Corrigendum to “Influence of posture on relationships between pelvic parameters and lumbar lordosis: Comparison of the standing, seated, and supine positions. A preliminary study” [Orthop. Traumatol. Surg. Res. 104 (2018) 565–568]

Abstract Study Design: A retrospective cohort study.Background: Sagittal imbalance of the spine is a comprehensive concept and can be caused by many causes. Paravertebral muscle is an important factor in the stabilization of spine.The active subsystem formed by the muscles around the lumbar spine plays an important role in maintaining lumbar spine stability and extendding the spine . Clinically, we found that some patients showed spinal sagittal balance when they were energetic, but hunched or leaning forward after a period of walking or working.Standing full-spine lateral digital radiographs shows increased sagittal vertical axis (SVA)dynamically.We call this symptoms a dynamic sagittal imbalance（DSI. However, the sagittal sequence, paravertebral muscle changes, and the correlation between them in DSI patients have not been clearly explored. The purpose of this study was to investigate the changes of spinal-pelvic parameters; paravertebral muscle; and the relationship between the two in DSI patients .Method: The study group comprised 31 patients with DSI and 42 control patients.All subjects underwent radiologic whole spine X-ray examination and lumbar MRI( Magnetic Resonance Imaging) scanning. Spinal-pelvic parameters such as sagittal vertical axis (SVA), thoracic kyphosis (TK), thoracolumbar kyphosis (TLK), lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT) and pelvic incidence (PI) was measured. The cross-sectional areas （CSA）of the erector spinae (ES),multiﬁdus (MF), and vertebral body were measured at L2/L3 and L4/L5. The fat infiltration (FI) and relative cross-sectional area (RCSA)of muscle of these muscles were quantitatively measured though Image J. All subjects were examined for bone mineral density and pulmonary function to test the overall skeletal muscle capacity.Result: Compared with the control group,the DSI group had a smaller lumbar lordosis，more severe fat infiltration and lower Relative functional cross-sectional area(RFCSA) of paravertebral muscle ES(erector spinae)&MF(multifidus). There was no correlation between muscle degeneration and spinal-pelvic parameters in DSI patients.In addition,There were no statistically significant differences in bone mineral density test and pulmonary function test which reflected systemic skeletal muscle capacity of whole body.Conclusion: DSI，along with moderate degeneration of the paravertebral muscles of the lumbar spine.Usually accompanied by a reduction in lumbar lordosis. DSI is regards as the pre-state of PDSI.

Download Full-text

Lumbar lordosis obtained with and without intervertebral thoracic spine motions during rhythmic gymnastics movements: a preliminary study

Computer Methods in Biomechanics & Biomedical Engineering ◽

10.1080/10255842.2020.1815320 ◽

2020 ◽

Vol 23 (sup1) ◽

pp. S232-S234

Author(s):

Y. Poulet ◽

C. Eyssartier ◽

T. Marsan ◽

L. Valdes-Tamayo ◽

M. Robert ◽

...

Keyword(s):

Thoracic Spine ◽

Lumbar Lordosis ◽

Rhythmic Gymnastics ◽

Preliminary Study

Download Full-text

How Sublaminar Bands Affect Postoperative Sagittal Alignment in AIS Patients with Preoperative Hypokyphosis? Results of a Series of 34 Patients with 2-Year Follow-Up

BioMed Research International ◽

10.1155/2016/1954712 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Sébastien Pesenti ◽

Antoine Chalopin ◽

Emilie Peltier ◽

Elie Choufani ◽

Matthieu Ollivier ◽

...

Keyword(s):

