Erratum to: Spinopelvic parameter changes and low back pain improvement due to femoral neck anteversion in patients with severe unilateral primary hip osteoarthritis undergoing total hip replacement

ObjectiveTo prospectively analyze the effect of three-dimensional chemoradiation on the bone mineral density of pelvic bones and its association with low back pain and disability in patients with locally advanced cervical cancer.MethodsIn biopsy proven locally advanced cervical cancer patients, bone mineral density and T scores for lumbar vertebrae 5, dorsal thoracic vertebrae 12, and T scores for the femoral neck were analyzed. Low back pain was scored using the visual analog scale while disability scoring was done using the Oswestry low back pain disability scale. Furthermore, a subgroup analysis for patients (classified according to menopausal status) was performed.ResultsIn total, 106 patients were analyzed. A statistically significant decline in mean bone mineral density was observed at all three sites (vertebrae 5 and 12, and the femoral neck) post-chemoradiation therapy compared with pretreatment bone mineral density (0.671 vs 0.828, −2.083 vs −1.531, −2.503 vs −1.626; all p<0.001). Similarly, in subgroup analyses, at all three sites, pre-menopausal patients showed a statistically significant association (0.876 vs 0.697, −1.203 vs −0.2.761, –1.403 vs −2.232; all p<0.001) while a non-significant association was observed for post-menopausal patients at vertebrae 12 (−1.707 vs −1.719; p=0.09) with a statistically significant association at vertebrae 5 and the femoral neck (0.803 vs 0.656, –1.746 vs −2.648; p<0.01). Although statistically significant low back pain and disability scores were observed overall and irrespective of menopausal status, no correlation between bone mineral density and low back pain and disability was observed.ConclusionPelvic bone mineral density decreases significantly after chemoradiation, irrespective of menopausal status. However, no correlation with low back pain and disability was observed. Pelvic bone mineral density analysis should be considered before chemoradiation in cervical cancer.

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Spinopelvic Alignment and Low Back Pain after Total Hip Replacement Arthroplasty in Patients with Severe Hip Osteoarthritis

Asian Spine Journal ◽

10.4184/asj.2018.12.2.325 ◽

2018 ◽

Vol 12 (2) ◽

pp. 325-334 ◽

Cited By ~ 7

Author(s):

Yawara Eguchi ◽

Satoshi Iida ◽

Chiho Suzuki ◽

Yoshiyuki Shinada ◽

Tomoko Shoji ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Japanese Orthopaedic Association ◽

Hip Osteoarthritis ◽

Direct Anterior Approach ◽

Low Back ◽

Lumbar Scoliosis ◽

Total Hip ◽

Replacement Arthroplasty ◽

Before And After

<sec><title>Study Design</title>Retrospective observational study.</sec><sec><title>Purpose</title>We examined change in lumbrosacral spine alignment and low back pain (LBP) following total hip arthroplasty (THA) in patients with severe hip osteoarthritis (OA).</sec><sec><title>Overview of Literature</title>Severe hip osteoarthritis has been reported to cause spine alignment abnormalities and low back pain, and it has been reported that low back pain is improved following THA.</sec><sec><title>Methods</title>Our target population included 30 patients (29 female, mean age 63.5 years) with hip OA who underwent direct anterior approach THA. There were 12 cases with bilateral hip disease and 18 cases with unilateral osteoarthritis. Visual analogue scale (VAS) scores for LBP and coxalgia, the Roland-Morris Disability Questionnaire (RDQ), and the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) were assessed before and after surgery. Spinal alignment metrics were measured before and after surgery.</sec><sec><title>Results</title>VAS for LBP change from preoperative to final postoperative observation was significantly improved (p <0.05), as was VAS for hip pain (<italic>p</italic><0.001). RDQ improved significantly (<italic>p</italic><0.01). All five domains of JOABPEQ were significantly improved (<italic>p</italic><0.05). In terms of coronal alignment, lumbar scoliosis change from preoperative to last observation was significantly reduced (<italic>p</italic><0.05). There were no significant changes in the sagittal alignment metrics. In addition, there was a correlation between before and after RDQ difference and before and after lumbar scoliosis difference (<italic>p</italic><0.05). VAS for LBP (<italic>p</italic><0.05) as well as RDQ (<italic>p</italic><0.05) were significantly improved only in unilateral OA. Lumbar scoliosis was significantly improved in cases of unilateral OA (<italic>p</italic><0.05), but alignment did not improve in cases of bilateral OA (<italic>p</italic>=0.29).</sec><sec><title>Conclusions</title>The present study demonstrates improvements in VAS for LBP, RDQ, and all domains of JOABPEQ. There were also significant reductions in lumbar scoliosis and an observed correlation of RDQ improvement with lumbar scoliosis improvement. We were able to observe improvements in lumbar scoliosis and low back pain only in cases of unilateral OA. It has been suggested that the mechanism of low back pain improvement following THA is related to compensatory lumbar scoliosis improvement.</sec>

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