Coronal imbalance in degenerative lumbar scoliosis

2016 ◽  
Vol 98-B (9) ◽  
pp. 1227-1233 ◽  
Author(s):  
H. Bao ◽  
P. Yan ◽  
Y. Qiu ◽  
Z. Liu ◽  
F. Zhu
Keyword(s):  
Degenerative Lumbar Scoliosis ◽  
Lumbar Scoliosis ◽  
Coronal Imbalance

scholarly journals Orientation of L4 coronal tilt relative to C7 plumb line as a predictor for postoperative coronal imbalance in patients with degenerative lumbar scoliosis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Jiandang Zhang ◽  
Zheng Wang ◽  
Pengfei Chi ◽  
Cheng Chi
Keyword(s):  
Deformity Correction ◽  
Plumb Line ◽  
Lower Amount ◽  
Consecutive Series ◽  
Degenerative Lumbar Scoliosis ◽  
Lumbar Scoliosis ◽  
Coronal Imbalance ◽  
Correction Surgery ◽  
The Impact ◽  
The Relationship

Abstract The study design is case–control. To evaluate the impact of preoperative coronal patterns based on the relationship between orientation of L4 coronal tilt and C7 plumb line on immediate postoperative coronal imbalance in degenerative lumbar scoliosis (DLS) patients. Although lumbosacral fractional curve has been long stressed in correction surgery of DLS, there is paucity of literature focusing on preoperative coronal pattern based on the relationship between orientation of L4 coronal tilt and C7 plumb line and its impact on immediate postoperative coronal imbalance in DLS patients. A consecutive series of DLS patients who underwent deformity correction surgery via posterior-only approach were reviewed. According to the relationship between orientation of L4 coronal tilt and C7 plumb line preoperatively, a total of 77 DLS patients who underwent posterior spinal corrective surgery were classified into: 1. Coronal consistency pattern, L4 coronally tilts toward C7 plumb line; 2. Coronal opposition pattern, L4 coronally tilts opposite C7 plumb line. Coronal imbalance was defined as global coronal malalignment (GCM) on either side more than or equal to 20 mm. Whole-spine standing radiographs of both pattern groups were assessed preoperatively and postoperatively. There were 37 patients with coronal consistency pattern and 40 patients with coronal opposition pattern. Compared to patients with coronal opposition pattern, patients with coronal consistency pattern had significantly higher postoperative GCM (P = 0.028), lower amount of GCM correction (P = 0.013) and higher incidence of postoperative coronal imbalance (P = 0.001); further logistic regression analysis revealed coronal consistency pattern was associated with increased odds of postoperative coronal imbalance (odds ratio: 5.981; 95% confidence interval 2.029–17.633; P = 0.001). DLS patients with preoperative coronal consistency pattern carried greater risk for immediate postoperative coronal imbalance following posterior long correction surgery. Level of evidence 3

scholarly journals Risk Factors for Immediate Postoperative Coronal Imbalance in Degenerative Lumbar Scoliosis Patients Fused to Pelvis

2020 ◽  
pp. 219256822091764
Author(s):  
Jiandang Zhang ◽  
Zheng Wang ◽  
Pengfei Chi
Keyword(s):  
Risk Factors ◽  
Cobb Angle ◽  
Deformity Correction ◽  
Lower Amount ◽  
Degenerative Lumbar Scoliosis ◽  
Retrospective Case ◽  
Lumbar Scoliosis ◽  
Coronal Imbalance ◽  
Type C ◽  
Upper Instrumented Vertebra

