SURGICAL CORRECTION OF TRUNK BALANCE IN SPINAL DEFORMITIES AND IN INSTABILITY OF HIP JOINTS



Cite item

Full Text

Abstract

Introduction. Restoration of trunk balance is the basic task in surgical correction of spinal deformities and in hip joint instability of various etiology. Purpose. To analyze and to define the relevance of roentgen-anatomical parameters of spine-pelvis relationships for surgical correction of deformities in the thoracolumbar spine and of hip joint instability of dysplastic and neurogenic etiology. Material and methods. An X-ray analysis of parameters of the frontal and sagittal spine-pelvis balance was performed in 220 patients with dysplastic and neurogenic deformities of the thoracic and lumbar spine (n = 98) and with instability of hip joints (n = 122) but who were able to walk. They were operated in the neuro-orthopedic department with orthopedics in National Medical Research Center for Children’s Health. The reference group included 60 relatively healthy children without any scoliotic deformities of the spine and with stable hip joints. Dynamics of changes in X-ray parameters was analyzed using findings of orthostatic spondylograms from the indicated groups of children. The obtained data were compared with reference values. Results. The trial performed has revealed typical changes in spine-pelvis relationship parameters in patients with hip joint instability and spine deformities and in the reference group . The researchers also found out relations between various parameters of the trunk balance before and after surgical correction. Conclusion. While planning a surgical correction of trunk balance in spinal deformities, one should take into account parameters of spine-pelvis relationships, such as PI, SS, PT, SVA deviation and the mid-sacral line; and in case of hip joint instability - local roentgen-angulometric parameters of the femoral and acetabular components of instability. This is due to the fact that the lower the level of reconstructive surgical manipulation is located, the greater effect it has at the frontal and sagittal balance of the trunk.

About the authors

O. B. Chelpachenko

National Medical Research Center for Children’s Health

Author for correspondence.
Email: chelpachenko81@mail.ru
ORCID iD: 0000-0002-0333-3105
Россия

