Abstract
Background and objectives: The influence of changes in spinal alignment after total hip arthroplasty (THA) on improvement in lower back pain (LBP) remains controversial. To evaluate how changes in spinal malalignment correlate with improvement in preoperative LBP in patients who underwent THA for hip osteoarthritis. Materials and Methods: From November 2015 to January 2017, 104 consecutive patients who underwent unilateral THA were prospectively registered. Whole spine X-rays and patient-reported outcomes (PROs) were obtained preoperatively and 12 months postoperatively. The PROs used were the Numerical Rating Scale (NRS) for back pain, EuroQol 5 Dimension, and Short Form-12. Results: Seventy-four (71%) patients with complete data were eligible for the analysis. The sagittal parameters changed slightly but significantly. Coronal alignment significantly improved. Twenty-six (37%) patients had LBP preoperatively. These patients had smaller lumbar lordosis (LL), larger PT, and larger PI minus LL than the patients without LBP. Fourteen (54%) of the 26 patients with preoperative LBP showed pain improvement, but there were no significant differences in the radiographic parameters. Conclusions: Although preoperative LBP was likely to be resolved after THA, there were no significant correlations between alignment changes and LBP improvement. The cause of LBP in patients with hip osteoarthritis (OA) patients might be multifactorial.
Highlights
It is well established that the maintenance of an upright standing position requires certain correlations among the spine, pelvis, and lower extremities [1,2,3,4,5]
We sought to assess the changes in spinal alignment and lower back pain (LBP), as well as the connections between spinal alignment and LBP, after total hip arthroplasty (THA)
About half of the patients with preoperative LBP showed improvement postoperatively; we did not find any relationship between improvement in LBP and either sagittal or coronal alignment changes
Summary
It is well established that the maintenance of an upright standing position requires certain correlations among the spine, pelvis, and lower extremities [1,2,3,4,5]. Preoperative leg length discrepancy is is corrected by the surgery, it would be reasonable to speculate that the spinal sagittal alignment will change [7,8]. The influence of spinal alignment changes on clinical symptoms, such as lower back pain (LBP), remains controversial [11,12]. We aimed to evaluate the associations eaxmpoenctgedsptioniaml aplriogvnem, wenhticchhamngayesaaffnedctipmeplvriocvoebmlieqnutitiyn apnrdeospcoerliaotsivise[L9,B1P0].afHteorwuenvielar,tethrael iTnHfluAe.nce of spinal alignment changes on clinical symptoms, such as lower back pain (LBP), remains controversial [11,12]. The influence of changes in spinal alignment after total hip arthroplasty (THA) on improvement in lower back pain (LBP) remains controversial. To evaluate how changes in spinal malalignment correlate with improvement in preoperative LBP in patients who underwent THA for hip osteoarthritis. The cause of LBP in patients with hip osteoarthritis (OA) patients might be multifactorial
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