STUDY DESIGN: Research using radiographic findings. OBJECTIVES: To compare spinopelvic parameters in detail between normal subjects and those who had bilateral gonarthrosis with or without spondylosis. SUMMARY OF LITERATURE REVIEW: The relationship between knee joint flexion contracture and hypolordosis in the lumbar spine has been well established. However, spinopelvic parameters in subjects with gonarthrosis without flexion contracture have not been well described in the literature. MATERIALS AND METHODS: Fifty-seven male subjects in their 60s with bilateral gonarthrosis over Kellgren-Lawrence grade III were included. They were subdivided into the KS group (with spinal osteoarthritis, n=32) and the KN group (without spinal osteoarthritis, n=25). Normal asymptomatic subjects without disease in their back or leg were analyzed as the control group (NN; n=84). The following spinopelvic parameters were measured and compared; C7 plumbline (C7PL), thoracic kyphosis (TK), thoracolumbar kyphosis (TLK), lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI). RESULTS: In the KS group, the C7PL was significantly anteriorly displaced compared to the KN group (1.7±4.5 cm vs. −0.6±2.9 cm, p=0.031) and the NN group (1.7±4.5 cm vs. −0.5±2.9 cm, p=0.014). TK in the KN group was significantly smaller than in the NN group (25.4±8.8° vs. 30.1±8.3°, p=0.041). The KS group had the smallest value of LL, while the NN group had the largest value of LL (−23.2±48.7° vs. −44.9±33.8° vs. −57.3±8.5°, p<0.001). No significant difference was observed in PI, SS, or PT among the 3 groups. A strong correlation was found between LL and SS in the NN group (R=−0.776, p<0.01), while this correlation was moderate in the KN group (R=−0.355, p<0.01). CONCLUSIONS: Overall balance was maintained in the subjects who had gonarthrosis without spinal osteoarthritis. Subjects with gonarthrosis showed less LL, especially if they had spinal osteoarthritis. Further studies are needed to characterize the differences in these pelvic parameters, and to evaluate changes in individuals with knee joint flexion contracture.
Animals ; Contracture ; Humans ; Incidence ; Knee ; Knee Joint ; Kyphosis ; Leg ; Lordosis ; Male ; Osteoarthritis ; Osteoarthritis, Spine ; Spine ; Spondylosis

The Taylor's approach is a special paramedian approach to enter the L5-S1 interspace. The L5-S1 interspace is the largest in vertebral column. This approach is particularly useful when the interspace has been narrowed by pathologic bone destruction such as rheumatoid arthritis or osteoarthritis. Surgery in geriatric patients is associated with a markedly higher incidence of perioperative complication or mortality rate. Optimal anesthetic management of geriatric patients depends on understanding of the normal anatomy and physiologic changes in response to drug in aging. We studied of 3-geriatric patients with Taylor's approach. These patients had problems with respiratory dysfunction and anatomic constraints, which make other approaches unfeasible.
Aging ; Arthritis, Rheumatoid ; Humans ; Incidence ; Mortality ; Osteoarthritis ; Spine

Foreatiers disease is a peculiar type of ankylosing hyperostosis of the spine characterized by ossification of the anterior and right lateral aspects of the vertebral column, particularly in the thoracic region. The clinical, pathological and reontgenographic features of the disorder allowed its differentiation from other spinal diseases including ankylosing spordylitis and osteoarthritis. A case of Forestiers disease is presented with brief review of literatures.
Hyperostosis ; Hyperostosis, Diffuse Idiopathic Skeletal ; Osteoarthritis ; Spinal Diseases ; Spine

Degenerative arthritis of the lumbar spine is one of the main causes of the low back pain over the fifth decade of life. Nowadays, it seems that the number of obese person increases gradually and the role of Obesity in the development of articular degeneration remains controversial. The authors studied 100 cases of the primary degenerative arthritis of the lumbar spine clinically and statistically and compared 50 cases among these with 2 control groups, with and without low back pain, from Mar. 1982 to Sep. 1982. The results were as follows: 1. Among the patients with the degenerative arthritis of the lumbar spine, the ratio of male to female was 1:4, and the age group with the highest frequency was the 6th decade (47%) 2. 44% was obese in the arthritis group and 26% in the control group with low back pain and 12% in the control group without low back pain. 3. The relative risk of the hypothesis that the arthritic patient is obeser than the patient with low back pain but without degenerative changes on X-ray was 2.3, but the hyposthesis was proved to be statistically insignificant. The relative risk of the hypothesis that the arthriticpatient was obeser than the patient without low back pain and degenerative changes on X-ray was 6.3 and proved to be statistically significant.
Arthritis ; Female ; Humans ; Low Back Pain ; Male ; Obesity ; Osteoarthritis ; Spine

