Abstract
OBJECTIVES:Spinopelvic alignment has been associated with improved quality of life in patients with vertebral deformities, and it helps to compensate for imbalances in gait. Although surgical treatment of scoliosis in patients with neuromuscular spinal deformities promotes correction of coronal scoliotic deformities, it remains poorly established whether this results in large changes in sagittal balance parameters in this specific population. The objective of this study is to compare these parameters before and after the current procedure under the hypothesis is that there is no significant modification.METHODS:Sampling included all records of patients with neuromuscular scoliosis with adequate radiographic records treated at Institute of Orthopedics and Traumatology of Clinics Hospital of University of São Paulo (IOT-HCFMUSP) from January 2009 to December 2013. Parameters analyzed were incidence, sacral inclination, pelvic tilt, lumbar lordosis, thoracic kyphosis, spinosacral angle, spinal inclination and spinopelvic inclination obtained using the iSite-Philips digital display system with Surgimap and a validated method for digital measurements of scoliosis radiographs. Comparison between the pre- and post-operative conditions involved means and standard deviations and the t-test.RESULTS:Based on 101 medical records only, 16 patients met the inclusion criteria for this study, including 7 males and 9 females, with an age range of 9-20 and a mean age of 12.9±3.06; 14 were diagnosed with cerebral palsy. No significant differences were found between pre and postoperative parameters.CONCLUSIONS:Despite correction of coronal scoliotic deformity in patients with neuromuscular deformities, there were no changes in spinopelvic alignment parameters in the group studied.
Highlights
In recent years, the sagittal balance of the spine has become a subject of growing interest, and its importance in the treatment of spine pathology has become increasingly recognized [1,2].Among the most commonly evaluated sagittal radiographic parameters, thoracic kyphosis (TK) and lumbar lordosis (LL) are already widely found in the pediatric population [3,4]
Sampling included all records of patients with neuromuscular scoliosis with adequate radiographic records treated at Institute of Orthopedics and Traumatology of Clinics Hospital of University of Sao Paulo (IOTHCFMUSP) from January 2009 to December 2013
Despite correction of coronal scoliotic deformity in patients with neuromuscular deformities, there were no changes in spinopelvic alignment parameters in the group studied
Summary
The sagittal balance of the spine has become a subject of growing interest, and its importance in the treatment of spine pathology has become increasingly recognized [1,2].Among the most commonly evaluated sagittal radiographic parameters, thoracic kyphosis (TK) and lumbar lordosis (LL) are already widely found in the pediatric population [3,4]. The sagittal balance of the spine has become a subject of growing interest, and its importance in the treatment of spine pathology has become increasingly recognized [1,2]. More recently, interest in other spinopelvic parameters has grown in the medical literature, and research into variations in such parameters in different populations has been increasingly conducted [5]. Proper spinopelvic alignment minimizes energy expenditure during walking and maintaining a horizontal gaze [1]. Proper alignment helps compensate for imbalances in gait [8]
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