Study Design: Retrospective case-control radiographic study. Objective: To identify risk factors for immediate postoperative coronal imbalance in degenerative lumbar scoliosis (DLS) patients fused to pelvis. Methods: A total of 71 DLS patients treated with deformity correction surgery were reviewed. Measurements included coronal parameters such as global coronal malalignment (GCM), major Cobb angle, L4/L5 coronal tilt and sagittal parameters. Based on the orientation of L4 coronal tilt relative to C7 plumb line (PL) preoperatively, coronal patterns were subdivided into (1) consistency pattern, L4 coronally tilts toward C7 PL, and (2) opposition pattern, L4 coronally tilts opposite C7 PL; the proportion of these 2 patterns was analyzed. Also, the proportion of type C and surgical factors were recorded. According to postoperative GCM, patients were divided into imbalanced group and balanced group. Results: Compared with the balanced group, the imbalanced group had a larger proportion of preoperative consistency pattern (79.17% vs 40.43%, P = .002), larger proportion of type C (29.17% vs 8.51%, P = .023), and lower amount of GCM correction (−4.92 ± 24.25 vs 14.52 ± 19.49 mm, P < .001). There were no significant intergroup differences regarding preoperative and postoperative major Cobb angle, preoperative and postoperative L4 or L5 coronal tilt, major Cobb correction, the amounts of correction of coronal tilt of L4/L5, osteotomy levels, osteotomy grades, instrumented levels, levels of interbody fusion, and distribution of upper instrumented vertebra. Conclusions: In addition to known risk factors such as type C, preoperative coronal consistency pattern might be a new risk factor for postoperative coronal imbalance in DLS patients fused to pelvis.

Impact of shift to the concave side of the C7-center sacral vertical line on de novo degenerative lumbar scoliosis progression in elderly volunteers

2020 ◽  
Vol 25 (1) ◽  
pp. 82-88
Author(s):  
Hiroki Ushirozako ◽  
Go Yoshida ◽  
Tomohiko Hasegawa ◽  
Yu Yamato ◽  
Tatsuya Yasuda ◽  
...  
Keyword(s):  
De Novo ◽  
Concave Side ◽  
Vertical Line ◽  
Degenerative Lumbar Scoliosis ◽  
Lumbar Scoliosis ◽  
Scoliosis Progression

scholarly journals Evaluation of Lumbar Stiffness after Long-Level Fusion  for Degenerative Lumbar Scoliosis in Chinese population

2020 ◽  
Author(s):  
Xinling Zhang ◽  
Lei Yuan ◽  
Yan Zeng ◽  
Zhongqiang Chen ◽  
Weishi Li ◽  
...  
Keyword(s):  
Internal Consistency ◽  
Chinese Population ◽  
Chinese Patients ◽  
Personal Hygiene ◽  
Degenerative Lumbar Scoliosis ◽  
Lumbar Scoliosis ◽  
Patient Reported ◽  
Elderly Chinese ◽  
The Impact ◽  
Level Fusion

Abstract Study Design: a retrospective study.Summary of Background Data: Long-level spinal instrumented fusion for DLS by intention eliminated spinal motion in an attempt to alleviate pain, improve deformity, and reduce disability. However, this surgery considerably impaired performance of activities of daily living (ADL) due to the resulting stiffness. The lumbar stiffness disability index (LSDI) was a validated measure of the effect of lumbar stiffness on functional activity, however, which might not be fully applicable to elderly Chinese population because of their several special lifestyles.Objective: To evaluate the lumbar stiffness in patients with degenerative lumbar scoliosis (DLS) after long-level fusion by Chinese-LSDI (C-LSDI).Methods: 129 DLS patients underwent long-level (≧4 levels) fusion surgery with at least one-year follow-up were included. The C-LSDI was designed by modifying LSDI and Korean-LSDI (K-LSDI) considering elderly Chinese lifestyles, and the patient-reported outcome questionnaire measuring the impact of lumbar stiffness on functional abilities in elderly Chinese with DLS was assessed for internal consistency and retest repeatability.Results: All patients showed increased lumbar stiffness with significantly improvement in pain and deformity postoperatively, and for items of performing personal hygiene after toileting and getting out of a car, people performed more inconvenient with increasing fixed levels. Compared with LSDI and K-LSDI, the C-LSDI demonstrated high internal consistency (Cronbach’s alpha=0.902) and retest reliability (ICC=0.904) in the elderly Chinese population. Conclusion: This study demonstrated that the C-LSDI questionnaire was a reliable and valid instrument for assessing functional limitations due to lumbar stiffness among elderly Chinese patients with DLS after long-level fusion. Although the effects of stiffness did trend toward greater impacts among patients underwent longer fusions, most patients were satisfied with trade-offs of function and pain relief in exchange for perceived increases in lumbar stiffness.

