Tabares NHI, Fleites MEE, Tabares SH, Morales SR

Language: Spanish
References: 26
Page: 1-19
PDF size: 386.46 Kb.

ABSTRACT

Studies have determined the importance of sagittal balance in the development of degenerative entities of the spine, mainly in the lumbar region; as well as in the results of the surgical interventions of these affections. The purpose of this paper is to review and discuss current concepts on vertebral and lumbar sagittal stability, as well as its influence on the degenerative spinal process, basically on stenosis, spondylolisthesis and degenerative scoliosis. There are pelvic parameters and spinal parameters that have to be taken into account for the preoperative and postoperative determination of sagittal balance. Sagittal balance is classified into normal balance, compensated balance and imbalance. This is very important to reach the correct diagnosis and apply the necessary surgical treatment.

REFERENCES

1. Dohzono S, Toyoda H, Takahashi S, Matsumoto T, Suzuki A, Terai H, et al. Factors associated with improvement in sagittal spinal alignment after microendoscopic laminotomy in patients with lumbar spinal canal stenosis. J Neurosurg Spine. 2016;25:39-45.

2. Obeid I, Boissiere L, Yilgor C, Larrieu D, Pellise F, Alanay A, et al. Global tilt: A single parameter incorporating spinal and pelvic sagittal parameters and least affected by patient positioning. Eur Spine J. 2016;25:3644-9.

3. Le Huec JC, Faundez A, Dominguez D, Hoffmeyer P, Aunoble S. Evidence showing the relationship between sagittal balance and clinical outcomes in surgical treatment of degenerative spinal diseases: a literature review. International Orthopaedics (SICOT). 2015;39:87-95.

4. Shin EK, Kim CH, Chung CK, Choi Y, Yim D, Jung W, et al. Sagittal imbalance in patients with lumbar spinal stenosis and outcomes after simple decompression surgery. Spine J. 2017;17:175-82.

5. Menezes-Reis R, Bonugli GP, Dalto VF, da Silva Herrero CF, Defino HL, Nogueira-Barbosa MH. Association between lumbar spine sagittal alignment and L4-L5 disc degeneration among asymptomatic young adults. Spine. 2016;41:E1081-7.

6. Lazennec JY, Folinais D, Bendaya S, Rousseau MA, Pour AE. The global alignment in patients with lumbar spinal stenosis: Our experience using the EOS full-body images. Eur J Orthop Surg Traumatol. 2016;26:713-24.

7. Chang DG, Ha KY, Kim YH, Lee EW. Spinopelvic alignment by different surgical methods in the treatment of degenerative sagittal imbalance of the lumbar spine. Clin Spine Surg. 2017;30:E390-7.

8. Keorochana G, Taghavi CE, Lee KB. Effect of sagittal alignment on kinematic changes and degree of disc degeneration in the lumbar spine: an analysis using positional MRI. Spine. 2011;36:893-8.

9. de Kunder SL, Rijkers K, van Kuijk SM, Evers SM, de Bie RA, van Santbrink H. A protocol of a randomized controlled multicenter trial for surgical treatment of lumbar spondylolisthesis: The Lumbar Interbody Fusion Trial (LIFT). BMC Musculoskelet Disord. 2016;17:417.

10. Försth P, Ólafsson G, Carlsson T, Frost A, Borgström F, Fritzell P, et al. A randomized, controlled trial of fusion surgery for lumbar spinal stenosis. N Engl J Med. 2016;374:1413-23.

11. Le Huec JC, Charosky S, Barrey C, Rigal J, Aunoble S. Sagittal imbalance cascade for simple degenerative spine and consequences: algorithm of decision for appropriate treatment. Eur Spine J. 2011;20(Suppl 5):699-703.

12. Kong LD, Zhang YZ, Wang F, Kong FL, Ding WY, Shen Y. Radiographic restoration of sagittal spinopelvic alignment after posterior lumbar interbody fusion in degenerative spondylolisthesis. Clin Spine Surg. 2016;29:E87-92.

13. Le Huec JC, Leijssen P, Duarte M, Aunoble S. Thoracolumbar imbalance analysis for osteotomy planification using a new method: FBI technique. Eur Spine J. 2011;19(Suppl 3):S233-364. Abstract S 239.

14. Young-Min Oh, Jong-Pil Eun. Clinical Impact of Sagital Spinopelvic Parameters on Disc Degeneration in Young Adults. Medicine. 2015;94(42):e1833.

15. Barrey C, Roussouly P, Le Huec JC, D'Acunzi G, Perrin G. Compensatory mechanisms contributing to keep the sagittal balance of the spine. Eur Spine J. 2013;22(Suppl 6):S834-41.

16. Lee JH, Na KH, Kim JH, Jeong HY, Chang DG. Is pelvic incidence a constant, as everyone knows? Changes of pelvic incidence in surgically corrected adult sagittal deformity. Eur Spine J. 2016;25:3707-14.

17. Ikuta K MK, Tominaga F, Sakuragi T, Kai K, Kitamura T. Clinical and radiological study focused on relief of low back pain following decompression surgery in selected patients of lumbar spinal stenosis associated with grade I degenerative spondylolisthesis. Spine. 2016;41(24):E1434-43.

18. Ahmad S, Hamad A, Bhalla A, Turner S, Balain B, Jaffray D. The outcome of decompression alone for lumbar spinal stenosis with degenerative spondylolisthesis. Eur Spine J. 2017;26:414-9.

19. Buckland AJ, Vira S, Oren JH, Lafage R, Harris BY, Spiegel MA, et al. When is compensation for lumbar spinal stenosis a clinical sagittal plane deformity? Spine. 2016;J 16:971-81.

20. Kitchen WJ, Mohamed M, Bhojak M, Wilby M. Neurogenic claudication secondary to degenerative spondylolisthesis: Is fusion always necessary? Br J Neurosurg. 2016;30:662-5.

21. Yang X, Kong Q, Song Y, Liu L, Zeng J, Xing R. The characteristics of spinopelvic sagittal alignment in patients with lumbar disc degenerative diseases. Eur Spine J. 2014;23:569-75.

22. Barrey C, Jund J, Noseda O, Roussouly P. Sagittal balance of the pelvis-spine complex and lumbar degenerative diseases. A comparative study about 85 cases. Eur Spine J. 2007;16:1459-67.

23. Hovorka I, Rousseau P, Bronsard N, Chalali M, Julia M, Carles M, et al. Extension reserve of the hip in relation to the spine: comparative study of two radiographic methods. Rev Chir Orthop Reparatrice Appar Mot. 2008;94(8):771-6.

24. Lafage V, Schwab F, Skalli W, Hawkinson N, Gagey PM, Ondra S, et al. Standing balance and sagittal plane spinal deformity: analysis of spinopelvic and gravity line parameters. Spine. 2008;33:1572-8.

25. 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. Spine. 2005;30:346-53.

26. Chen Q, Cao L, Bian C, Wang HR, Lin H, Li XL, Jiang YQ, Dong J. Degenerative spondylolisthesis in the fifth lumbar vertebra and radiographic parameters: A correlation analysis. Clin Spine Surg. 2017;30:E1233-8.