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Pelvic and spinal postural changes between standing-sitting positions following lumbosacral fusion: a pilot study
PURPOSE: Prospective pre-operative and post-operative comparative analysis of radiographic spino-pelvic parameters between sitting versus standing positions of patients with LS fusion, to detect adaptation mechanisms around fused spinal segments. METHODS: Sixteen patients aged 53.9 ± 15.9 who underw...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9349097/ https://www.ncbi.nlm.nih.gov/pubmed/35266032 http://dx.doi.org/10.1007/s00264-022-05365-6 |
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author | Borgeaud, Thomas Le Huec, Jean-Charles Faundez, Antonio |
author_facet | Borgeaud, Thomas Le Huec, Jean-Charles Faundez, Antonio |
author_sort | Borgeaud, Thomas |
collection | PubMed |
description | PURPOSE: Prospective pre-operative and post-operative comparative analysis of radiographic spino-pelvic parameters between sitting versus standing positions of patients with LS fusion, to detect adaptation mechanisms around fused spinal segments. METHODS: Sixteen patients aged 53.9 ± 15.9 who underwent LS fusion between L3 and S1 were extracted from the database of an ongoing prospective study. Different spino-pelvic parameters were evaluated on full spine X-rays, standing, then sitting straight. Parameters were compared pre-operative versus post-operative, and on standing versus sitting X-rays. RESULTS: Preliminary results revealed a significantly greater pre-operative pelvic tilt (PT) in sitting than standing posture, (p = 0.020) but not in post-operative (p = 0.087). After surgery, PT was lower in sitting compared to pre-operative (p = 0.034) but not in standing (p = 0.245). L4–S1 lordosis was lower in sitting than standing in pre-operative (p = 0.014) and post-operative (p = 0.021). Surgery decreased segmental lordosis above the fusion (PSL, proximal sagittal lordosis) in sitting (p = 0.039) but not in standing (p = 0.193). No significant differences in thoracic kyphosis (TK) were observed. Fusions down to L5 versus S1 showed no significant differences for PT and PSL, neither in sitting versus standing, nor pre-operative versus post-operative. CONCLUSION: Before fusion, compared to standing, PT increases in sitting straight posture (pelvic retroversion), and the lumbar spine adapts by decreasing its lordosis, mainly at L4–S1. After fusion, the segments adjacent to the instrumented section, adapt in flexion at lumbosacral and thoracolumbar junctions, i.e. just below and above (PSL). This might have mechanical implications for the occurrence of adjacent segment disease. |
format | Online Article Text |
id | pubmed-9349097 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-93490972022-08-05 Pelvic and spinal postural changes between standing-sitting positions following lumbosacral fusion: a pilot study Borgeaud, Thomas Le Huec, Jean-Charles Faundez, Antonio Int Orthop Original Paper PURPOSE: Prospective pre-operative and post-operative comparative analysis of radiographic spino-pelvic parameters between sitting versus standing positions of patients with LS fusion, to detect adaptation mechanisms around fused spinal segments. METHODS: Sixteen patients aged 53.9 ± 15.9 who underwent LS fusion between L3 and S1 were extracted from the database of an ongoing prospective study. Different spino-pelvic parameters were evaluated on full spine X-rays, standing, then sitting straight. Parameters were compared pre-operative versus post-operative, and on standing versus sitting X-rays. RESULTS: Preliminary results revealed a significantly greater pre-operative pelvic tilt (PT) in sitting than standing posture, (p = 0.020) but not in post-operative (p = 0.087). After surgery, PT was lower in sitting compared to pre-operative (p = 0.034) but not in standing (p = 0.245). L4–S1 lordosis was lower in sitting than standing in pre-operative (p = 0.014) and post-operative (p = 0.021). Surgery decreased segmental lordosis above the fusion (PSL, proximal sagittal lordosis) in sitting (p = 0.039) but not in standing (p = 0.193). No significant differences in thoracic kyphosis (TK) were observed. Fusions down to L5 versus S1 showed no significant differences for PT and PSL, neither in sitting versus standing, nor pre-operative versus post-operative. CONCLUSION: Before fusion, compared to standing, PT increases in sitting straight posture (pelvic retroversion), and the lumbar spine adapts by decreasing its lordosis, mainly at L4–S1. After fusion, the segments adjacent to the instrumented section, adapt in flexion at lumbosacral and thoracolumbar junctions, i.e. just below and above (PSL). This might have mechanical implications for the occurrence of adjacent segment disease. Springer Berlin Heidelberg 2022-03-09 2022-08 /pmc/articles/PMC9349097/ /pubmed/35266032 http://dx.doi.org/10.1007/s00264-022-05365-6 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Paper Borgeaud, Thomas Le Huec, Jean-Charles Faundez, Antonio Pelvic and spinal postural changes between standing-sitting positions following lumbosacral fusion: a pilot study |
title | Pelvic and spinal postural changes between standing-sitting positions following lumbosacral fusion: a pilot study |
title_full | Pelvic and spinal postural changes between standing-sitting positions following lumbosacral fusion: a pilot study |
title_fullStr | Pelvic and spinal postural changes between standing-sitting positions following lumbosacral fusion: a pilot study |
title_full_unstemmed | Pelvic and spinal postural changes between standing-sitting positions following lumbosacral fusion: a pilot study |
title_short | Pelvic and spinal postural changes between standing-sitting positions following lumbosacral fusion: a pilot study |
title_sort | pelvic and spinal postural changes between standing-sitting positions following lumbosacral fusion: a pilot study |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9349097/ https://www.ncbi.nlm.nih.gov/pubmed/35266032 http://dx.doi.org/10.1007/s00264-022-05365-6 |
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