Top

European Spine Journal

Published in:

01-03-2014 | Original Article

The characteristics of spinopelvic sagittal alignment in patients with lumbar disc degenerative diseases

Authors: Xi Yang, Qingquan Kong, Yueming Song, Limin Liu, Jiancheng Zeng, Rong Xing

Published in: European Spine Journal | Issue 3/2014

Abstract

Purpose

A comparative study of the spinopelvic sagittal alignment in patients with lumbar disc degeneration or herniation (LDD/LDH) in normal population was designed to analyse the role of sagittal anatomical parameter (pelvic incidence, PI) and positional parameters in the pathogenesis and development of the disease. Several comparative studies of these patients with asymptomatic controls have been done. However, in previous studies without lumbar MRI, a certain number of asymptomatic LDD patients should have been included in the control group and then impacted on the results.

Methods

Based on MRI findings, we divided 60 LDD or LDH patients and 110 asymptomatic volunteers into the normal group (NG) and the degeneration group (DG), which was further subdivided into the symptomatic (SDG) and asymptomatic (ADG) subgroups according to patients’ symptoms. Standing full spine radiographs were used to measure sagittal parameters, including PI, sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL), thoracic kyphosis (TK), sagittal vertical axis (SVA), and sacrum-bicoxofemoral distance (SFD).

Results

The PI, SS and LL in DG were significantly lower than NG, while the SVA and SFD were significantly greater (P < 0.05). PI correlated well with the SS and LL in all subjects. However, the trend lines of SS or LL over PI were downward in DG. PI was similar in SDG and ADG (P = 0.716) but SS and LL were significantly lower and SVA was significantly greater (P < 0.05).

Conclusions

PI may play a predisposing role in the pathogenesis of lumbar disc degenerative diseases. The secondary structural and compensatory factors would lead to a straighter spine after disc degenerative change.

Vialle R, Levassor N, Rillardon L, Templier A, Skalli W, Guigui P (2005) Radiographic analysis of the sagittal alignment and balance of the spine in asymptomatic subjects. J Bone Joint Surg Am 87(2):260–267PubMedCrossRef

Legaye J, Duval-Beaupère G, Hecquet J, Marty C (1998) Pelvic incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves. Eur Spine J 7(2):99–103PubMedCentralPubMedCrossRef

Jackson RP, Hales C (2000) Congruent spinopelvic alignment on standing lateral radiographs of adult volunteers. Spine (Phila Pa 1976) 25(21):2808–2815CrossRef

Berthonnaud E, Dimnet J, Roussouly P, Labelle H (2005) Analysis of the sagittal balance of the spine and pelvis using shape and orientation parameters. J Spinal Disord Tech 18(1):40–47PubMedCrossRef

Korovessis PG, Stamatakis MV, Baikousis AG (1998) Reciprocal angulation of vertebral bodies in the sagittal plane in a asymptomatic greek population. Spine (Phila Pa 1976) 23(6):700–704CrossRef

Kobayashi T, Atsuta Y, Matsuno T, Takeda N (2004) A longitudinal study of congruent sagittal spinal alignment in an adult cohort. Spine (Phila Pa 1976) 29(6):671–676CrossRef

Duval-Beaupere G, Schimdt C, Cosson P (1992) A baricentremetric study of the sagittal shape of spine and pelvis: the conditions required for an economic standing position. Ann Biomed Eng 20(4):451–462PubMedCrossRef

During J, Goudfrooij H, Keessen W, Beeker TW, Crowe A (1985) Toward standards for posture. Postural characteristics of the lower back system in normal and pathologic conditions. Spine (Phila Pa 1976) 10(1):83–87CrossRef

Mangione P, Gomez D, Senegas J (1997) Study of the course of the incidence angle during growth. Eur Spine J 6(3):163–167PubMedCentralPubMedCrossRef

10.

Vaz G, Roussouly P, Berthonnaud E, Dimnet J (2002) Morphology and equilibrium of pelvis and spine. Eur Spine J 11(1):80–87PubMedCentralPubMedCrossRef

11.

Boulay C, Tardieu C, Hecquet J et al (2006) Sagittal alignment of spine and pelvis regulated by pelvic incidence: standard values and prediction of lordosis. Eur Spine J 15(4):415–422PubMedCentralPubMedCrossRef

12.