K. V. Zherdev

National Medical Research Center for Children’s Health

Email: noemail@neicon.ru
ORCID iD: 0000-0003-3698-6011
Россия

A. P. Fisenko

National Medical Research Center for Children’s Health

Email: noemail@neicon.ru
ORCID iD: 0000-0001-8586-7946
Россия

A. S. Butenko

National Medical Research Center for Children’s Health

Email: noemail@neicon.ru
ORCID iD: 0000-0002-7542-8218
Россия

S. P. Yatsyk

National Medical Research Center for Children’s Health

Email: noemail@neicon.ru
ORCID iD: 0000-0001-6966-1040
Россия

E. Yu. Dyakonova

National Medical Research Center for Children’s Health

Email: noemail@neicon.ru
ORCID iD: 0000-0002-8563-6002
Россия

O. E. Chelpachenko

Institute of Cellular and Intracellular Symbiosis

Email: noemail@neicon.ru
ORCID iD: 0000-0002-6719-5805
Россия

References

  1. Diebo B.G., Lafage V., Schwab F. Pelvic Incidence: The Great Biomechanical Effort. Spine. 2016; (41): 21-2. doi: 10.1097/BRS.0000000000001430
  2. Дюбуссе Ж. Биомеханические и клинические аспекты переднего доступа при хирургическом лечении кифозов и кифосколиозов у детей и подростков. Хирургия позвоночника. 2010; (1): 018-0281
  3. Diebo B.G., Challier V., Shah N.V., Kim D., Murray D.P., Kelly J.J., Lafage R., Paulino C.B., Passias P.G., Schwab F.J., Lafage V. The Dubousset Functional Test is a Novel Assessment of Physical Function and Balance. Clin Orthop Relat Res. 2019; 477(10): 2307-15. doi: 10.1097/CORR.0000000000000820
  4. Okamoto, M., Jabour, F., Sakai, K. et al. Sagittal balance measures are more reproducible when measured in 3D vs in 2D using full-body EOS® images. European Radiology.2018; 28(11): 4570-7. doi: 10.1007/s00330-018-5485-0
  5. Pumberger M., Schmidt H., Putzier M. Spinal Deformity Surgery: A Critical Review of Alignment and Balance. Asian Spine J. 2018; 12(4): 775-83. doi: 10.31616/asj.2018.12.4.775. Epub 2018 Jul 27.
  6. Yamato Y., Sato Y., Togawa D., Hasegawa T., Yoshida G., Yasuda T., Banno T., Arima H., Oe S., Mihara Y., Ushirozako H., Yamada T., Matsuyama Y. Differences in the geometrical spinal shape in the sagittal plane according to age and magnitude of pelvic incidence in healthy elderly individuals. J Orthop Sci. 2019; pii: S0949-2658(19)30207-6. doi: 10.1016/j.jos.2019.07.005
  7. Okuzu Y., Goto K., Okutani Y., Kuroda Y., Kawai T., Matsuda Sh. Hip-Spine Syndrome: Acetabular Anteversion Angle Is Associated with Anterior Pelvic Tilt and Lumbar Hyperlordosis in Patients with Acetabular Dysplasia. A Retrospective Study. JB JS Open Access. 2019; 4(1): e0025. doi: 10.2106/JBJS.OA.18.00025
  8. Бортулёв П.И., Виссарионов С.В., Басков В.Е., Овечкина А.В., Барсуков Д.Б., Поздникин И.Ю. Клинико-рентгенологические показатели позвоночно-тазовых соотношений у детей с диспластическим подвывихом бедра. Травматология и ортопедия России. 2018; 24(3): 74-82. doi: 10.21823/2311-2905-2018-24-3-74-82
  9. Roussouly P., Pinheiro-Franco J.L. Biomechanical analysis of the spino-pelvic organization and adaptation in pathology. Eur Spine J. 2011; 20 Suppl 5: 609-18. doi: 10.1007/s00586-011-1928-x
  10. Bassani T., Galbusera F., Luca A., Lovi A., Gallazzi E., Brayda-Bruno M.Physiological variations in the sagittal spine alignment in an asymptomatic elderly population. Spine J. 2019; (1): 1529-9430(19)30898-8. doi: 10.1016/j.spinee.2019.07.016
  11. Аверкиев В.А., Кудяшев А.Л., Артюх В.А., Надулич К.А., Теремшонок А.В., Нагорный Е.Б. Особенности сагиттальных позвоночно-тазовых взаимоотношений у пациентов с коксовертебральным синдромом. Хирургия позвоночника. 2012; (4): 49-54.
  12. Батршин И.Т., Садовая Т.Н. Разновысокость нижних конечностей с перекосом таза и фронтальная деформация позвоночника. Хирургия позвоночника. 2007; (3): 39-44.
  13. Tournemine S., Angelliaume A., Simon A.L., Ilharreborde B. Are postoperative standing radiographs relevant before hospital discharge in adolescent idiopathic scoliosis? Eur Spine J. 2019; 28(6): 1363-70. doi: 10.1007/s00586-019-05971-w.
  14. Noshchenko A., Hoffecker L., Cain C.M.J., Patel V.V,. Burger E.L. Spinopelvic Parameters in Asymptomatic Subjects Without Spine Disease and Deformity: A Systematic Review With Meta-Analysis. Clin Spine Surg. 2017; 30(9): 392-403. doi: 10.1097/BSD.0000000000000533
  15. Borges P.A., Zelada F.G.B., Dos Santos Barros T.F., Letaif O.B., da Rocha I.D., Marcon R.M., Cristante A.F., Barros-Filho T.E.P. A Comparative Study of Sagittal Balance in Patients with Neuromuscular Scoliosis. Clinics (Sao Paulo). 2017; 72(8) :481-4. doi: 10.6061/clinics/2017(08)05
  16. Saltychev M., Pernaa K., Seppänen M., Mäkelä K., Laimi K. Pelvic incidence and hip disorders: A systematic review and quantitative analysis. J. Acta Orthopaedica. 2018; 89(1): 66-70. doi: 10.1080/17453674.201.1377017
  17. Шнайдер Л.С., Павлов В.В., Крутько А.В., Базлов В.А., Мамуладзе Т.З., Пелеганчук А.В. Изменения позвоночно-тазового баланса после эндопротезирования тазобедренного сустава у пациентов с врожденным вывихом бедра. Хирургия позвоночника, 2018; 15 (4): 80-6.
  18. Батршин, И. Т. Топографическая характеристика латеральных дуг искривления при деформациях позвоночника. Гений ортопедии. 2011; (4): 63-7.
  19. Бортулёв П.И., Виссарионов С.В., Басков В.Е., Барсуков Д.Б., Поздникин И.Ю., Познович М.С. Влияние тройной остеотомии таза на позвоночно-тазовые соотношения у детей с диспластическим подвывихом бедра. Ортопедия, травматология и восстановительная хирургия детского возраста. 2019; 7 (2): 5-16. doi: 10.17816/PTORS725-16
  20. Попов И.В., Захарин В.Р., Шаров В.А., Кузьминова А.Д. Анализ сагиттального баланса у пациентов травматолого-ортопедического профиля. Смоленский медицинский альманах. 2018; (2): 75-8.

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2020

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies