Objective:To explore the influence of the changes of sagittal balance index of lumbar spine on the natural absorption after lumbar disc rupture and protrusion.Methods:From August 2016 to August 2017,64 patients with r...Objective:To explore the influence of the changes of sagittal balance index of lumbar spine on the natural absorption after lumbar disc rupture and protrusion.Methods:From August 2016 to August 2017,64 patients with ruptured lumbar disc herniation and treated with natural absorption in our hospital were selected as the research subjects.According to the size of the herniated discs after 2 years,the subjects were divided into the reabsorption lumbar disc herniation group(group 1,2,3,and 4)and the non-reabsorption group(group 0).The pelvic incidence angle(PI),the sacral slope(SS),the pelvic tilting(PT),and the lumbar lordosis(LL)were measured and compared at the time of admission and 2 years after follow-up.Results:There were no significant differences in the PI value and the change of PI value during the entry and re-examination of different groups.There was no significant difference in the PT,SS,and LL values among the patients in each group;At the time of reexamination,the PT had a decreasing trend and the SS and LL had an increasing trend.With the increase of the patient's score,the changes in PT,SS,and LL values showed an increasing trend.Conclusion:The PT,SS and LL values of patients with lumbar intervertebral disc herniation had significant changes before and after treatment.Changes in the sagittal balance index of the lumbar spine were important factors affecting the natural absorption of lumbar disc herniation.展开更多
Long before its current understanding, the concept of balance was common among spine surgeons dealing with deformities, but it was a hard one to transfer to clinical practice. Thanks to the pioneering work of Duval-Be...Long before its current understanding, the concept of balance was common among spine surgeons dealing with deformities, but it was a hard one to transfer to clinical practice. Thanks to the pioneering work of Duval-Beaupere and followers, the idea of balancing the sagittal contour of the spine has gained scientific status and is now in the armamentarium of the skilled surgeon as the single most important tool to achieve superior clinical results in adult spinal deformity surgery.展开更多
Background:Prospective study objectives.A sagittal balance is a good tool to improve the functional outcome of spine spondylolisthesis surgeries,primarily noted that it has a good impact in deformity surgery and then ...Background:Prospective study objectives.A sagittal balance is a good tool to improve the functional outcome of spine spondylolisthesis surgeries,primarily noted that it has a good impact in deformity surgery and then applied to every spine surgery and the aim of this study is to evaluate its functional outcome when considered in preoperative planning for non-dysplastic low-and mid-grade spondylolisthesis surgeries.Method:Forty patients diagnosed as low-or mid-grade non-dysplastic spondylolisthesis had undergone surgery at Cairo University after failed medical treatment had been evaluated preoperatively by measuring the sagittal balance parameters which include SVA,spinopelvic angles,lumbar lordosis,pelvic tilt,sacral slope,and pelvic incidence and then measure it along a follow-up period of 1 year postoperatively started from February 2018 and correlate it with functional outcome using Oswestry score(ODI)and VAS.Correction of parameters has been estimated preoperatively by manual estimation and Surgimap application then applied during the operation.Results:All patients were treated by surgical treatment through posterior transpedicular screw fixation with conventional or reduction screws and fusion±TLIF cages.The mean of lumbar lordosis and mean spinopelvic angles were increased in a statistically significant manner.Pelvis tilt was decreased in a statistically insignificant manner.The mean of pelvic incidence was not changed and statistically insignificant,and this is matching the fact that pelvic incidence is a constant parameter.The sacral slope was increased in a statistically insignificant manner.Final results showed that 37 had a statistically significant improvement in their ODI>20%at the last visit.Three patients had a poor clinical outcome with ODI scorFinal results showed that 37 had a statistically significant improvement in their ODI>20%at the last visit.Three patients had a poor clinical outcome with ODI score of>20%improvement,and we noticed that the level of pathology was at the level of L4L5,SVA was positive and worsen postoperatively,and also,it is accompanied by decreased lumbar lordosis.Change in ODI means statistically significant improvement when considering sagittal parameters preoperation and during operation.Conclusion:Sagittal balance parameters should be considered in the surgical management of low-grade spondylolisthesis cases to improve their functional outcome.展开更多
