-operative and last follow up data. In this study, patients who did not have sacropelvic fixation showed 11.4° of PI change between pre- and post-operative data.…”

Section: Resultsmentioning

confidence: 99%

“…Although patients with lumbopelvic problems tended to show large PI change, unlike healthy subjects, 31,32 not every patient with a lumbopelvic problem did. Zhao et al 35 compared pre- and post-operative PI change from standing to sitting in patients and did not show high PI change. Kargin et al 36 showed only 2.7° of PI change in patients pre- and post-operation.…”

Section: Discussionmentioning

confidence: 99%

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Movement of the sacroiliac joint: Anatomy, systematic review, and biomechanical considerations

Cho

Kwak

2020

Proc Inst Mech Eng H

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Several researchers investigated the anatomy and biomechanics of the sacroiliac joint (SIJ) to understand the relationship between lower back pain and the SIJ. Many studies concluded that the SIJ has little movement; however, some studies using spinopelvic parameters mentioned high change in pelvic incidence (PI). In this study, SIJ movement and PI change reported in previous studies were reviewed according to position and posture changes. Literature on SIJ movement was reviewed by searching through the publication databases. In biomechanical studies, the result of the rotational angle in the sagittal plane was mainly investigated to compare with the results of PI change. From the results of SIJ movement studies, the minimum movement of nutation and count-nutation was 0.01°, and maximum movement was 2.27°. From the results of PI change studies with different positions and movements, the highest change was 9°, and the lowest change was 0°. Movement of the SIJ was limited by its anatomical structure; maximum movement of the SIJ was 9° in a previous study. Therefore, SIJ movement should be studied more intensely as biomechanical perspective to understand its movement.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Movement of the sacroiliac joint: Anatomy, systematic review, and biomechanical considerations

Cho

Kwak

2020

Proc Inst Mech Eng H

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“…Sagittal malalignment following osteotomy is a major determinant of clinical outcome in AS patients 2 , 6 . Given the complex interactional compensatory mechanisms between spine and pelvis, it is difficult for the surgeon to control and correct sagittal malalignment, especially to restore the neutral pelvic position 11 , 13 . Moreover, the retroversion of pelvis cannot be corrected directly, and is restored mainly by reconstructing lumbar lordosis and spinopelvic harmony 12 , 20 .…”

Section: Discussionmentioning

confidence: 99%

“…Predicting sagittal alignment and knowing the required degree of osteotomy can be of great help in designing a successful surgical plan. However, there is no clear method to predict the postoperative sagittal alignment for AS kyphosis, especially to evaluate the change of pelvic posture after osteotomy 11 – 13 , which might hamper the development of an appropriate surgical plan. In adult spinal deformity (ASD), Lafage et al 14 , 15 proposed two formulae to predict the postoperative pelvic tilt (PT) and SVA, and guide the formulation of surgical plans, which contributed to resolving the problem in ASD.…”

Section: Introductionmentioning

confidence: 99%

Prediction formulae of sagittal alignment in thoracolumbar kyphosis secondary to ankylosing spondylitis after osteotomy

Luo

Yang

Duan

et al. 2023

Sci Rep

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To construct and validate prediction formulae of sagittal alignment in thoracolumbar kyphosis secondary to ankylosing spondylitis (AS) after osteotomy. A total of 115 AS patients who suffered from thoracolumbar kyphosis and underwent osteotomy were enrolled, with 85 patients in derivation group and 30 patients in validation group. Radiographic parameters were measured on lateral radiographs, including thoracic kyphosis, lumbar lordosis (LL), T1 pelvic angel (TPA), sagittal vertical axis (SVA), osteotomized vertebral angle, pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and PI and LL mismatch (PI-LL). Prediction formulae of SS, PT, TPA and SVA were established; and their effectiveness was evaluated. There was no significant difference in baseline characteristics between the two groups (p > 0.05). In derivation group, LL and PI-LL were correlated with SS, and were then used to establish the prediction formula of SS[SS = − 12.791–0.765 × (LL) + 0.357 × (PI-LL), R2 = 68.3%]; PI and PI-LL were correlated with PT, and the prediction formula of PT were thus established[PT = 12.108 + 0.402 × (PI-LL) + 0.252 × (PI), R2 = 56.8%]; PT, PI-LL and LL were correlated with TPA, and were used to establish the prediction formula of TPA[TPA = 0.225 + 0.597 × (PT) + 0.464 × (PI-LL)-0.161 × (LL), R2 = 87.4%]; PT, PI-LL and age were correlated with SVA, and were used to establish the prediction formula of SVA[SVA = 36.157 + 2.790 × (PI-LL) + 1.657 × (Age)-1.813 × (PT), R2 = 41.5%]. In validation group, the predictive SS, PT, TPA and SVA were basically consistent with corresponding real values; and the mean error between predictive values and real values was of 1.3° in SS, 1.2° in PT, 1.1° in TPA and 8.6 mm in SVA. Postoperative SS, PT, TPA and SVA could be predicted with PI and the planned LL and PI-LL using prediction formulae, providing a method for AS kyphosis to plan postoperative sagittal alignment. Change of pelvic posture after osteotomy was quantitatively evaluated using the formulae.

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“…Reasons for that might be, that spinopelvic disorders often are aggravated in patients with significantly impaired hip function. [9][10][11][12][13] Due to improvement of the hip function and the reduction of the groin pain, the spine symptoms might be also influenced in a positive way. Further, placing and securing the pelvis in the lateral decubitus position and using clinical parameters and anatomic structures for implant placement (Ranawat sign, transverse acetabular ligament) produced good clinical and radiographic results.…”

Section: Discussionmentioning

confidence: 99%

Total hip arthroplasty and lumbar spine disorders: Plain co-existence or mutual influence?

et al. 2020

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Lumbar spine disorders (LSD) might influence the outcome after total hip arthroplasty (THA). Despite a known common prevalence of LSD and degenerative hip disorders, this study investigates their mutual influence in case of co-existence with the purpose to advance surgeons planning and patient’s prognosis. Patients with and without LSD were compared before and at the one-year postoperative examination. For clinical evaluation the WOMAC was assessed. The radiological analysis focused on cup anteversion and inclination. The total group included 203 consecutive patients. The overall incidence of LSD was 51.0%. Patients with LSD were on average 4.3 years older and had a 1.8 higher BMI than non-LSD patients (P<0.05). The cup positioning and the clinical results were comparable between both groups before and at the last time of follow up (P>0.05). No hip dislocations nor clinical signs of impingement were seen.We can conclude that there is a high degree of co-existence of LSD and hip disorders. However, a strong negative impact of LSD to clinical or radiologic results could not be confirmed in our study.

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The relationship between global spinal alignment and pelvic orientation from standing to sitting following pedicle subtraction osteotomy in ankylosing spondylitis patients with thoracolumbar kyphosis

Cited by 11 publications

References 23 publications

Movement of the sacroiliac joint: Anatomy, systematic review, and biomechanical considerations

Movement of the sacroiliac joint: Anatomy, systematic review, and biomechanical considerations

Prediction formulae of sagittal alignment in thoracolumbar kyphosis secondary to ankylosing spondylitis after osteotomy

Total hip arthroplasty and lumbar spine disorders: Plain co-existence or mutual influence?

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