Idiopathic Scoliosis ◽

Cobb Angle ◽

Lumbar Lordosis ◽

Thoracic Kyphosis ◽

Radiographic Evaluation ◽

Cervical Lordosis ◽

Pelvic Parameters ◽

Sublaminar Bands ◽

Thoracic Idiopathic Scoliosis

Hypokyphosis is currently observed in thoracic idiopathic scoliosis. The use of sublaminar bands allows a good restoration of sagittal balance of the spine. The aim of the study was to provide a middle-term radiographic analysis of patients with adolescent idiopathic scoliosis with preoperative hypokyphosis treated by posterior arthrodesis with sublaminar bands. This retrospective study included 34 patients with Lenke 1 scoliosis associated with hypokyphosis (TK < 20°). A radiographic evaluation was performed with a 2-year follow-up. Cobb angle, cervical lordosis, thoracic kyphosis, lumbar lordosis, and pelvic parameters were measured preoperatively, postoperatively, and at 6-month and 2-year follow-up. The mean preoperative thoracic kyphosis was 10.5° versus 24.1° postoperatively (p<0.001), representing a mean gain of 13°. Cobb angle ranged from 59.3° to 17.9° postoperatively (mean correction 69%,p<0.001). Cobb angle increased between the immediate postoperative measurement and the 6-month follow-up (17.9 versus 19.9,p=0.03). Cervical curvature changed from a 5.6° kyphosis to a 3.5° lordosis (p=0.001). Concerning lumbar lordosis, preoperative measurement was 39.7° versus 41.3° postoperatively (p=0.27). At 6-month follow-up, lumbar lordosis significantly increased to 43.6° (p=0.03). All parameters were stable at final follow-up. Correction performed by sublaminar bands is efficient for both fontal and sagittal planes. Moreover, the restoration of normal thoracic kyphosis is followed by an adaptation of the adjacent curvatures with improved cervical lordosis and lumbar lordosis.

Download Full-text

Conflicting calculations of pelvic incidence and pelvic tilt secondary to transitional lumbosacral anatomy (lumbarization of S-1): case report

Journal of Neurosurgery Spine ◽

10.3171/2016.5.spine16196 ◽

2017 ◽

Vol 26 (1) ◽

pp. 45-49 ◽

Cited By ~ 4

Author(s):

Charles H. Crawford ◽

Steven D. Glassman ◽

Jeffrey L. Gum ◽

Leah Y. Carreon

Keyword(s):

Sagittal Balance ◽

Lumbar Lordosis ◽

Pelvic Incidence ◽

Adult Spinal Deformity ◽

Accurate Identification ◽

Current Case ◽

Pelvic Parameters ◽

Radiology Reports ◽

Sagittal Malalignment

Advancements in the understanding of adult spinal deformity have led to a greater awareness of the role of the pelvis in maintaining sagittal balance and alignment. Pelvic incidence has emerged as a key radiographic measure and should closely match lumbar lordosis. As proper measurement of the pelvic incidence requires accurate identification of the S-1 endplate, lumbosacral transitional anatomy may lead to errors. The purpose of this study is to demonstrate how lumbosacral transitional anatomy may lead to errors in the measurement of pelvic parameters. The current case highlights one of the potential complications that can be avoided with awareness. The authors report the case of a 61-year-old man who had undergone prior lumbar surgeries and then presented with symptomatic lumbar stenosis and sagittal malalignment. Radiographs showed a lumbarized S-1. Prior numbering of the segments in previous surgical and radiology reports led to a pelvic incidence calculation of 61°. Corrected numbering of the segments using the lumbarized S-1 endplate led to a pelvic incidence calculation of 48°. Without recognition of the lumbosacral anatomy, overcorrection of the lumbar lordosis might have led to negative sagittal balance and the propensity to develop proximal junction failure. This case illustrates that improper identification of lumbosacral transitional anatomy may lead to errors that could affect clinical outcome. Awareness of this potential error may help improve patient outcomes.

Download Full-text

Acute Reciprocal Changes Distant from the Site of Spinal Osteotomies Affect Global Postoperative Alignment

Advances in Orthopedics ◽

10.4061/2011/415946 ◽

2011 ◽

Vol 2011 ◽

pp. 1-7 ◽

Cited By ~ 27

Author(s):

Eric Klineberg ◽

Frank Schwab ◽

Christopher Ames ◽

Richard Hostin ◽

Shay Bess ◽

...

Keyword(s):

Lumbar Lordosis ◽

Thoracic Kyphosis ◽

Radiographic Analysis ◽

Pelvic Parameters ◽

Sagittal Malalignment ◽

Lumbar Osteotomy

Introduction. Three-column vertebral resections are frequently applied to correct sagittal malalignment; their effects on distant unfused levels need to be understood.Methods. 134 consecutive adult PSO patients were included (29 thoracic, 105 lumbar). Radiographic analysis included pre- and postoperative regional curvatures and pelvic parameters, with paired independentt-tests to evaluate changes.Results. A thoracic osteotomy with limited fusion leads to a correction of the kyphosis and to a spontaneous decrease of the unfused lumbar lordosis (−8°). When the fusion was extended, the lumbar lordosis increased (+8°). A lumbar osteotomy with limited fusion leads to a correction of the lumbar lordosis and to a spontaneous increase of the unfused thoracic kyphosis (+13°). When the fusion was extended, the thoracic kyphosis increased by 6°.Conclusion. Data from this study suggest that lumbar and thoracic resection leads to reciprocal changes in unfused segments and requires consideration beyond focal corrections.

