Sagittal spinal-pelvic alignment in patients with Crowe type IV developmental dysplasia of the hip

Abstract Background The impact of high dislocated dysplastic hips on spinal-pelvic alignment has not been well described. This study aims to evaluate compensatory spinal radiographic changes and presence of back pain in patients with Crowe type IV developmental dysplasia of the hip (DDH). Methods An observational study was conducted from July 2016 to December 2017, and 49 consecutive patients with Crowe IV DDH were enrolled. Forty-nine sex- and age-matched asymptomatic healthy adults were recruited as the controls. The sacral slope (SS), lumbar lordosis (LL), spino-sacral angle (SSA), C7 tilt (C7T), and sagittal vertical axis (SVA [C7]) were measured on lateral whole spine radiographs. The presence of low back pain and visual analogue scale (VAS) scores were recorded. Results The patients with Crowe IV DDH showed significantly greater SS (47.5 ± 7.5° vs. 40.4 ± 6.7°, p < 0.05), LL (− 63.7 ± 9.2° vs. − 53.3 ± 11.5°, P < 0.05), SSA (141.8° ± 7.2° vs. 130.6 ± 7.9°, p < 0.05), C7T (93.9 ± 3.6° vs. 91.1 ± 3.7°, P < 0.05), and lower SVA(C7) (− 16 mm[− 95–45] vs. 6.4 mm[− 52–47], p < 0.05) compared to the controls. The patients with bilateral Crowe IV DDH also exhibited larger SS, LL, SSA, and C7T and a smaller SVA (C7) than those with unilateral Crowe IV DDH. Sixty-three percent of the patients with Crowe IV DDH reported low back pain. Conclusion The patients with Crowe IV DDH exhibited abnormal spinal-pelvic alignment characterized by anterior pelvic tilt, lumbar hyperlordosis, and a backward-leaning trunk. Bilateral Crowe IV DDH had a greater impact on spinal-pelvic alignment than unilateral Crowe IV DDH.

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Sagittal Spinal-pelvic Alignment in Patients with Crowe Type IV Developmental Dysplasia of the Hip

10.21203/rs.3.rs-19815/v2 ◽

2020 ◽

Author(s):

Peng Ren ◽

Xiangpeng Kong ◽

Wei Chai ◽

Yan Wang

Keyword(s):

Back Pain ◽

Vertical Axis ◽

Developmental Dysplasia ◽

Sacral Slope ◽

Sagittal Vertical Axis ◽

Type Iv ◽

Anterior Pelvic Tilt ◽

Whole Spine ◽

The Impact ◽

Dysplasia Of The Hip

Abstract Background: The impact of high dislocated dysplastic hips on spinal-pelvic alignment has not been well described. This study aims to evaluate compensatory spinal radiographic changes and presence of back pain in patients with Crowe type IV developmental dysplasia of the hip (DDH).Methods: An observational study was conducted from July 2016 to December 2017, and 49 consecutive patients with Crowe IV DDH were enrolled. Forty-nine sex- and age-matched asymptomatic healthy adults were recruited as the controls. The sacral slope (SS), lumbar lordosis (LL), spino-sacral angle (SSA), C7 tilt (C7T), and sagittal vertical axis (SVA[C7]) were measured on lateral whole spine radiographs. The presence of low back pain (LBP) and visual analogue scale (VAS) scores were recorded. Results: The patients with Crowe IV DDH showed significantly greater SS (47.5±7.5° vs. 40.4±6.7°, p<0.05), LL (-63.7±9.2° vs. -53.3±11.5°, P<0.05), SSA (141.8°±7.2° vs. 130.6±7.9°, p<0.05), C7T (93.9±3.6° vs. 91.1±3.7°, P<0.05), and lower SVA(C7) (-16mm[-95-45] vs. 6.4mm[-52-47], p<0.05) compared to the controls. The patients with bilateral Crowe IV DDH also exhibited larger SS, LL, SSA, and C7T and a smaller SVA (C7) than those with unilateral Crowe IV DDH. Sixty-three percent of the patients with Crowe IV DDH reported LBP.Conclusion: The patients with Crowe IV DDH exhibited abnormal spinal-pelvic alignment characterized by anterior pelvic tilt, lumbar hyperlordosis, and a backward-leaning trunk. Bilateral Crowe IV DDH had a greater impact on spinal-pelvic alignment than unilateral Crowe IV DDH.

