The Relationship between Sagittal Spinal Alignment and Surgical Results in Degenerative Lumbar Scoliosis with Spinal Stenosis.
10.4184/jkss.2002.9.2.133
- Author:
Whoan Jeang KIM
1
;
Jin Sup YEOM
;
Jong Won KANG
;
Kyou Hyeun KIM
;
Seung Hun LEE
;
Keun Jong CHOY
;
Won Sik CHOY
Author Information
1. Department of Orthopaedic Surgery, Eulji University, Taejon, Korea. ortho@hananet.net
- Publication Type:Original Article
- Keywords:
Lumbar spine;
Degenerative scoliosis;
Sagittal spinal alignment;
Sagittal vertical axis
- MeSH:
Animals;
Axis, Cervical Vertebra;
Follow-Up Studies;
Lordosis;
Retrospective Studies;
Scoliosis*;
Spinal Stenosis*;
Spine
- From:Journal of Korean Society of Spine Surgery
2002;9(2):133-142
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
STUDY DESIGN: A retrospective study. OBJECTIVES: To analyze the correlation between clinical results and sagittal vertical axis, clinical results and total lumbar lordosis in degenerative lumbar scoliosis with spinal stenosis. SUMMARY OF LITERATURE REVIEW: There has been no report about the relation between sagittal spinal alignment and surgical outcome of degenerative lumbar scoliosis. MATERIALS AND METHODS: We reviewed 38 surgical cases of degenerative lumbar scoliosis from February 1997 to February 2001 with an average follow-up of 35 months. In whole spine standing AP and lateral radiographs, scoliotic angle(Cobb method), total lumbar lordosis(L1-S1) and the sagittal vertical axis(C7 plumb line) were measured. In lumbar flexion-extension and standing side bending views, the lateral translation was measured and instability was determined. Clinical results were evaluated based on the Kirkaldy-Willis criteria. RESULTS: The scoliotic angles at preoperative, postoperative and follow-up were 15.0+/-4.9, 5.3+/-3.1 and 7.1+/-3.7 degrees retro-spectively. Total lumbar lordosis were 28.7+/-6.1, 40.6+/-7.3 and 35.1+/-10.2 degrees retrospectively. Sagittal vertical axis at preoperative and the last follow-up were 3.3+/-3.2 and 0.1 +/-3.3 cm retrospectively. According to Kirkaldy-Willis criteria, 6 cases were excellent, 24 cases good, 7 cases fair and 1 case poor. There was no statistical correlation between total lumbar lordosis and the clinical results (r=-0.061, p=0.717). Sagittal vertical axis was significantly correlated with the clinical results (r=0.519, p=0.001). CONCLUSIONS: For improvement of surgical outcome of degenerative lumbar scoliosis, the sagittal vertical axis should be used as a parameter of sagittal alignment rather than the total lumbar lordosis.