Download Full-text

Relationship between thoracic hypokyphosis, lumbar lordosis and sagittal pelvic parameters in adolescent idiopathic scoliosis

European Spine Journal ◽

10.1007/s00586-013-2852-z ◽

2013 ◽

Vol 22 (11) ◽

pp. 2414-2420 ◽

Cited By ~ 41

Author(s):

Jean-Luc Clément ◽

Anne Geoffray ◽

Fatima Yagoubi ◽

Edouard Chau ◽

Federico Solla ◽

...

Keyword(s):

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Lumbar Lordosis ◽

Pelvic Parameters

Download Full-text

Contribution of hip extension and lumbar lordosis during back walkover performed by rhythmic and woman artistic gymnasts: a preliminary study

Computer Methods in Biomechanics & Biomedical Engineering ◽

10.1080/10255842.2020.1812841 ◽

2020 ◽

Vol 23 (sup1) ◽

pp. S101-S103

Author(s):

C. Eyssartier ◽

Y. Poulet ◽

T. Marsan ◽

L. Valdes-Tamayo ◽

S. El Oujaji ◽

...

Keyword(s):

Lumbar Lordosis ◽

Preliminary Study ◽

Hip Extension

Download Full-text

Minimally invasive transforaminal lumbar interbody fusion with expandable versus static interbody devices: radiographic assessment of sagittal segmental and pelvic parameters

Neurosurgical FOCUS ◽

10.3171/2017.5.focus17197 ◽

2017 ◽

Vol 43 (2) ◽

pp. E10 ◽

Cited By ~ 25

Author(s):

Ammar H. Hawasli ◽

Jawad M. Khalifeh ◽

Ajay Chatrath ◽

Chester K. Yarbrough ◽

Wilson Z. Ray

Keyword(s):

Lumbar Lordosis ◽

Pelvic Incidence ◽

Transforaminal Lumbar Interbody Fusion ◽

Disc Height ◽

Disc Space ◽

Pelvic Parameters ◽

Radiographic Measurements ◽

Index Level ◽

Segmental Lordosis ◽

Foraminal Height

OBJECTIVEMinimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) has been adopted as an alternative technique to hasten recovery and minimize postoperative morbidity. Advances in instrumentation technologies and operative techniques have evolved to maximize patient outcomes as well as radiographic results. The development of expandable interbody devices allows a surgeon to perform MIS-TLIF with minimal tissue disruption. However, sagittal segmental and pelvic radiographic outcomes after MIS-TLIF with expandable interbody devices are not well characterized. The object of this study is to evaluate the radiographic sagittal lumbar segmental and pelvic parameter outcomes of MIS-TLIF performed using an expandable interbody device.METHODSA retrospective review of MIS-TLIFs performed between 2014 and 2016 at a high-volume center was performed. Radiographic measurements were performed on lateral radiographs before and after MIS-TLIF with static or expandable interbody devices. Radiographic measurements included disc height, foraminal height, fused disc angle, lumbar lordosis, pelvic incidence, sacral slope, and pelvic tilt. Mismatch between pelvic incidence and lumbar lordosis were calculated for each radiograph.RESULTSA total of 48 MIS-TLIFs were performed, predominantly at the L4–5 level, in 44 patients. MIS-TLIF with an expandable interbody device led to a greater and more sustained increase in disc height when compared with static interbody devices. Foraminal height increased after MIS-TLIF with expandable but not with static interbody devices. MIS-TLIF with expandable interbody devices increased index-level segmental lordosis more than with static interbody devices. The increase in segmental lordosis was sustained in the patients with expandable interbody devices but not in patients with static interbody devices. For patients with a collapsed disc space, MIS-TLIF with an expandable interbody device provided superior and longer-lasting increases in disc height, foraminal height, and index-level segmental lordosis than in comparison with patients with static interbody devices. Using an expandable interbody device improved the Oswestry Disability Index scores more than using a static interbody device, and both disc height and segmental lordosis were correlated with improved clinical outcome. Lumbar MIS-TLIF with expandable or static interbody devices had no effect on overall lumbar lordosis, pelvic parameters, or pelvic incidence–lumbar lordosis mismatch.CONCLUSIONSPerforming MIS-TLIF with an expandable interbody device led to a greater and longer-lasting restoration of disc height, foraminal height, and index-level segmental lordosis than MIS-TLIF with a static interbody device, especially for patients with a collapsed disc space. However, neither technique had any effect on radiographic pelvic parameters.

Download Full-text