OBJECTIVE: To evaluate the prevalence of osteoporosis and degenerative knee osteoarthritis (OA) in female patients over 50 years, who were surgically indicated for lumbar spinal stenosis (LSS). METHODS: The study subjects were 76 female patients who underwent spinal surgery for LSS between January and December 2006. Radiographs of thoracolumbar spine, hip and knee were taken. Osteoporotic profiles including lumbar and hip bone mineral density (BMD) measurements and proper treatment of osteoporosis were investigated. RESULTS: The mean age was 65.1 (50~86) years old. Seven-teen patients (22.4%) and nine-teen patients (25.0%) had spine and hip BMD below a T score of -2.5. Thirty-two patients (48.0%) and four patients (5.2%) had knee and hip OA of K-L grade III and IV each. Old thoracolumbar osteoporotic compression fractures were confirmed in 6 patients (7.8%). Forty-eight percent (48.0%) of enrolled patients had hypovitaminosis D. According to osteoporosis guidelines from the Korean Society of Bone Metabolism, 31 patients (40.7%) qualified to be candidates of intensive osteoporosis treatments. CONCLUSION: The prevalence of osteoporosis and knee OA in LSS patients was 25.0% and 42.1%. Based on checking up BMD and knee OA in female patient with LSS, proper treatments of osteoporosis and degenerative knee OA should be considered.
Bone Density ; Female ; Fractures, Compression ; Hip ; Humans ; Knee ; Osteoarthritis ; Osteoarthritis, Knee ; Osteoporosis ; Prevalence ; Spinal Stenosis ; Spine

PURPOSE: Patients with osteoarthritis of knee joint often concomitantly suffer from degenerative disease of the spine. Furthermore, resulting spinal problems could influence function and pain after total knee arthroplasty (TKA), and hence, cause the results of TKA to be misinterpreted. The purpose of this prospective study was to evaluate the effect of spinal disorders, as assessed by Swiss Spinal Stenosis score (SSS scores), on knee function as assessed by knee scores, the Hospital for Special Surgery scale (HSS scale) and Western Ontario & McMaster Osteoarthritis Index scores (WOMAC scores) in patients that after TKA. MATERIALS AND METHODS: One hundred and forty nine osteoarthritic knees of 87 patients were enrolled in this study. All patients received TKA by single surgeon (W-S Cho) from August 2009 to May 2010. Preoperative and postoperative 1- and 2-years HSS scale, Knee, WOMAC, and SSS scores were recorded and analyzed. RESULTS: Postoperative HSS scale, Knee, and WOMAC scores showed marked improvements versus preoperative scores, and scores at 2 years postoperatively were better than at 1 year postoperatively. No significant correlation was found between postoperative Knee scores and SSS scores. On the other hand, statistically significant correlations were found between HSS and SSS scores and between WOMAC and SSS scores. Interestingly, differences between Knee scores and HSS scores were found to be significantly correlated with SSS scores. CONCLUSION: When evaluating outcome after TKA, spinal problems should be investigated concomitantly. SSS scores appear to provide a suitable means of assessing spinal problems.
Arthroplasty ; Hand ; Humans ; Joints ; Knee ; Ontario ; Osteoarthritis ; Osteoarthritis, Knee ; Prospective Studies ; Spinal Stenosis ; Spine

PURPOSE: To examine the correlation between bone mineral density (BMD) and radiographic changes in knee osteoarthritis (OA). MATERIALS AND METHODS: BMD of the lumbar spine and hip was measured, using dual x-ray energy absorptiometry, in 297 Korean women who visited our clinic with knee joint pain; anteroposterior weight bearing X-ray of the knees was also taken. Radiographic OA was defined as a Kellgren-Lawrence score of >or=2. The relationship between BMD and the radiographic changes of OA was examined using correlation and multiple regression analysis. RESULTS: Mean BMD was lower in subjects with knee OA (n=136) than in non OA subjects (n=161): Mean BMD in the lumbar spine, OA group was 0.863 +/-0.154 g/cm2 and in the non OA group 0.896 +/-0.131 g/cm2, and there was no significant correlation between the BMD of the spine and radiographic knee OA (r=-0.087, p=0.134). Mean BMD in the hip, OA group was 0.610 +/-0.135 g/cm2 and in the non OA group was 0.662+/-0.105 g/cm2, and the difference between the two groups was significant (r=-0.227, p<0.001). CONCLUSION: Hip BMD and radiographic knee OA were found to be negatively correlated, although the mechanism remains unclear. This result differs from that of a western study and further study is needed.
Bone Density* ; Female ; Hip ; Humans ; Knee Joint ; Knee* ; Osteoarthritis ; Osteoarthritis, Knee* ; Spine ; Weight-Bearing