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Sagittal Spinal-pelvic Alignment in Patients with Crowe Type IV Developmental Dysplasia of the Hip

10.21203/rs.3.rs-19815/v1 ◽

2020 ◽

Author(s):

Peng Ren ◽

Xiangpeng Kong ◽

Wei Chai ◽

Yan Wang

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Developmental Dysplasia ◽

Lower Limbs ◽

Control Group ◽

Sacral Slope ◽

Low Back ◽

Compensatory Mechanisms ◽

Type Iv ◽

Dysplasia Of The Hip

Abstract Background The compensatory mechanisms of the spine, pelvis, and lower limbs are essential to maintaining an upright posture. The effect of a high dislocated dysplastic hip on spinal-pelvic alignment has not been well described. The aim of this study was to investigate the sagittal spinal-pelvic alignment in patients with Crowe type IV developmental dysplasia of the hip(DDH). Methods A prospective study was conducted from July 2016 to December 2017, and 49 consecutive patients with unilateral or bilateral high dislocated dysplastic hips were enrolled. Forty-nine sex- and age-matched asymptomatic healthy adults were also recruited as a control group. The sacral slope (SS), lumbar lordosis (LL), spino-sacral angle (SSA), C7 tilt (C7T), and sagittal vertical axis (SVA[C7])were measured on lateral whole spine radiographs. The presence of low back pain and visual analogue scale (VAS) scores were recorded. Results Patients with high dislocated dysplastic hips showed significantly greater SS(47.5±7.5° vs. 40.4±6.7°, p<0.001), LL(-63.7±9.2° vs. -53.3±11.5°, P<0.001), SSA(141.8°±7.2° vs. 130.6±7.9°, p<0.001), C7T(93.9±3.6° vs. 91.1±3.7°, P<0.001), and lower SVA(C7) (-16mm[-95-45] vs. 6.4mm[-52-47], p<0.001) compared to normal controls. Patients with bilateral high dislocated dysplastic hips also exhibited larger SS, LL, SSA, and C7T and a smaller SVA(C7) than those of patients with unilateral hip dysplasia. 63.2% of the patients with high dislocated dysplastic hips reported low back pain. Conclusion Patients with Crowe type IV DDH exhibited abnormal spinal-pelvic alignment characterized by anterior pelvic tilt, lumbar hyperlordosis, and a backward-leaning trunk. Bilateral dislocated dysplastic hips had a greater impact on spinal-pelvic alignment than unilateral dislocated dysplastic hips.

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Analysis of Coronal And Sagittal Spinopelvic Parameters In Developmental Dysplasia of The Hip

10.21203/rs.3.rs-1209847/v1 ◽

2022 ◽

Author(s):

Guangyang Zhang ◽

Mufan Li ◽

Hang Qian ◽

Xu Wang ◽

Xiaoqian Dang ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Scoring System ◽

Oswestry Disability Index ◽

Pearson Correlation ◽

Developmental Dysplasia ◽

Low Back ◽

Spinopelvic Parameters ◽

Pelvic Radiograph ◽

Dysplasia Of The Hip

Abstract Background: The observational study aimed to investigate the change and correlations of the spinopelvic parameters as well as the relationships with the related symptoms in unilateral developmental dysplasia of the hip (DDH) patients. Methods: The clinical data of 22 unilateral DDH patients and 20 healthy volunteers were collected from 2016 to 2021. All patients and volunteers were taken the antero-posterior pelvic radiograph and the frontal and lateral radiography of the whole spine as a routine examination. And the clinical symptoms, signs and functions were measured according to Oswestry Disability Index and Low Back Pain Scoring System. Then the t test and Pearson correlation were used to analyze the data. Results: The Cobb(8.68±6.21°), L3(4.79±5.47°), CB(1.65±1.57cm), PT(15.02±9.55°) and TLK (7.69±6.66°) were significantly larger in the DDH patients, whereas LL(37.41±17.17°) were significantly smaller (P＜0.05). As for the coronal spinopelvic parameters, CB was found to be associated with L3 (R=0.58, P＜0.01). Of the sagittal spinopelvic parameters, SS was found to be associated with LL (R=0.48, P=0.02), and TLK was found to be related to ST and TK, respectively (R=0.49, P=0.02; R=-0.45, P=0.04). In terms of relations between the spinal and pelvic parameters, PI were found to be related to the SS (R=0.58, P＜0.01). An analysis of relations revealed a correlation between the Oswestry Disability Index and Cobb(R=0.59, P＜0.01), PT(R=0.49, P=0.02), TK(R=-0.46, P=0.03) and TLK(R=0.44, P=0.04). Furthermore, an analysis of relations revealed a correlation between Low Back Pain Scoring System and Cobb (R=-0.44, P=0.04), L3(R=-0.53, P=0.01), PT (R=-0.44, P=0.04), TK(R=0.46, P=0.03) and TLK(R=-0.43, P=0.05). Conclusion: The parameters are related to each other and compensate each other to maintain the balance of the coronal and sagittal planes of the spine. In addition, the change of some parameters is closely related to the quality of life of the patients, and can provide some clues for the clinical diagnosis and treatment of DDH.

