Evaluation of sagittal balance and spinopelvic parameters in patients with lumbar disc herniation
Abstract
Aim: The objective of this study was to analyze sagittal balance throughout with spinopelvic parameters, in patients with a lumbar disc herniation and evaluate these patients with functional quality assessment questionnaires.
Material Method: A total of 88 adult patients were evaluated in this study. All these patients were examined clinically in a physical medicine and rehabilitation policlinic, from one physician in Sivas Numune State Hospital for a lumbar disc herniation between 01 March-01 November 2018. The physical examination findings and records in the patient's files were evaluated. The Oswestry disability (ODI) questionnaire, Roland Morris (RDI) questionnaire and Health Assessment Questionnaire (HAQ) were evaluated for all voluntary patients. All patients were confirmed with full spinal anteroposterior and lateral radiographs and lumbar MRI. Three group pathologies were evaluated in this study: Group1; disc herniation with bulging ,Group 2; one level disc herniation and Group 3 multilevel disc herniation, including lumber disc protrusion, extrusion, and sequestration. Spino-pelvic parameters; lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS) were measured on full spine radiographs in a standing position.
Results: LL was significantly less by multilevel disc herniation group as compared with bulging group and one level disc herniation group (p<0.05). It was a poor correlation between LL and waist circumference by multilevel disc herniation group. When compared groups with functional assessment questionnaires, all groups were not statistically different each from other. We demonstrated not significantly different by all three groups between ODI, HAQ and RDI scores.
Conclusion: Spinal sagittal imbalance caused by LDH is one type of compensatory response to prevent low back pain. This mechanism mainly includes a loss of LL and PT. Two important factors that need to be considered are the paravertebral muscles strengthening to prevent sagittal imbalance and keeping the body weight and waist circumference in the normal range.
Keywords
Kaynakça
- 1. Wang T, Wang H, Zhang D, Zhang Y, Ding W. Radiological analysis for thoracolumbar disc herniation in spinopelvic sagittal alignment. :2–7. 2. Lamartina C, Berjano P, Petruzzi M, Sinigaglia A, Casero G, Cecchinato R, et al. Criteria to restore the sagittal balance in deformity and degenerative spondylolisthesis. European Spine Journal. 2012;21(SUPPL. 1):27–31. 3. Liang C, Sun J, Cui X, Jiang Z, Zhang W, Li T. Spinal sagittal imbalance in patients with lumbar disc herniation: Its spinopelvic characteristics, strength changes of the spinal musculature and natural history after lumbar discectomy. BMC Musculoskeletal Disorders [Internet]. 2016;17(1):1–8. Available from: http://dx.doi.org/10.1186/s12891-016-1164-y4. Wei X, Gengwu L, Chao C, Yifan L, Shang S, Ruixi H, et al. Correlations between the sagittal plane parameters of the spine and pelvis and lumbar disc degeneration. Journal of Orthopaedic Surgery and Research. 2018;13(1):1–9. 5. Stevens ML, Lin CCW, Maher CG. The Roland Morris Disability Questionnaire. Journal of Physiotherapy. 2016;62(2):116. 6. Mehra A, Baker D, Disney S, Pynsent PB. Oswestry disability index scoring made easy. Annals of the Royal College of Surgeons of England. 2008;90(6):497–9. 7. Bruce B, Fries JF. Bruce(haq).pdf. 2003;6:1–6. 8. Illes T. The importance of spinopelvic parameters in patients with lumbar disc lesions. 2002;104–8. 9. Roussouly P, Gollogly S, Berthonnaud E, Dimnet J. Classification of the Normal Variation in the Sagittal Alignment of the Human Lumbar Spine and Pelvis in the Standing Position Pierre Roussouly , MD ,* Sohrab Gollogly , MD ,* Eric Berthonnaud , Ph.D.,† and. 2005;30(3):2005. 10. Evcik D, Yücel A. Lumbar lordosis in acute and chronic low back pain patients. Rheumatology International. 2003;23(4):163–5. 11. Endo K, Suzuki H, Tanaka H, Kang Y, Yamamoto K. Sagittal spinal alignment in patients with lumbar disc herniation. European Spine Journal. 2010;19(3):435–8. 12. Wang T, Wang H, Liu FY, Yang DL, Ma L, Ding WY. The characteristics of spino-pelvic sagittal parameters and obesity factors for adolescents with lumbar disc herniation. International Journal of Clinical and Experimental Medicine. 2016;9(7):14321–8. 13. Oh B-H, Kim H-H, Kim C-Y, Nam C-W. Comparison of physical function according to the lumbar movement method of stabilizing a patient with chronic low back pain. Journal of Physical Therapy Science [Internet]. 2015;27(12):3655–8. Available from: https://www.jstage.jst.go.jp/article/jpts/27/12/27_jpts-2015-603/_article
Ayrıntılar
Birincil Dil
İngilizce
Konular
Sağlık Kurumları Yönetimi
Bölüm
Araştırma Makalesi
Yayımlanma Tarihi
29 Aralık 2018
Gönderilme Tarihi
25 Aralık 2018
Kabul Tarihi
27 Aralık 2018
Yayımlandığı Sayı
Yıl 2018 Cilt: 40 Sayı: 4