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Influence of lumbar lordosis restoration on thoracic curve and sagittal position in lumbar degenerative kyphosis patients.
- Source :
-
Spine [Spine (Phila Pa 1976)] 2009 Feb 01; Vol. 34 (3), pp. 280-4. - Publication Year :
- 2009
-
Abstract
- Study Design: A retrospective study.<br />Objectives: To determine postsurgical correlations between thoracic and lumbar sagittal curves in lumbar degenerative kyphosis (LDK) and to determine predictability of spontaneous correction of thoracic curve and sacral angle after surgical restoration of lumbar lordosis and fusion.<br />Summary of Background Data: To our knowledge, there are only a limited number of articles about the relationship between thoracic and lumbar curve in sagittal thoracic compensated LDK.<br />Methods: Retrospective review of 53 consecutive patients treated with combined anterior and posterior spinal arthrodesis. We included patients with sagittal thoracic compensated LDK caused by sagittal imbalance in this study. Total lumbar lordosis, thoracic kyphosis, sacral slope, and C7 plumb line were measured on the pre- and postoperative whole spine lateral views. Postoperative changes in thoracic kyphosis, sacral slope, and C7 plumb line according to the surgical lumbar lordosis restoration were measured and evaluated.<br />Results: The mean preoperative sagittal imbalance by plumb line was 78.3 mm (+/-76.5); this improved to 13.6 mm (+/-25) after surgery (P < 0.0001). Mean lumbar lordosis was 9.4 degrees (+/-19.2) before surgery and increased to 38.4 degrees (+/-13.1) at follow-up (P < 0.0001). Mean thoracic kyphosis was 1.1 degrees (+/-12.7) before surgery and increased to 17.6 degrees (+/-12.2) at follow-up (P < 0.0001). Significant preoperative correlations existed between kyphosis and lordosis (r = 0.772, P < 0.0001) and between lordosis and sacral slope (r = 0.785, P < 0.0001). Postoperative lumbar lordosis is correlated to thoracic kyphosis increase (r = 0.620, P < 0.0001). Postoperative lumbar lordosis is correlated to sacral slope increase (r = 0.722, P < 0.0001).<br />Conclusion: Reciprocal relationship exists between lumbar lordosis and thoracic kyphosis in sagittal thoracic compensated LDK. Surgical restoration of lumbar lordosis for LDK brings about high level of statistical correlation to thoracic kyphosis improvement. At the same time, the reciprocal relationship is maintained.
- Subjects :
- Aged
Cohort Studies
Diskectomy
Female
Humans
Internal Fixators
Kyphosis diagnostic imaging
Kyphosis pathology
Lordosis
Lumbar Vertebrae diagnostic imaging
Lumbar Vertebrae pathology
Lumbosacral Region anatomy & histology
Lumbosacral Region physiology
Male
Middle Aged
Radiography
Range of Motion, Articular physiology
Plastic Surgery Procedures instrumentation
Plastic Surgery Procedures methods
Retrospective Studies
Spinal Fusion instrumentation
Spondylosis diagnostic imaging
Spondylosis pathology
Thoracic Vertebrae anatomy & histology
Thoracic Vertebrae physiology
Treatment Outcome
Kyphosis surgery
Lumbar Vertebrae surgery
Recovery of Function physiology
Spinal Fusion methods
Spondylosis surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1528-1159
- Volume :
- 34
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Spine
- Publication Type :
- Academic Journal
- Accession number :
- 19179923
- Full Text :
- https://doi.org/10.1097/BRS.0b013e318191e792