Sagittal Spinal-pelvic Alignment in Patients with Crowe Type IV Developmental Dysplasia of the Hip

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2020 Oct 18

PMID 33069234

Citations 2

Authors

Peng Ren

Xiangpeng Kong

Wei Chai

Yan Wang

Affiliations

Soon will be listed here.

Abstract

Background: The impact of high dislocated dysplastic hips on spinal-pelvic alignment has not been well described. This study aims to evaluate compensatory spinal radiographic changes and presence of back pain in patients with Crowe type IV developmental dysplasia of the hip (DDH).

Methods: An observational study was conducted from July 2016 to December 2017, and 49 consecutive patients with Crowe IV DDH were enrolled. Forty-nine sex- and age-matched asymptomatic healthy adults were recruited as the controls. The sacral slope (SS), lumbar lordosis (LL), spino-sacral angle (SSA), C7 tilt (C7T), and sagittal vertical axis (SVA [C7]) were measured on lateral whole spine radiographs. The presence of low back pain and visual analogue scale (VAS) scores were recorded.

Results: The patients with Crowe IV DDH showed significantly greater SS (47.5 ± 7.5° vs. 40.4 ± 6.7°, p < 0.05), LL (- 63.7 ± 9.2° vs. - 53.3 ± 11.5°, P < 0.05), SSA (141.8° ± 7.2° vs. 130.6 ± 7.9°, p < 0.05), C7T (93.9 ± 3.6° vs. 91.1 ± 3.7°, P < 0.05), and lower SVA(C7) (- 16 mm[- 95-45] vs. 6.4 mm[- 52-47], p < 0.05) compared to the controls. The patients with bilateral Crowe IV DDH also exhibited larger SS, LL, SSA, and C7T and a smaller SVA (C7) than those with unilateral Crowe IV DDH. Sixty-three percent of the patients with Crowe IV DDH reported low back pain.

Conclusion: The patients with Crowe IV DDH exhibited abnormal spinal-pelvic alignment characterized by anterior pelvic tilt, lumbar hyperlordosis, and a backward-leaning trunk. Bilateral Crowe IV DDH had a greater impact on spinal-pelvic alignment than unilateral Crowe IV DDH.

Citing Articles

Coronal and sagittal spinopelvic alignment in the patients with unilateral developmental dysplasia of the hip: a prospective study.

Zhang G, Li M, Qian H, Wang X, Dang X, Liu R Eur J Med Res. 2022; 27(1):160.

PMID: 36030216 PMC: 9419408. DOI: 10.1186/s40001-022-00786-w.

Change of Pelvic Sagittal Tilt after Total Hip Arthroplasty in Patients with Bilateral Crowe Type IV Developmental Dysplasia of the Hip.

Zhang B, Du Y, Sun J, Shen J, Li T, Zhou Y Orthop Surg. 2022; 14(5):919-926.

PMID: 35445552 PMC: 9087458. DOI: 10.1111/os.13275.

References

Piazzolla A, Solarino G, Bizzoca D, Montemurro V, Berjano P, Lamartina C . Spinopelvic parameter changes and low back pain improvement due to femoral neck anteversion in patients with severe unilateral primary hip osteoarthritis undergoing total hip replacement. Eur Spine J. 2017; 27(1):125-134. DOI: 10.1007/s00586-017-5033-7. View

Offierski C, Macnab I . Hip-spine syndrome. Spine (Phila Pa 1976). 1983; 8(3):316-21. DOI: 10.1097/00007632-198304000-00014. View

Zhu F, Bao H, He S, Wang F, Zhu Z, Liu Z . Lumbo-femoral angle: a novel sagittal parameter related to quality of life in patients with adult scoliosis. Eur Spine J. 2014; 24(6):1244-50. DOI: 10.1007/s00586-014-3614-2. View

Matsuyama Y, Hasegawa Y, Yoshihara H, Tsuji T, Sakai Y, Nakamura H . Hip-spine syndrome: total sagittal alignment of the spine and clinical symptoms in patients with bilateral congenital hip dislocation. Spine (Phila Pa 1976). 2004; 29(21):2432-7. DOI: 10.1097/01.brs.0000143671.67779.14. View

Sariali E, Lazennec J, Khiami F, Gorin M, Catonne Y . Modification of pelvic orientation after total hip replacement in primary osteoarthritis. Hip Int. 2009; 19(3):257-63. DOI: 10.1177/112070000901900312. View

