Sagittal profile in spinal deformities and degenerative lumbar spondylolisthesis

Vol 32| Issue 2 | July – Dec 2019 | page: 31-38 | Suresh S Pillai, Harisankar M, Jaifer K


Authors: Suresh S Pillai [1], Harisankar M [2], Jayafar K [3]

[1] Department of spine surgery, Baby memorial Hospital, Calicut, Kerala, India.
[2] Department of Orthopaedics, Baby memorial Hospital, Calicut, Kerala, India.
[3] Consultant Orthopedic surgeon, Calicut, Kerala, India.

Address of Correspondence

Dr. Suresh S Pillai,
Baby memorial Hospital, Calicut, Kerala, India.
E-mail: sureshorth@googlemail.com


Abstract

Sagittal balance is a biomechanical feature of bipedal human spine which maintains the centre of gravity between the two legs for an energy efficient ambulation. A lot of compensatory mechanisms develop when there is loss of sagittal balance like loss of segmental lordosis, hyperextension at other lumbar segments, retrolisthesis, retroversion of pelvis, increased pelvic tilt and reduced sacral slope. Intrinsic pelvic morphology (pelvic incidence) determines the ability to compensate.
In degenerative lumbar spondylolisthesis pelvic parameters definitely matter. A high pelvic tilt is correlated with poor clinical outcome, poor quality of life and complications after surgery. Degenerative lumbar spondylolisthesis without instability or with single level degenerative listhesis does not cause much imbalance. Patients with multilevel degenerative disc disease, and degenerative scoliosis occurring along with degenerative spondylolisthesis requires restoration of lumbar lordosis by sagittal realignment procedures. Sagittal balance is essential for energy efficient posture, gait and function.
We have done a prospective study to assess the correlation between recurrence of symptoms and sagittal spine pelvic imbalance in lumbar intervertebral disc prolapse. It was observed that the recurrence of symptoms of lumbar IVDP was significantly correlated with sagittal spinopelvic imbalance (p value < 0.001).
Keywords: Sagittal balance, Spinal deformity, Degenerative lumbar spondylolisthesis, Recurrence, IVDP, Pelvic incidence, Lumbar lordosis.


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How to Cite this Article: Pillai S S, Harisankar M, Jayafar K | Sagittal Profile In Spinal Deformities And Degenerative Lumbar Spondylolisthesis | Kerala Journal of Orthopaedics | July – Dec 2019; 32(2): 31-38.

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