基金Scientific research project of Sichuan health and Family Planning Commission(No.16pj389)
文摘Objective:To explore the influence of the changes of sagittal balance index of lumbar spine on the natural absorption after lumbar disc rupture and protrusion.Methods:From August 2016 to August 2017,64 patients with ruptured lumbar disc herniation and treated with natural absorption in our hospital were selected as the research subjects.According to the size of the herniated discs after 2 years,the subjects were divided into the reabsorption lumbar disc herniation group(group 1,2,3,and 4)and the non-reabsorption group(group 0).The pelvic incidence angle(PI),the sacral slope(SS),the pelvic tilting(PT),and the lumbar lordosis(LL)were measured and compared at the time of admission and 2 years after follow-up.Results:There were no significant differences in the PI value and the change of PI value during the entry and re-examination of different groups.There was no significant difference in the PT,SS,and LL values among the patients in each group;At the time of reexamination,the PT had a decreasing trend and the SS and LL had an increasing trend.With the increase of the patient's score,the changes in PT,SS,and LL values showed an increasing trend.Conclusion:The PT,SS and LL values of patients with lumbar intervertebral disc herniation had significant changes before and after treatment.Changes in the sagittal balance index of the lumbar spine were important factors affecting the natural absorption of lumbar disc herniation.
文摘Long before its current understanding, the concept of balance was common among spine surgeons dealing with deformities, but it was a hard one to transfer to clinical practice. Thanks to the pioneering work of Duval-Beaupere and followers, the idea of balancing the sagittal contour of the spine has gained scientific status and is now in the armamentarium of the skilled surgeon as the single most important tool to achieve superior clinical results in adult spinal deformity surgery.
文摘Background:Prospective study objectives.A sagittal balance is a good tool to improve the functional outcome of spine spondylolisthesis surgeries,primarily noted that it has a good impact in deformity surgery and then applied to every spine surgery and the aim of this study is to evaluate its functional outcome when considered in preoperative planning for non-dysplastic low-and mid-grade spondylolisthesis surgeries.Method:Forty patients diagnosed as low-or mid-grade non-dysplastic spondylolisthesis had undergone surgery at Cairo University after failed medical treatment had been evaluated preoperatively by measuring the sagittal balance parameters which include SVA,spinopelvic angles,lumbar lordosis,pelvic tilt,sacral slope,and pelvic incidence and then measure it along a follow-up period of 1 year postoperatively started from February 2018 and correlate it with functional outcome using Oswestry score(ODI)and VAS.Correction of parameters has been estimated preoperatively by manual estimation and Surgimap application then applied during the operation.Results:All patients were treated by surgical treatment through posterior transpedicular screw fixation with conventional or reduction screws and fusion±TLIF cages.The mean of lumbar lordosis and mean spinopelvic angles were increased in a statistically significant manner.Pelvis tilt was decreased in a statistically insignificant manner.The mean of pelvic incidence was not changed and statistically insignificant,and this is matching the fact that pelvic incidence is a constant parameter.The sacral slope was increased in a statistically insignificant manner.Final results showed that 37 had a statistically significant improvement in their ODI>20%at the last visit.Three patients had a poor clinical outcome with ODI scorFinal results showed that 37 had a statistically significant improvement in their ODI>20%at the last visit.Three patients had a poor clinical outcome with ODI score of>20%improvement,and we noticed that the level of pathology was at the level of L4L5,SVA was positive and worsen postoperatively,and also,it is accompanied by decreased lumbar lordosis.Change in ODI means statistically significant improvement when considering sagittal parameters preoperation and during operation.Conclusion:Sagittal balance parameters should be considered in the surgical management of low-grade spondylolisthesis cases to improve their functional outcome.
