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| SHU Shibin,BAO Hongda,GU Qi.The compensatory pattern of sagittal profile in patients with degenerative scoliosis[J].Chinese Journal of Spine and Spinal Cord,2019,(6):484-489. |
| The compensatory pattern of sagittal profile in patients with degenerative scoliosis |
| Received:March 28, 2019 Revised:May 20, 2019 |
| English Keywords:Degenerative scoliosis Lower limb compensation EOS imaging system Whole body sagittal alignment |
| Fund:江苏省临床医学中心（编号:YXZXA2016009） |
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| English Abstract: |
| 【Abstract】 Objectives: To investigate the effects of lower limb compensation on full-body sagittal alignment, and to explore the whole body compensatory pattern in degenerative scoliosis(DS), by comparing the parameters of patients with and without lower limb compensation on standing EOS full body films. Methods: Forty-three DS patients in our hospital between October 2017 and February 2018 were included. All patients underwent full body EOS films preoperatively. The following sagittal parameters were recorded: thoracic kyphosis, lumbar lordosis, pelvic incidence, sacral slope, pelvic tilt and sagittal vertical axis. The horizontal offset between anatomical landmarks on the sagittal plane was measured, including the CCOM to the ankle center(Cr-A), the C2 to the ankle center(C2-A), the C7 to the ankle center(C7-A) and the C2 to the femoral head center(C2-F). The knee angle(KA) was also measured. All patients were divided into patients with lower limb compensation group and patients without lower limb compensation group according to whether KA was greater than 3 degrees. The differences of sagittal parameters between patients with and without compensation were compared by the independent sample t test. Results: A total of 20 DS patients without lower limb compensation and 23 DS patients with lower limb compensation were included in this study. There was no significant difference of PI or PI-LL between the two groups. The PT of patients with lower extremity compensation was 24.8°±10.4°, which was significantly greater than that of patients without lower limb compensation. The TK of patients with lower extremity compensation was 21.9°±14.0°, which was significantly higher than that of patients without lower extremity compensation. The KA of patients with lower extremity compensation was 5.7°±1.0°, which was significantly higher than that of patients without lower extremity compensation. The SVA of patients with lower limb compensation(62.2±38.0mm) was significantly smaller than that of patients without lower limb compensation(90.9±24.7mm). The difference of C2-A between the two groups was also statistically significant. The horizontal offset of patients with lower extremity compensation was significantly smaller than that of patients without lower extremity compensation(52.2±8.1mm vs 68.6±26.3mm), the difference was averaged at 16.4mm. Conclusions: DS patients can make the sagittal profile of the whole body in a more favourable balance state through lower limb compensation, while patients without lower limb substitution may need to reduce the overall imbalance trend of thoracic kyphosis compensation sagittal plane due to pelvic posterior rotation limitation. |
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