Dezateux C, Rosendahl K . Developmental dysplasia of the hip. Lancet. 2007; 369(9572):1541-1552. DOI: 10.1016/S0140-6736(07)60710-7. View

Okuda T, Fujita T, Kaneuji A, Miaki K, Yasuda Y, Matsumoto T . Stage-specific sagittal spinopelvic alignment changes in osteoarthritis of the hip secondary to developmental hip dysplasia. Spine (Phila Pa 1976). 2007; 32(26):E816-9. DOI: 10.1097/BRS.0b013e31815ce695. View

Weng W, Wang W, Wu M, Xu Z, Xu L, Qiu Y . Characteristics of sagittal spine-pelvis-leg alignment in patients with severe hip osteoarthritis. Eur Spine J. 2014; 24(6):1228-36. DOI: 10.1007/s00586-014-3700-5. View

Mac-Thiong J, Roussouly P, Berthonnaud E, Guigui P . Sagittal parameters of global spinal balance: normative values from a prospective cohort of seven hundred nine Caucasian asymptomatic adults. Spine (Phila Pa 1976). 2010; 35(22):E1193-8. DOI: 10.1097/BRS.0b013e3181e50808. View

10.

Roussouly P, Pinheiro-Franco J . Biomechanical analysis of the spino-pelvic organization and adaptation in pathology. Eur Spine J. 2011; 20 Suppl 5:609-18. PMC: 3175914. DOI: 10.1007/s00586-011-1928-x. View

11.

Hasegawa K, Okamoto M, Hatsushikano S, Shimoda H, Ono M, Homma T . Standing sagittal alignment of the whole axial skeleton with reference to the gravity line in humans. J Anat. 2017; 230(5):619-630. PMC: 5382592. DOI: 10.1111/joa.12586. View

12.

Legaye J, Duval-Beaupere G, Hecquet J, Marty C . Pelvic incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves. Eur Spine J. 1998; 7(2):99-103. PMC: 3611230. DOI: 10.1007/s005860050038. View

13.

Le Huec J, Saddiki R, Franke J, Rigal J, Aunoble S . Equilibrium of the human body and the gravity line: the basics. Eur Spine J. 2011; 20 Suppl 5:558-63. PMC: 3175916. DOI: 10.1007/s00586-011-1939-7. View

14.

Chaleat-Valayer E, Mac-Thiong J, Paquet J, Berthonnaud E, Siani F, Roussouly P . Sagittal spino-pelvic alignment in chronic low back pain. Eur Spine J. 2011; 20 Suppl 5:634-40. PMC: 3175927. DOI: 10.1007/s00586-011-1931-2. View

15.

Crowe J, Mani V, Ranawat C . Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am. 1979; 61(1):15-23. View

16.

Morvan G, Mathieu P, Vuillemin V, Guerini H, Bossard P, Zeitoun F . Standardized way for imaging of the sagittal spinal balance. Eur Spine J. 2011; 20 Suppl 5:602-8. PMC: 3175923. DOI: 10.1007/s00586-011-1927-y. View

17.

Yoshimoto H, Sato S, Masuda T, Kanno T, Shundo M, Hyakumachi T . Spinopelvic alignment in patients with osteoarthrosis of the hip: a radiographic comparison to patients with low back pain. Spine (Phila Pa 1976). 2005; 30(14):1650-7. DOI: 10.1097/01.brs.0000169446.69758.fa. View

18.

Parvizi J, Pour A, Hillibrand A, Goldberg G, Sharkey P, Rothman R . Back pain and total hip arthroplasty: a prospective natural history study. Clin Orthop Relat Res. 2010; 468(5):1325-30. PMC: 2853644. DOI: 10.1007/s11999-010-1236-5. View

19.

Funao H, Tsuji T, Hosogane N, Watanabe K, Ishii K, Nakamura M . Comparative study of spinopelvic sagittal alignment between patients with and without degenerative spondylolisthesis. Eur Spine J. 2012; 21(11):2181-7. PMC: 3481103. DOI: 10.1007/s00586-012-2374-0. View

20.

Weiner D, Distell B, Studenski S, Martinez S, Lomasney L, Bongiorni D . Does radiographic osteoarthritis correlate with flexibility of the lumbar spine?. J Am Geriatr Soc. 1994; 42(3):257-63. DOI: 10.1111/j.1532-5415.1994.tb01748.x. View