Aono K, Kobayashi T, Jimbo S, Atsuta Y, Matsuno T (2010) Radiographic analysis of newly developed degenerative spondylolisthesis in a mean twelve-year prospective study. Spine (Phila Pa 1976) 35(8):887–891CrossRef

13.

Barrey C, Jund J, Noseda O, Roussouly P (2007) Sagittal balance of the pelvis-spine complex and lumbar degenerative diseases. A comparative study about 85 cases. Eur Spine J 16(9):1459–1467PubMedCentralPubMedCrossRef

14.

Rajnics P, Templier A, Skalli W, Lavaste F, Illes T (2002) The importance of spinopelvic parameters in patients with lumbar disc lesions. Int Orthop 26(2):104–108PubMedCentralPubMed

15.

Endo K, Suzuki H, Tanaka H, Kang Y, Yamamoto K (2010) Sagittal spinal alignment in patients with lumbar disc herniation. Eur Spine J 19(3):435–438PubMedCentralPubMedCrossRef

16.

Barrey C, Jund J, Perrin G, Roussouly P (2007) Spinopelvic alignment of patients with degenerative spondylolisthesis. Neurosurgery 61(5):981–986PubMedCrossRef

17.

Lazennec JY, Ramare S, Arafati N et al (2000) Sagittal alignment in lumbosacral fusion relations between radiological parameters and pain. Eur Spine J 9(1):47–55PubMedCentralPubMedCrossRef

18.

Modic MT, Ross JS (2007) Lumbar degenerative disk disease. Radiology 245(1):43–61 ReviewPubMed

19.

Wiesel SW, Tsourmas N, Feffer HL, Citrin CM, Patronas N (1984) A study of computer-assisted tomography. I. The incidence of positive CAT scans in an asymptomatic group of patients. Spine (Phila Pa 1976) 9(6):549–551CrossRef

20.

Boden SD, Davis DO, Dina TS, Patronas NJ, Wiesel SW (1990) Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects: a prospective investigation. J Bone Joint Surg Am 72(3):403–408PubMed

21.

Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS (1994) Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med 331(2):69–73PubMed

22.

Wiltse LL, Winter RB (1983) Terminology and measurements of spondylolisthesis. J Bone Joint Surg 65(6):768–772PubMed

23.

Lafage V, Schwab F, Patel A, Hawkinson N, Farcy JP (2009) Pelvic tilt and truncal inclination: two key radiographic parameters in the setting of adults with spinal deformity. Spine (Phila Pa 1976) 34(17):E599–E606CrossRef

24.

Roussouly P, Gollogly S, Berthonnaud E, Dimnet J (2005) Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position. Spine (Phila Pa 1976) 30(3):346–353CrossRef

25.

Barrey C, Roussouly P, Perrin G, Le Huec JC (2011) Sagittal balance disorders in severe degenerative spine. Can we identify the compensatory mechanisms? Eur Spine J Suppl 5:626–633CrossRef

26.

Pfirrmann CW, Metzdorf A, Zanetti M, Hodler J, Boos N (2001) Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine (Phila Pa 1976) 26(17):1873–1878CrossRef

Title: The characteristics of spinopelvic sagittal alignment in patients with lumbar disc degenerative diseases
Authors: Xi Yang
Qingquan Kong
Yueming Song
Limin Liu
Jiancheng Zeng
Rong Xing
Publication date: 01-03-2014
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 3/2014
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-013-3067-z

At a glance: The STEP trials

Springer Medicine

The characteristics of spinopelvic sagittal alignment in patients with lumbar disc degenerative diseases

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 3/2014

Multiaxial high-modularity spinopelvis (HMSP) fixation device in neuromuscular scoliosis: a comparative study

The growth and increase of the number of journals focusing on Spine: a scientific blessing?

A SNP in the 5′UTR of GDF5 is associated with susceptibility to symptomatic lumbar disc herniation in the Chinese Han population

Revision surgery for implant failure after PSO

ANNOUNCEMENTS For Issue 3-2014

The relationship between spinopelvic parameters and clinical symptoms of severe isthmic spondylolisthesis: a prospective study of 64 patients