Comparison between oblique lumbar interbody fusion and posterior lumbar interbody fusion in the treatment of degenerative lumbar scoliosis: a retrospective clinical study

2020 ◽  
Author(s):  
chaojun Xu ◽  
Yingjie HAO ◽  
Lei YU ◽  
Guangduo ZHU ◽  
Zhinan REN ◽  
...  
Keyword(s):  
Cobb Angle ◽  
Interbody Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Length Of Hospital Stay ◽  
Vertical Axis ◽  
Degenerative Lumbar Scoliosis ◽  
Lumbar Interbody Fusion ◽  
Lumbar Scoliosis ◽  
Significant Difference ◽  
Oblique Lumbar Interbody Fusion

Abstract Backgroud Few studies compared radiographic and clinical outcomes between oblique lumbar interbody fusion and posterior lumbar interbody fusion in degenerative lumbar scoliosis. Methods This study retrospectively analyzed the case data of 40 patients with degenerative lumbar scoliosis in our hospital from July 2016 to October 2018. Among which,19 cases underwent oblique lumbar Interbody fusion(OLIF group) and 21 cases underwent posterior lumbar interbody fusion(PLIF group). The duration of the operation, volume of intraoperative hemorrhage, incision length, bed rest time, length of hospital stay, and complications were recorded for all patients. The clinical effects of 40 patients were evaluated by VAS for back pain and Oswestry Disability Index (ODI) and The radiographic parameters were evaluated using the lumbar scoliosis Cobb angle, sagittal vertical axis(SVA), coronal vertical axis(CVA), lumbar lordosis(LL), pelvic tilt(PT), sacral slope(SS), and Disc height(DH). Results The duration of the operation, the volume of intraoperative hemorrhage, incision length, bed rest time, length of hospital stay of the OLIF group were shorter than the PLIF group( P ＜ 0.05 ). The VAS scores for back pain, the ODI of the two groups were significantly decreased, which compared with the preoperative( P ＜ 0.05 )，which in OLIF group was significantly more decreased than in PLIF( P ＜ 0.05 ) at 7 days and 3 months postoperatively, but at the last follow-up there were no significant difference between the two groups( P ＞ 0.05 ); The lumbar scoliosis Cobb angle, SVA, CVA, PT, LL, SS were significantly improved postoperatively( P ＜ 0.05 ). The OLIF group showed higher DH, smaller Cobb angle, and greater LL than the PLIF group at any time point( P ＜ 0.05 ). but there were no significant difference in SVA, CVA, PT and SS between the two groups at any follow-up points( P ＞ 0.05 ). The overall complication rate was slightly higher in the PLIF group（47.62%）than in the OLIF group（26.32%）without significant difference(x 2 =1.931, P =0.165). But the incidence of major complications in the PLIF group was significantly higher than that in the OLIF group (Fisher, P =0.026). Conclusion OLIF provides an alternative minimally invasive treatment for DLS, which compared with PLIF. It has the characteristics of a small incision, rapid recovery, fewer complications related to the surgical approach, and satisfactory orthopedics. Keywords : Minimally invasive, Oblique lumbar interbody fusion, Degenerative adult lumbar scoliosis , Posterior lumbar interbody fusion

Comparison of Short Fusion versus Long Fusion for Degenerative Lumbar Scoliosis

2007 ◽  
Vol 42 (6) ◽  
pp. 795 ◽  
Author(s):  
Kyu-Jung Cho ◽  
Se-Il Suk ◽  
Seung-Rim Park ◽  
Jin-Hyok Kim ◽  
Sung-Soo Kim ◽  
...  
Keyword(s):  
Degenerative Lumbar Scoliosis ◽  
Lumbar Scoliosis
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