Document Detail

Sagittal spinal alignment in patients with lumbar disc herniation.
MedLine Citation:
PMID:  20091188     Owner:  NLM     Status:  MEDLINE    
A retrospective cross-sectional study was designed to evaluate total sagittal spinal alignment in patients with lumbar disc herniation (LDH) and healthy subjects. Abnormal sagittal spinal alignment could cause persistent low back pain in lumbar disease. Previous studies analyzed sciatic scoliotic list in patients with lumbar disc herniation; but there is little or no information on the relationship between sagittal alignment and subjective findings. The study subjects were 61 LDH patients and 60 age-matched healthy subjects. Preoperative and 6-month postoperatively lateral whole-spine standing radiographs were assessed for the distance between C7 plumb line and posterior superior corner on the top margin of S1 sagittal vertical axis (SVA), lumbar lordotic angle between the top margin of the first lumbar vertebra and first sacral vertebra (L1S1), pelvic tilting angle (PA), and pelvic morphologic angle (PRS1). Subjective symptoms were evaluated by the Japanese Orthopedic Association (JOA) score for lower back pain (nine points). The mean SVA value of the LDH group (32.7 +/- 46.5 mm, +/- SD) was significantly larger than that of the control (2.5 +/- 17.1 mm), while L1S1 was smaller (36.7 +/- 14.5 degrees ) and PA was larger (25.1 +/- 9.0 degrees ) in LDH than control group (49.0 +/- 10.0 degrees and 18.2 +/- 6.0 degrees , respectively). At 6 months after surgery, the malalignment recovered to almost the same level as the control group. SVA correlated with the subjective symptoms measured by the JOA score. Sagittal spinal alignment in LDH exhibits more anterior translation of the C7 plumb line, less lumbar lordosis, and a more vertical sacrum. Measurements of these spinal parameters allowed assessment of the pathophysiology of LDH.
Kenji Endo; Hidekazu Suzuki; Hidetoshi Tanaka; Yupeng Kang; Kengo Yamamoto
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Publication Detail:
Type:  Journal Article     Date:  2009-12-20
Journal Detail:
Title:  European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society     Volume:  19     ISSN:  1432-0932     ISO Abbreviation:  Eur Spine J     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-09     Completed Date:  2010-06-02     Revised Date:  2013-05-31    
Medline Journal Info:
Nlm Unique ID:  9301980     Medline TA:  Eur Spine J     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  435-8     Citation Subset:  IM    
Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
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MeSH Terms
Cross-Sectional Studies
Intervertebral Disc Displacement / pathology*,  physiopathology,  surgery
Low Back Pain / pathology,  physiopathology,  surgery
Lumbar Vertebrae / pathology*,  physiopathology,  surgery
Lumbosacral Region / pathology,  physiopathology,  surgery
Middle Aged
Retrospective Studies
Severity of Illness Index
Spinal Fusion
Spine / pathology*,  physiopathology,  surgery
Statistics, Nonparametric
Treatment Outcome

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