Investigating sagittal spinal alignment, low back pain, and clinical outcomes after total hip arthroplasty for lumbar hyperlordosis: a retrospective study

Author(s):  
Yaichiro Okuzu ◽  
Takuma Miyahara ◽  
Koji Goto ◽  
Yutaka Kuroda ◽  
Toshiyuki Kawai ◽  
...  
2020 ◽  
Author(s):  
Fumiko Saiki ◽  
Takeyuki Tanaka ◽  
Naohiro Tachibana ◽  
Hirofumi Oshima ◽  
Taizo Kaneko ◽  
...  

Abstract BackgroundTotal hip arthroplasty (THA) is an established procedure for patients with osteoarthritis (OA) of the hip joint that effectively relieves pain and restores function. Because contracture of the hip joint as well as preoperative leg length discrepancy is expected to improve by the surgery, it would be reasonable to speculate that spinal sagittal alignment will also change. However, the influence of spinal alignment changes on clinical symptoms, such as low back pain (LBP), remains controversial. In this study, we aimed to evaluate the associations between spinal alignment changes and improvement in preoperative LBP after THA.MethodsFrom November 2015 to January 2017, 104 consecutive patients who underwent THA were prospectively enrolled. Whole spine X-rays were obtained preoperatively and 12 months postoperatively. The patient-reported outcomes (PROs) used were the Numerical Rating Scale (NRS) for back pain, EuroQol 5 Dimension, and Short Form-12. The presence of LBP was defined as an NRS of ≥4. Changes in spinal alignment and PROs before and after surgery were evaluated.ResultsSeventy-four (71%) patients were included in the study. The sagittal spinal parameters changed slightly but significantly; pelvic incidence (PI) decreased, pelvic tilt (PT) increased, and sacral slope decreased. Coronal spinal alignment significantly improved after surgery. Twenty-six (37%) patients had LBP preoperatively. The patients with preoperative LBP had smaller lumbar lordosis (LL), larger PT, and larger PI minus LL than those in the patients without. Fourteen (54%) of the 26 patients with preoperative LBP showed improvement, but there were no significant differences in the pre- and postoperative radiographic parameters.ConclusionAlthough preoperative LBP was likely to resolve after THR, there were no significant correlations between alignment changes and LBP improvement. The cause of LBP in patients with hip OA patients might be multifactorial.


2017 ◽  
Vol 40 (8) ◽  
pp. 573-579 ◽  
Author(s):  
Kelsey L. Corcoran ◽  
Andrew S. Dunn ◽  
Lance R. Formolo ◽  
Gregory P. Beehler

2020 ◽  
Vol 1 (2) ◽  
pp. 35-37
Author(s):  
I Made Buda Kurniantara ◽  
Gusti Ayu Alit Triwahyuni

Introduction: Osteoarthritis (OA) is the most common arthritis and one of the main causes of disability. This injury can occur in any joint, but the most common OA occurrence globally, especially in Indonesia, is Knee OA (KOA). Damage caused by KOA's degenerative process affects the knee and affects the surrounding structures, such as the lumbar vertebra, which increases symptoms of low back pain (LBP). The occurrence of symptoms of LBP is thought to be caused by knee spine syndrome, which is a condition reduced lumbar lordosis angle due to the degenerative phase of KOA. the mechanism of this syndrome has not yet been discussed in detail, so further discussion is needed in the future. Methods: We searched articles using a list of keywords, including "knee osteoarthritis and low back pain", "knee osteoarthritis and knee contracture", "knee contracture and muscle weakness", "knee contracture and spinal alignments", "knee osteoarthritis and spinal alignment", "knee osteoarthritis and sagittal spinal alignment", and "muscle activation and spinal imbalance" on the data sources of PubMed, ScienceDirect, and Google Scholar. The argumentative, descriptive analysis was used for the data analysis technique. Results: Based on the literature search, the author found four related articles. This study provides evidence of the effect of KOA on lumbar proprioception. These articles explained that an impact on knee posture could have long-term effects both in the spine and pelvis, such as lumbar lordosis. Conclusion: Knee spine syndrome results from a reduced angle of lumbar lordosis, increasing pressure between discs, which might increase LBP symptoms. In the future, it is hoped that there will be studies that raise the relationship between KOA and symptom of LBP.


2003 ◽  
Vol 52 (2) ◽  
pp. 356-360 ◽  
Author(s):  
Tadatsugu Morimoto ◽  
Katsuhiro Aida ◽  
Keisuke Nishida ◽  
Kenji Tsunoda ◽  
Kazumasa Maeda ◽  
...  

2015 ◽  
Vol 15 (10) ◽  
pp. S152-S153
Author(s):  
Xiao Han ◽  
Weijun Wang ◽  
Mingda Wu ◽  
Fei Liu ◽  
Minghui Sun ◽  
...  

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