The lumbar lordosis index: a new ratio to detect spinal malalignment with a therapeutic impact for sagittal balance correction decisions in adult scoliosis surgery
The lumbar lordosis index: a new ratio to detect spinal malalignment with a therapeutic impact for sagittal balance correction decisions in adult scoliosis surgery
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DOI：
10.1007/s00586-013-2711-y
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发表时间：
2013-06-01
影响因子：
2.8
通讯作者：
Obeid, Ibrahim
中科院分区：
文献类型：
--
作者：
Boissiere, Louis;Bourghli, Anouar;Obeid, Ibrahim
在成人脊柱侧凸中经常观察到骶椎对线不良。C7铅垂线、腰部前凸和骨盆倾斜是评估矢状面平衡以及需要进行椎骨截骨术来纠正的主要因素。我们描述了一个比率：腰椎前凸指数（腰椎前凸/骨盆发生率比值）（LLI）并分析其与脊柱排列不良和椎体截骨术的关系。53例手术治疗的成人脊柱侧凸患者术前和术后进行全脊柱EOS X线检查，测量脊柱骨盆参数和LLI。在预测理论腰椎前凸后计算前凸缺乏。相关性分析表明，所有参数均与脊柱排列不良相关，但LLI的相关性最高（r = -0.978）。它也是本研究中预测脊柱截骨术需求的最佳参数（如果LLI < 0.5，则r = 1）。LLI是矢状面对线不良分析的统计学验证参数。它可以作为一种数学工具来检测成人脊柱侧凸的脊柱对线不良，并指导外科医生决定实现成人脊柱侧凸矢状面矫正的椎体截骨术。它也可用于解释成人脊柱侧凸的临床系列。
Sagittal malalignment is frequently observed in adult scoliosis. C7 plumb line, lumbar lordosis and pelvic tilt are the main factors to evaluate sagittal balance and the need of a vertebral osteotomy to correct it. We described a ratio: the lumbar lordosis index (ratio lumbar lordosis/pelvic incidence) (LLI) and analyzed its relationships with spinal malalignment and vertebral osteotomies.53 consecutive patients with a surgical adult scoliosis had preoperative and postoperative full spine EOS radiographies to measure spino-pelvic parameters and LLI. The lack of lordosis was calculated after prediction of theoretical lumbar lordosis. Correlation analysis between the different parameters was performed.All parameters were correlated with spinal malalignment but LLI is the most correlated parameter (r = -0.978). It is also the best parameter in this study to predict the need of a spinal osteotomy (r = 1 if LLI < 0.5).LLI is a statistically validated parameter for sagittal malalignment analysis. It can be used as a mathematical tool to detect spinal malalignment in adult scoliosis and guides the surgeon decision of realizing a vertebral osteotomy for adult scoliosis sagittal correction. It can be used as well for the interpretation of clinical series in adult scoliosis.