The Impact of Adult Thoracolumbar Spinal Deformities on Standing to Sitting Regional and Segmental Reciprocal Alignment
| Autor: | Nicholas Stekas, Renaud Lafage, Aaron J. Buckland, Aaron Hockley, Cole Bortz, Peter L. Zhou, Frank J. Schwab, Haddy Alas, Heiko Koller, Samantha R. Horn, Deeptee Jain, Peter G. Passias, Michael C. Gerling, Bassel G. Diebo, Frank A. Segreto, Leah Steinmetz, Christopher Varlotta, Shaleen Vira, David H. Ge, Dennis Vasquez-Montes, Katherine E. Pierce, Avery E. Brown, John Y. Moon, Nicholas J. Frangella, Virginie Lafage |
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| Rok vydání: | 2019 |
| Předmět: |
030222 orthopedics
education.field_of_study medicine.medical_specialty Lordosis business.industry Population Retrospective cohort study Scoliosis medicine.disease Sitting Sagittal plane Surgery 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Lumbar medicine Deformity Orthopedics and Sports Medicine Biomechanics medicine.symptom business education 030217 neurology & neurosurgery |
| Zdroj: | International journal of spine surgery. 13(4) |
| ISSN: | 2211-4599 |
| Popis: | BACKGROUND: Regional and segmental changes of the lumbar spine have previously been described as patients transition from standing to sitting; however, alignment changes in the cervical and thoracic spine have yet to be investigated. So, the aim of this study was to assess cervical and thoracic regional and segmental changes in patients with thoracolumbar deformity versus a nondeformed thoracolumbar spine population. METHODS: This study was a retrospective cohort study of a single center's database of full-body stereoradiographic imaging and clinical data. Patients were ≥ 18 years old with nondeformed spines (nondegenerative, nondeformity spinal pathologies) or thoracolumbar deformity (ASD: PI-LL > 10°). Patients were propensity-score matched for age and maximum hip osteoarthritis grade and were stratified by Scoliosis Research Society (SRS)–Schwab classification by PI-LL, SVA, and PT. Patients with lumbar transitional anatomy or fusions were excluded. Outcome measures included changes between standing and sitting in global alignment parameters: sagittal vertical axis (SVA), pelvic incidence minus lumbar lordosis (PI-LL), pelivc tilt (PT), thoracic kyphosis, cervical alignment, cervical SVA, C2-C7 lordosis (CL), T1 slop minus CL (TS-CL), and segmental alignment from C2 to T12. Another analysis was performed using patients with cervical and thoracic segmental measurements. RESULTS: A total of 338 patients were included (202 nondeformity, 136 ASD). After propensity-score matching, 162 patients were included (81 nondeformity, 81 ASD). When categorized by SRS-Schwab classification, all nondeformity patients were nonpathologically grouped for PI-LL, SVA, and PT, whereas ASD patients had mix of moderately and markedly deformed modifiers. There were significant differences in pelvic and global spinal alignment changes from standing to sitting between nondeformity and ASD patients, particularly for SVA (nondeformed: 49.5 mm versus ASD: 27.4 mm; P&thinsp |
| Databáze: | OpenAIRE |
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