PURPOSE: The purpose of this study was to measure the bone mineral density (BMD) of the proximal tibia, lumbar spine and proximal femur and to determine out their correlations with the knee alignment in knee osteoarthritic (OA) patients. MATERIALS AND METHODS: The study involved 203 patients (322 knees) with knee osteoarthritis and who had underwent total knee arthroplasty from July 2005 to September 2006. The BMDs of the proximal tibia, lumbar spine and proximal femur were measured and compared. The knee alignment was checked and its correlation with each BMD was analyzed. RESULTS: The mean BMD of the medial proximal tibia, lateral proximal tibia, lumbar spine and proximal femur were 0.857+/-0.180 g/cm(2), 0.772+/-0.177 g/cm(2), 0.940+/-0.174 g/cm(2), and 0.721+/-0.126 g/cm(2), respectively. The mean knee alignment was 10.2+/-4.7degrees varus and the deformity got severe as the BMD of the lateral proximal tibia, lumbar spine and proximal femur were lower and that of the medial proximal tibia was higher. CONCLUSION: The BMD of the proximal tibia was lower than that of the lumbar spine and higher than that of the proximal femur in patients with knee osteoarthritis. The BMDs of the lateral proximal tibia, lumbar spine and proximal femur were negatively correlated with the degree of varus deformity, but that of the medial proximal tibia was positively correlated.
Arthroplasty ; Bone Density ; Congenital Abnormalities ; Femur ; Humans ; Knee ; Lower Extremity ; Osteoarthritis ; Osteoarthritis, Knee ; Spine ; Tibia

OBJECTIVES: The purpose of this study was to determine the association between the bone mineral density (BMD) and severity of spinal osteoarthritis (spondylosis) in osteoporotic spinal compression fracture. METHODS: Fifty six patients were evaluated 66 cases had an osteoporotic thoracolumbar compression fracture between January 2008 and June 2010. The average patient age was 76.2 years (M/F : 8/48). Age and body mass index (BMI, kg/m2) were measured, and the BMD was performed using peripheral quantitative computed tomography (pQCT). Simple thoracolumbar (T-L) spine lateral radiography was evaluated for three criteria: presence of osteophytes, disc space narrowing and vertebral body sclerosis. The findings were graded 0 to 3 and analyzed statistically for a correlation with the BMD and fractured vertebrae. RESULTS: Acute compression fractures comprised of 15 cases and the most common site of acute fractures with old fractures was lumbar spine (L1; 30 cases, 45.4%). The average of BMI was 23.32 and BMD (T-score) was -4.47. Pearson's rho showed a positive association between the weight, height and the BMD (P < 0.01). In terms of the BMD versus spondylosis, there was a positive association with high score in the high order cortical bone. Compression fractures occurrence rate in the absent and present of spondylosis was 74.3% and 22.4%, and 69% occur in the spinal segmental with no bony spur with chi-square test (P < 0.01). CONCLUSION: In the present of spondylosis was high score of cortical BMD and low rate of compression fracture. Spondylosis could be one of a factor of the occurrence in acute and adjacent compression fracture after old fractures.
Body Mass Index ; Bone Density ; Fractures, Compression ; Humans ; Osteoarthritis, Spine ; Osteophyte ; Sclerosis ; Spine ; Spondylosis

STUDY DESIGN: We analysed retrospectively the entry point of pedicle screw in the lower lumbar spine using computed tomoscan. OBJECTIVES: The purpose of this study is to find the ideal entry point of pedicle screw in the lower lumbar spine. MATERIALS AND METHODS: We evaluated 98 patients with each second, third, fourth, fifth lumbar spine, and divide three group into normal group(NP), osteoarthritis group(OA), degenerative spondylolisthesis group(DS). We collected the two axial images of lower lumbar spine from CT at the same level. One image is parallel to upper end plate and again, the facet joint is well visuable, another image is the pedicle which cross the center, and the size of the both sides of pedicle is same and largest. And then we were superimposed mathematically above two images with computer. With the use of these three images, facet joint and pedicle axis orientation, pedicle isthmus width, distance between facet joint and pedicle axis, distance between lateral surface of facet and pedicle axis are measured. RESULT: The ideal entry point of pedicle screw is 3mm lateral from lateral end of facet joint in NP group, in OA 0.5~1mm medial and in DS 0.3mm medial from lateral end of facet joint. CONCLUSION: The selected anatomical landmark using the pedicle screw insertion is not advisable because of the variations of pedicle width and orientation depend on pathologic state of the lower lumbar spine, especially facet joint. We suggest that the sugeon should selected well the ideal entry point of the pedicle screw, knowing the shape and any anatomical variations of the pedicle in details before screw insertion with peroperative computed tomoscan.
Axis, Cervical Vertebra ; Humans ; Osteoarthritis ; Retrospective Studies ; Spine* ; Spondylolisthesis ; Zygapophyseal Joint