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Efficacy of Integrating Cervical Posture Correction With Lumbar Stabilization Exercises for Mechanical Low Back Pain: A Randomized Blinded Clinical Trial

Journal of Applied Biomechanics ◽

10.1123/jab.2020-0005 ◽

2020 ◽

pp. 1-9

Author(s):

Aliaa M. Elabd ◽

Salah-Eldin B. Rasslan ◽

Haytham M Elhafez ◽

Omar M. Elabd ◽

Mohamed A. Behiry ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Vertical Axis ◽

Low Back ◽

Sagittal Vertical Axis ◽

Significant Group ◽

Lumbar Stabilization ◽

Group A ◽

Craniovertebral Angle ◽

Cervical Posture

Although current lumbar stabilization exercises are beneficial for chronic mechanical low back pain, further research is recommended focusing on global spinal alignment normalization. This randomized, controlled, blinded trial was conducted to determine the effects of adding cervical posture correction to lumber stabilization on chronic mechanical low back pain. Fifty adult patients (24 males) with chronic mechanical low back pain and forward head posture received 12 weeks treatment of either both programs (group A) or lumbar stabilization (group B). The primary outcome was back pain. The secondary outcomes included the craniovertebral angle, Oswestry Disability Index, C7-S1 sagittal vertical axis, and sagittal intervertebral movements. The multivariate analysis of variance indicated a significant group-by-time interaction (P = .001, partial η2 = .609). Pain, disability, C7-S1 sagittal vertical axis, and l2-l3 intervertebral rotation were reduced in group A more than B (P = .008, .001, .025, and .001). Craniovertebral angle was increased in A when compared to B (P = .001). However, there were no significant group-by-time interactions for other intervertebral movements. Within-group comparisons were significant for all outcomes except for craniovertebral angle within patients in the control group. Adding cervical posture correction with lumber stabilization for management of chronic low back pain seemed to have better effects than the application of a stabilization program only.

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Relationship of sagittal spinal alignment with low back pain and physical performance in the general population

Scientific Reports ◽

10.1038/s41598-021-00116-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Kazuhiro Hira ◽

Keiji Nagata ◽

Hiroshi Hashizume ◽

Yoshiki Asai ◽

Hiroyuki Oka ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Physical Performance ◽

Linear Regression Analysis ◽

Vertical Axis ◽

Low Back ◽

Spinal Alignment ◽

Sagittal Vertical Axis ◽

Sagittal Spinal Alignment ◽

Relationship Of

AbstractStudies have suggested a relationship between sagittal spinal malalignment and low back pain (LBP). The current study investigated the relationship of spinal alignment with LBP and physical performance in 1491 individuals who attended the second follow-up visit of the Wakayama Spine Study. The sagittal vertical axis at C7 (C7 SVA) was measured by a spine surgeon. The occurrence of LBP within one month, pain intensity, Oswestry Disability Index (ODI), and physical performance (grip strength, 6-m walking time, chair stand test, one-leg standing test) were also evaluated. LBP in the previous month was determined using ODI, and indicators of physical performance were measured. The mean C7 SVA was 11.0 ± 42.7 mm and was significantly greater in older participants (p < 0.001). LBP was more prevalent in participants with a greater C7 SVA (< 40 mm, 35.7%; 40–95 mm, 47.3%; ≥ 95 mm, 59.4%; p < 0.001) and those with a higher ODI score (10.0%, 17.5%, and 29.4%, respectively; p < 0.001). Physical performance significantly decreased in participants with a greater C7 SVA (p < 0.001). Multiple linear regression analysis revealed that LBP and physical performance were significantly associated with C7 SVA (p < 0.001). Thus, sagittal spinal malalignment may lead to LBP and decreased physical performance.

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Relationship of Sagittal Spinal Alignment With Low Back Pain And Physical Performance In A Population-Based Japanese Cohort: The Wakayama Spine Study

10.21203/rs.3.rs-576310/v1 ◽

2021 ◽

Author(s):

Kazuhiro Hira ◽

Keiji Nagata ◽

Hiroshi Hashizume ◽

Yoshiki Asai ◽

Hiroyuki Oka ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Physical Performance ◽

Linear Regression Analysis ◽

Vertical Axis ◽

Low Back ◽

Spinal Alignment ◽

Sagittal Vertical Axis ◽

Sagittal Spinal Alignment ◽

Sagittal Malalignment

Abstract Studies have suggested a relationship between sagittal malalignment of the spine and low back pain (LBP). The Wakayama Spine Study investigated the relationship between spinal alignment, LBP, and physical performance in 1491 individuals who attended a second follow-up visit as part of the ROAD Study and for whom standing lateral spinal radiographs were available. The sagittal vertical axis at C7 (C7 SVA) was measured by a spinal surgeon. LBP in the previous month was determined by the Oswestry Disability Index (ODI), and indicators of physical performance were measured. The mean C7 SVA was 11.0 ± 42.7 mm and significantly greater in older subjects (p<0.001). Based on their C7 SVA, the subjects were divided into small (<40 mm), intermediate (40≤SVA<95 mm), and large (≥95 mm) groups. LBP was more prevalent in subjects with a larger C7 SVA (small, 35.7%; intermediate, 47.3%; large, 59.4%; p<0.001) and those with a higher ODI score (10.0%, 17.5%, and 29.4%, respectively; p<0.001). Physical performance was significantly decreased in subjects with a larger C7 SVA (p<0.001). Multiple linear regression analysis revealed that LBP and physical performance were significantly associated with C7 SVA (p<0.001). Thus, sagittal malalignment of the spine may lead to LBP and decreased physical performance.

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