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

2018 ◽  
Vol 12 (2) ◽  
pp. 325-334 ◽  
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><p>Retrospective observational study.</p></sec><sec><title>Purpose</title><p>We examined change in lumbrosacral spine alignment and low back pain (LBP) following total hip arthroplasty (THA) in patients with severe hip osteoarthritis (OA).</p></sec><sec><title>Overview of Literature</title><p>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.</p></sec><sec><title>Methods</title><p>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.</p></sec><sec><title>Results</title><p>VAS for LBP change from preoperative to final postoperative observation was significantly improved (p &lt;0.05), as was VAS for hip pain (<italic>p</italic>&lt;0.001). RDQ improved significantly (<italic>p</italic>&lt;0.01). All five domains of JOABPEQ were significantly improved (<italic>p</italic>&lt;0.05). In terms of coronal alignment, lumbar scoliosis change from preoperative to last observation was significantly reduced (<italic>p</italic>&lt;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>&lt;0.05). VAS for LBP (<italic>p</italic>&lt;0.05) as well as RDQ (<italic>p</italic>&lt;0.05) were significantly improved only in unilateral OA. Lumbar scoliosis was significantly improved in cases of unilateral OA (<italic>p</italic>&lt;0.05), but alignment did not improve in cases of bilateral OA (<italic>p</italic>=0.29).</p></sec><sec><title>Conclusions</title><p>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.</p></sec>

scholarly journals THA First: Low Back Pain in Patients with Both Hip Osteoarthritis and Lumbar Degenerative Disease is Relieved after Total Hip Arthroplasty

2020 ◽  
Author(s):  
Tianfei Ran ◽  
Song Ke ◽  
Mingrui Lv ◽  
Jie Li ◽  
Xin Song ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Hip Osteoarthritis ◽  
Degenerative Disease ◽  
Low Back ◽  
Lumbar Degenerative Disease ◽  
Total Hip ◽  
Operation Group

Abstract Background: With the aging of population, the number of patients suffering from hip osteoarthritis complicated with lumbar degenerative disease is increasing. Both diseases may require surgery, however, which is first? the sequence of total hip arthroplasty (THA) and lumbar surgery remains controversial. Methods: The data of our hospital, from 2010 to 2019 were retrieved, and a group of patients who had undergone total hip replacement (THA, n = 153) and also suffered from lumbar degenerative diseases were identified. We studied the improvement of hip joint function and the relief of low back pain (LBP), and also discussed the effect of unilateral and bilateral THA on the relief of LBP. Results: The LBP visual analysis scale (VAS) of 153 patients decreased from (4.13 ± 1.37) preoperatively to (1.90 ± 1.44) postoperatively. The average Harris Hip score (HHS) increased from 45.33 ± 13.23 preoperatively to 86.44 ± 7.59 postoperatively of the latest follow-up. According to Japanese Orthopedic Association (JOA) scoring system, the proportion of patients with good response to treatment in the clinical results of these 153 patients reached 93.46%. LBP VAS decreased from 4.18 ± 1.38 preoperatively to 1.95 ± 1.49 postoperatively in unilateral group and from 3.94 ± 1.32 preoperatively to 1.73 ± 1.23 postoperatively in bilateral group respectively. These results showed that the lumbar pain was relieved significantly after surgery. Conclusion: THA can relieve LBP while relieve hip pain and restore hip function. And the relief of LBP and recovery of lumbar function in unilateral operation group were better than those in bilateral operation group. These findings can be helpful to surgeons in making decisions. For patients with both hip disease and lumbar degenerative disease, THA first may bring additional benefits to patients.

Gait Analysis of Patients with Low Back Pain Before and After Surgery

Spine ◽  
1993 ◽  
Vol 18 (11) ◽  
pp. 1451-1455
Author(s):  
Soussan Khodadadeh ◽  
Stephen M. Eisenstein
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Gait Analysis ◽  
Low Back ◽  
Before And After

Microendoscopic Decompression for Lumbar Spinal Stenosis Associated with Adjacent Segment Disease following Lumbar Fusion Surgery: 5-year Follow-up of a Retrospective Case Series

2021 ◽  
Author(s):  
Shizumasa Murata ◽  
Akihito Minamide ◽  
Yukihiro Nakagawa ◽  
Hiroshi Iwasaki ◽  
Hiroshi Taneichi ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Japanese Orthopaedic Association ◽  
Leg Pain ◽  
Adjacent Segment ◽  
Low Back ◽  
Spinal Decompression ◽  
Analog Scale ◽  
Clinically Important Difference ◽  
Lumbar Spinal

Abstract Background and Study Aims Surgical treatment options for lumbar spinal stenosis (LSS) based on adjacent segment disease (ASD) after spinal fusion typically involve decompression, with or without fusion, of the adjacent segment. The clinical benefits of microendoscopic decompression for LSS based on ASD have not yet been fully elucidated. We aimed to investigate the clinical results of microendoscopic spinal decompression surgery for LSS based on ASD. Patients and Methods From 2011 to 2014, consecutive patients who underwent microendoscopic spinal decompression without fusion for LSS based on ASD were enrolled. Data of 32 patients (17 men and 15 women, with a mean age of 70.5 years) were reviewed. Japanese Orthopaedic Association score and low back pain/leg pain visual analog scale score were utilized to measure neurologic and axial pain outcomes, respectively. Additionally, after the surgeries, we analyzed the magnetic resonance imaging (MRI), computed tomography (CT) scans, or radiographs to identify any new instabilities of the decompressed segments or progression of ASD adjacent to the decompressed segments. Results The Japanese Orthopaedic Association recovery rate at the 5-year postoperative visit was 49.2%. The visual analog scale scores for low back pain and leg pain were significantly improved. The minimum clinically important difference for leg pain (decrease by ≥24 mm) and clinically important difference for low back pain (decrease by ≥38 mm) were achieved in 84% (27/32) and 72% (23/32) of cases, respectively. Regarding new instability after microendoscopic decompression, no cases had apparent spinal instability at the decompression segment and adjacent segment to the decompressed segment. Conclusions Microendoscopic spinal decompression is an effective treatment alternative for patients with LSS caused by ASD. The ability to perform neural decompression while maintaining key stabilizing structures minimizes subsequent clinical instability. The substantial clinical and economic benefits of this approach may make it a favorable alternative to performing concurrent fusion in many patients.

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