Compensatory mechanisms contributing to keep the sagittal balance of the spine
Compensatory mechanisms contributing to keep the sagittal balance of the spine
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DOI：
10.1007/s00586-013-3030-z
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发表时间：
2013-11-01
影响因子：
2.8
通讯作者：
Perrin, Gilles
中科院分区：
文献类型：
--
作者：
Barrey, Cedric;Roussouly, Pierre;Perrin, Gilles
脊柱老化以小关节关节炎、退行性腰椎间盘疾病、骨重建和伸肌萎缩为特征，导致腰椎进行性后凸畸形。本文旨在描述严重退行性腰椎退变患者的不同代偿机制。根据失衡的严重程度，可以观察到三个阶段：平衡、平衡与代偿机制平衡和失衡。对于最后两个阶段，代偿机制可以限制腰椎前凸度丧失对整体矢状面排列的影响，从而有助于保持脊柱的矢状面平衡。基本概念是延伸脊柱后凸的相邻节段，允许补偿矢状面不平衡，但可能会导致不良影响。最后，我们提出了一个三步算法来分析全局平衡状态，并考虑到脊柱、骨盆和下肢区域的代偿机制的存在。
Aging spine is characterized by facet joints arthritis, degenerative disc disease, bone remodeling and atrophy of extensor muscles resulting in a progressive kyphosis of the lumbar spine.The aim of this paper is to describe the different compensatory mechanisms for patients with severe degenerative lumbar spine.According to the severity of the imbalance, three stages are observed: balanced, balanced with compensatory mechanisms and imbalanced. For the two last stages, the compensatory mechanisms permit to limit the consequences of loss of lumbar lordosis on global sagittal alignment and therefore contribute to keep the sagittal balance of the spine.The basic concept is to extend adjacent segments of the kyphotic spine allowing for compensation of the sagittal unbalance but potentially inducing adverse effects.Finally, we propose a three-step algorithm to analyze the global balance status and take into consideration the presence of the compensatory mechanisms in the spinal, pelvic and lower limb areas.