Static and Dynamic Parameters in Patients With Degenerative Flat Back and Change After Corrective Fusion Surgery
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective To evaluate characteristics of static and dynamic parameters in patients with degenerative flat back (DFB) and to compare degree of their improvement between successful and unsuccessful surgical outcome groupsMethods Forty-seven patients with DFB were included who took whole spine X-ray and three-dimensional motion analysis before and 6 months after corrective surgery. Forty-four subjects were selected as a control group. As static parameters, thoracic kyphosis (TK), thoracolumbar junction (TLJ), lumbar lordosis (LL), pelvic incidence (PI), sacral slope (SS), and pelvic tilt (PT) were measured. As dynamic parameters, maximal and minimal angle of pelvic tilt, lower limb joints, and thoracic and lumbar vertebrae column (dynamic TK and LL) in sagittal plane were obtained.Results The DFB group showed smaller TK and larger LL, pelvic posterior tilt, hip flexion, knee flexion, and ankle dorsiflexion than the control group. Most of these parameters were significantly corrected by fusion surgery. Dynamic spinal parameters correlated with static spinal parameters. The successful group obtained significant improvement in maximal and minimal dynamic LL than the unsuccessful group. Conclusion The DFB group showed characteristic lower limb and spinal angles in dynamic and static parameters. Correlation between static and dynamic parameters was found in spinal segment. Dynamic LL was good predictor of successful surgical outcomes.
Abstract
Objective To evaluate characteristics of static and dynamic parameters in patients with degenerative flat back (DFB) and to compare degree of their improvement between successful and unsuccessful surgical outcome groupsMethods Forty-seven patients with DFB were included who took whole spine X-ray and three-dimensional motion analysis before and 6 months after corrective surgery. Forty-four subjects were selected as a control group. As static parameters, thoracic kyphosis (TK), thoracolumbar junction (TLJ), lumbar lordosis (LL), pelvic incidence (PI), sacral slope (SS), and pelvic tilt (PT) were measured. As dynamic parameters, maximal and minimal angle of pelvic tilt, lower limb joints, and thoracic and lumbar vertebrae column (dynamic TK and LL) in sagittal plane were obtained.Results The DFB group showed smaller TK and larger LL, pelvic posterior tilt, hip flexion, knee flexion, and ankle dorsiflexion than the control group. Most of these parameters were significantly corrected by fusion surgery. Dynamic spinal parameters correlated with static spinal parameters. The successful group obtained significant improvement in maximal and minimal dynamic LL than the unsuccessful group. Conclusion The DFB group showed characteristic lower limb and spinal angles in dynamic and static parameters. Correlation between static and dynamic parameters was found in spinal segment. Dynamic LL was good predictor of successful surgical outcomes.
참고문헌 (19)
- Lee JC, "Quantitative analysis of back muscle degeneration in the patients with the degenerative lumbar flat back using a digital image analysis: comparison with the normal controls", Spine (Phila Pa 1976), 33, pp.318~325 (2008)
- Takemitsu Y, "Lumbar degenerative kyphosis: clinical, radiological and epidemiological studies", Spine (Phila Pa 1976), 13, pp.1317~1326 (1988)
- Bae JS, "Radiological analysis of lumbar degenerative kyphosis in relation to pelvic incidence", Spine J, 12, pp.1045~1051 (2012)
- Kang CH, "MRI of paraspinal muscles in lumbar degenerative kyphosis patients and control patients with chronic low back pain", Clin Radiol, 62, pp.479~486 (2007)
- Lee CS, "Dynamic sagittal imbalance of the spine in degenerative flat back: significance of pelvic tilt in surgical treatment", Spine (Phila Pa 1976), 26, pp.2029~2035 (2001)
- Sarwahi V, "Characterization of gait function in patients with postsurgical sagittal (flatback) deformity: a prospective study of 21 patients", Spine (Phila Pa 1976), 27, pp.2328~2337 (2002)
- Barrey C, "Sagittal balance disorders in severe degenerative spine. Can we identify the compensatory mechanisms?", Eur Spine J, 20(5), pp.626~633 (2011)
- Jang JS, "Changes in sagittal alignment after restoration of lower lumbar lordosis in patients with degenerative flat back syndrome", J Neurosurg Spine, 7, pp.387~392 (2007)
- Jang JS, "Influence of lumbar lordosis restoration on thoracic curve and sagittal position in lumbar degenerative kyphosis patients", Spine (Phila Pa 1976), 34, pp.280~284 (2009)
- Khodadadeh S, "Gait analysis of patients with low back pain before and after surgery", Spine (Phila Pa 1976), 18, pp.1451~1455 (1993)
- McGinley JL, "The reliability of three-dimensional kinematic gait measurements:a systematic review", Gait Posture, 29, pp.360~369 (2009)
- Shum GL, "Three-dimensional kinetics of the lumbar spine and hips in low back pain patients during sit-to-stand and stand-to-sit", Spine (Phila Pa 1976), 32, pp.E211~E219 (2007)
- Suda Y, "Gait analysis of patients with neurogenic intermittent claudication", Spine (Phila Pa 1976), 27, pp.2509~2513 (2002)
- Kim WJ, "Factors affecting clinical results after corrective osteotomy for lumbar degenerative kyphosis", Asian Spine J, 4, pp.7~14 (2010)
- Macnab I, "Negative disc exploration: an analysis of the causes of nerve-root involvement in sixty-eight patients", J Bone Joint Surg Am, 53, pp.891~903 (1971)
- Ahn Y, "Percutaneous endoscopic lumbar discectomy for recurrent disc herniation: surgical technique, outcome, and prognostic factors of 43 consecutive cases", Spine (Phila Pa 1976), 29, pp.E326~E332 (2004)
- Legaye J, "Pelvic incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves", Eur Spine J, 7, pp.99~103 (1998)
- Barrey C, "Compensatory mechanisms contributing to keep the sagittal balance of the spine", Eur Spine J, 22(6), pp.S834~S841 (2013)
- Obeid I, "Global analysis of sagittal spinal alignment in major deformities: correlation between lack of lumbar lordosis and flexion of the knee", Eur Spine J, 20(5), pp.681~685 (2011)