MODIFICATION OF THE SPINOPELVIC PARAMETERS WITH SURGICAL POSITIONING AND THE ROLE OF THE HIP

ABSTRACT Post-operative lumbar pain is related to alterations in the sagittal and spinopelvic parameters. A lumbar fusion that fails to maintain, or that worsens the physiological lordosis alters the sagittal balance. Objective: To analyze spinopelvic variation in different surgical positions. Methods: A prospective, analytical and comparative study of spinograms, lumbosacral radiographs in the surgical position over a 4-pole quadratus lumborum, and lumbosacral radiographs with quadratus lumborum and support in the knees. A sample of 129 patients, of both sexes, aged between 18 and 60 years, and presenting with lower back pain. Lumbar Lordosis (LL), Pelvic Tilt (PT), Pelvic Incidence (PI) and Sacral Slope (SS) were measured. Results: PI was the most stable parameter. With quadratus lumborum, a slight increase in PT, a decrease in SS and a significant reduction in LL were found. With quadratus lumborum and support in the knees, a decrease in PT and a slight increase in SS were found, while the LL value remained similar to that of the spinogram. Conclusion: The intraoperative position with hip flexion of between 40° and 45° over quadratus lumborum reduced LL to 10.52° in men and 16.21° in women, increased PT, and decreased SS. The intraoperative position with hip flexion of between 0° and 10° showed the same values as the reference spinogram. Level of Evidence II; Prospective comparative study.

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3D Biometrics for Hindfoot Alignment Using Weightbearing Computed Tomography

Foot & Ankle International ◽

10.1177/1071100719835492 ◽

2019 ◽

Vol 40 (6) ◽

pp. 720-726 ◽

Cited By ~ 24

Author(s):

Jian Zhong Zhang ◽

François Lintz ◽

Alessio Bernasconi ◽

Shu Zhang ◽

Keyword(s):

Computed Tomography ◽

Comparative Study ◽

Interobserver Reliability ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Level Of Evidence ◽

Hindfoot Alignment ◽

Mean Values ◽

Intraclass Correlation Coefficients ◽

Prospective Comparative Study

Background: Weightbearing computed tomography (WBCT) is a useful tool for the assessment of hindfoot alignment (HA). Foot ankle offset (FAO) is a recently introduced parameter, determined from WBCT images using semiautomatic software. The aim of this study was to determine the clinical relevance and reproducibility of FAO for the evaluation of HA. Methods: A prospective comparative study was performed on consecutive patients requiring bilateral WBCT between September 2017 and April 2018. Based on the clinical assessment of HA, patients were divided into 3 groups: (1) normal alignment group (G1), (2) valgus (G2), and (3) varus (G3). FAO and long axial view (HACT) were measured on WBCT images, and the groups were compared. The reproducibility of FAO and HACT was determined through intraclass correlation coefficients (ICCs). Regression analysis was performed to investigate the correlation between the 2 methods. Overall, 249 feet (126 patients) were included (G1 = 115, G2 = 78, and G3 = 56 feet). Results: The mean values for FAO and HACT were 1.2% ± 2.8% and 3.9 ± 3.1, respectively, in G1; 8.1% ± 3.7% and 9.7 ± 4.9 in G2; and −6.6% ± 4.8% and −8.2 ± 6.6 in G3. Intra- and interobserver reliability was 0.987 and 0.988 for FAO and 0.949 and 0.949 for HACT, respectively. There was a good linear correlation between HACT and FAO ( R2 = 0.744), with a regression slope of 1.064. Conclusions: WBCT was a useful method for the characterization of HA. FAO was reproducible and correlated well with physical examination. Level of Evidence: Level II, prospective comparative study.

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Spinopelvic Parameters Do Not Predict the Sagittal Orientation of the Acetabulum

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120957420 ◽

2020 ◽

Vol 8 (10) ◽

pp. 232596712095742

Author(s):

Munif Hatem ◽

Scott J. Nimmons ◽

Anthony Nicholas Khoury ◽

Hal David Martin

Keyword(s):

Pelvic Incidence ◽

Sagittal Plane ◽

Cross Sectional Study ◽

Sacral Slope ◽

Spinopelvic Parameters ◽

Level Of Evidence ◽

Cross Sectional ◽

Spinopelvic Parameter ◽

Magnetic Resonance Arthrogram ◽

Sagittal Orientation

Background: The orientation of the acetabulum has a fundamental role in impingement and instability of the hip, and the spinopelvic parameters are thought to predict the sagittal orientation of the acetabulum (SOA). However, similar to the acetabular version (axial orientation) and inclination (coronal orientation), the cephalic or caudal orientation of the acetabulum in the sagittal plane, or SOA, may primarily be an intrinsic feature of the acetabulum itself. Purpose: To determine whether the spinopelvic parameters predict the sagittal orientation of the acetabulum in individuals without lumbar deformity. Study Design: Cross-sectional study; Level of evidence, 4. Methods: A retrospective analysis was performed in 89 patients (94 hips; 62 female, 27 male; mean ± SD age, 45.9 ± 15.4 years) without lumbosacral deformity who underwent magnetic resonance arthrogram (MRA) for assessment of hip pain. The SOA was determined in the sagittal cut MRA. A line was drawn at the distal limit of the anterior and posterior acetabular horns longitudinally to the transverse ligament, and the angle between this line and the axial plane represented the SOA. The sacral slope, pelvic incidence, and spinopelvic tilt were determined using a 3-dimensional cursor and the axial, sagittal, and coronal cuts. All MRA studies were performed with the patient in the supine position. Results: The SOA had a mean ± SD cephalic orientation of 18° ± 6.6°. No significant correlation was observed between the SOA and the sacral slope ( r = –0.03; P = .77). A weak correlation was observed between the SOA and the pelvic incidence ( r = 0.22; P = .03) and between the SOA and the spinopelvic tilt ( r = 0.41; P < .01). Conclusion: The SOA cannot be presumed based on the spinopelvic parameter. Similar to the well-known parameters to assess the axial and coronal orientation of the acetabulum, the assessment of the SOA demands acetabular-specific parameters. Additional studies are necessary to assess the SOA in asymptomatic hips, including disparities between genders. Clinically significant values for abnormal SOA of the acetabulum remain to be defined.

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Evaluation of the role of hyperbaric oxygen therapy in the treatment of diabetic foot ulcers: a prospective comparative study

Hellenic Journal of Surgery ◽

10.1007/s13126-016-0321-y ◽

2016 ◽

Vol 88 (4) ◽

pp. 219-224 ◽

Cited By ~ 2

Author(s):

Chandrakant Munjewar ◽

Ishaq Nabi ◽

Santosh Gautam ◽

Neelam Ahirwar ◽

Poras Chaudhary ◽

...

Keyword(s):

Comparative Study ◽

Hyperbaric Oxygen ◽

Diabetic Foot ◽

Hyperbaric Oxygen Therapy ◽

Oxygen Therapy ◽

Foot Ulcers ◽

Diabetic Foot Ulcers ◽

Prospective Comparative Study

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A prospective comparative study of the role of CT and MRI-MRCP in the preoperative assessment of obstructive jaundice and their intraoperative corroboration

Hellenic Journal of Surgery ◽

10.1007/s13126-014-0088-y ◽

2014 ◽

Vol 86 (1) ◽

pp. 19-25

Author(s):

Meenakshi Rao ◽

Poras Chaudhary ◽

Mohinder P. Arora ◽

Umesh C. Garga

Keyword(s):

Obstructive Jaundice ◽

Comparative Study ◽

Preoperative Assessment ◽

Prospective Comparative Study ◽

Ct And Mri

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Prospective comparative study assessing role of ultrasound versus thermography in breast cancer detection

Breast Disease ◽

10.3233/bd-180321 ◽

2018 ◽

Vol 37 (4) ◽

pp. 191-196 ◽

Cited By ~ 3

Author(s):

A. Alikhassi ◽

Sh. F. Hamidpour ◽

M. Firouzmand ◽

M. Navid ◽

M. Eghbal

Keyword(s):

Breast Cancer ◽

Comparative Study ◽

Cancer Detection ◽

Breast Cancer Detection ◽

Prospective Comparative Study

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Spine, Pelvis and Hip Kinematics—Characterizing the Axial Plane in Healthy and Osteoarthritic Hips

Applied Sciences ◽

10.3390/app11219921 ◽

2021 ◽

Vol 11 (21) ◽

pp. 9921

Author(s):

Danilo S. Catelli ◽

Brendan Cotter ◽

Mario Lamontagne ◽

George Grammatopoulos

Keyword(s):

Pelvic Tilt ◽

Hip Osteoarthritis ◽

Axial Plane ◽

Sacral Slope ◽

Healthy Individuals ◽

Spinopelvic Parameters ◽

Dynamic Motion ◽

Hip Disease ◽

Hip Kinematics ◽

Hip Flexion

Abnormal spinopelvic movements are associated with inferior outcomes following total hip arthroplasty (THA). This study aims to (1) characterize the agreement between dynamic motion and radiographic sagittal assessments of the spine, pelvis, and hip; (2) determine the effect of hip osteoarthritis (OA) on kinematics by comparing healthy individuals with pre-THA patients suffering from uni- or bilateral hip OA. Twenty-four OA patients pre-THA and eight healthy controls underwent lateral spinopelvic radiographs in standing and seated bend-and-reach (SBR) positions. Lumbar-lordosis (LL), sacral-slope (SS), and pelvic–femoral (PFA) angles were measured in both positions, and the differences (Δ) between SBR and standing were computed to assess spine flexion (SF), pelvic tilt (PT), and hip flexion (HF), respectively. Dynamic SBR and seated maximal trunk rotation (STR) tasks were performed at the biomechanics laboratory. Peak sagittal and axial kinematics for spine, pelvis, and hip, and range of motion (ROM), were calculated for SBR and STR. Radiograph readings correlated with sagittal kinematics during SBR for ΔLL and SFmax (r = 0.66, p < 0.001), ΔPT and PTmax (r = 0.44, p = 0.014), and ΔPFA and HFmax (r = 0.70, p < 0.001), with a satisfactory agreement in Bland–Altman analyses. Sagittal SBR spinal (r = 0.33, p = 0.022) and pelvic (r =0.35, p = 0.018) flexions correlated with the axial STR rotations. All axial spinopelvic parameters were different between the OA patients and controls, with the latter exhibiting significantly greater mobility and less variability. Bilaterally affected patients exhibited lower peak and ROM compared to controls. The biomechanics laboratory performed reliable assessments of spinopelvic and hip characteristics, in which the axial plane can be included. The sagittal and axial pelvic kinematics correlate, illustrating that pelvic rotation abnormalities are likely also contributing to the inferior outcomes seen in patients with abnormal spinopelvic flexion characteristics. Axial rotations of the pelvis and spine were least in patients with bilateral hip disease, further emphasizing the importance of the hip–pelvic–spine interaction.

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ARE SCORING SYSTEMS USEFUL FOR PREDICTING RESULTS OF TREATMENT FOR CLUBFOOT USING THE PONSETI METHOD?

Acta Ortopédica Brasileira ◽

10.1590/1413-785220192701189801 ◽

2019 ◽

Vol 27 (1) ◽

pp. 8-11 ◽

Cited By ~ 1

Author(s):

Jiři Jochymek ◽

Tereza Peterková

Keyword(s):

Comparative Study ◽

Treatment Outcomes ◽

Clinical Evaluation ◽

Scoring Systems ◽

Ponseti Method ◽

Therapy Outcomes ◽

Level Of Evidence ◽

Results Of Treatment ◽

Clinical Scoring ◽

Prospective Comparative Study

ABSTRACT Objective: The aim of this study was to verify whether the Pirani and Dimeglio clinical scoring systems could predict results of Ponseti therapy. Methods: Forty-seven patients with clubfoot deformities treated with the Ponseti method were enrolled in the study. Clinical evaluation with the Pirani and Dimeglio scoring systems was performed before the treatment and after the second cast fixation. The number of fixations, necessity for achillotomy, and recurrence of the deformity were determined as parameters of the therapy results. The patients were divided into three groups according to the severity of their deformities, and the groups were compared with one another. Results: Clubfoot correction required an average of 6.8 casts. Five patients developed a recurrence. Comparing the therapy outcomes among the groups, we found statistically significant differences in the Pirani classification after the second fixation (the number of casts [p =.003] and necessity to perform an achillotomy [p =.014]) and in the Dimeglio scores before therapy (number of casts [p =.034]) and after the second fixation (number of relapses [p =.032]). Conclusion: Although clinical scoring systems showed some dependence on the parameters of treatment outcomes, their predictive function can be used in only a limited way. Level of evidence II, Prospective comparative study.

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EFFECTS OF SAGITTAL BALANCE DIFFERENCES ON SPONDYLOLISTHESIS

Acta Ortopédica Brasileira ◽

10.1590/1413-785220192702205665 ◽

2019 ◽

Vol 27 (2) ◽

pp. 120-123

Author(s):

Zeliha Cosgun ◽

Emine Dagistan ◽

Yasar Dagistan

Keyword(s):

Sagittal Balance ◽

Lumbar Lordosis ◽

Pelvic Tilt ◽

Normal Population ◽

Sacral Slope ◽

Routine Practice ◽

Compensatory Mechanism ◽

Spinopelvic Parameters ◽

Level Of Evidence ◽

Stage 1

ABSTRACT Objectives: This study aimed to compare the lumbar lordosis (LL) and spinopelvic parameters of patients with stage 1–2 spondylolisthesis to those of the normal population and demonstrate the importance of these parameters in sagittal balance. Methods: The lumbosacral parameters on the lateral radiographs of a total of 125 patients were retrospectively compared. Lumbosacral parameters including pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis angle (LLA), L5 incidence (L5I), L5 slope (L5S), and sacral table angle (STA) were compared between groups. Results: Comparison of the parameters between groups revealed no sex-based differences (p > 0.05). Conclusions: Abnormal sagittal spinopelvic parameters are commonly examined for their effects on the development of spondylolisthesis and should be used in routine practice. We found that the low SS values in our study, unlike those of other similar studies, may be a compensatory mechanism developed to reduce pain and maintain sagittal balance. Level of Evidence II; retrospective study.

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