Preoperative Factors Associated With Low Back Pain Improvement After Total Hip Arthroplasty in a Japanese Population
| Autor: | Toshiyuki Kawai, Koji Goto, Yutaka Kuroda, Shuichi Matsuda, Yaichiro Okuzu |
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| Rok vydání: | 2022 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty Arthroplasty Replacement Hip Scoliosis Japan health services administration Humans Medicine Orthopedics and Sports Medicine Pelvis Retrospective Studies Lumbar Vertebrae Cobb angle business.industry Japanese population medicine.disease Low back pain Sagittal plane nervous system diseases body regions medicine.anatomical_structure Coronal plane Lordosis Physical therapy population characteristics medicine.symptom business Low Back Pain Total hip arthroplasty |
| Zdroj: | The Journal of Arthroplasty. 37:69-74 |
| ISSN: | 0883-5403 |
| Popis: | Background Spinal disorders and low back pain (LBP) have been associated with worse clinical outcomes of total hip arthroplasty (THA). It is essential to identify spinal factors associated with post-THA LBP improvement. Therefore, we aimed to determine the proportion of patients with improved LBP after THA and to identify the preoperative spinal factors associated with LBP improvement. Methods We included 151 patients who underwent primary THA between December 2015 and December 2019 and had a preoperative visual analog scale score for LBP of ≥2. The patients were classified into the LBP improved or LBP continued group based on a visual analog scale score for LBP at 1 year after THA. Preoperative spinal parameters were compared between the 2 groups. Results Ninety-five patients (62.9%) were classified into the LBP improved group. Among the coronal spinal parameters, the Cobb angle was significantly lower in the LBP improved group. Among the sagittal spinal parameters, the LBP continued group showed a significantly more posteriorly titled pelvis, lower lumbar lordosis, greater sagittal vertical axis, and greater pelvic incidence minus lumbar lordosis mismatch, indicating a sagittal spinal imbalance. Logistic regression analysis found that preoperative factors associated with LBP improvement after THA had a low Cobb angle and high anterior pelvic plane angle (anteriorly tilted pelvis). Conclusion Among patients with LBP before THA, 62.9% had improved LBP. Sagittal spinal imbalance and high Cobb angle were the key spinal factors associated with persistent LBP. Our findings suggest that hip surgeons should evaluate spinal alignment before THA in patients with LBP. |
| Databáze: | OpenAIRE |
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