Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Orthop Surg. 2013 Nov;5(4):261-5. doi: 10.1111/os.12076.
The study hypotheses were that: (i) there would be a difference in sagittal plane alignment between patients with symptomatic osteoarthritis of the hip and those with lumbar degenerative disk disease; and (ii) that sagittal plane lumbar alignment would change following total hip arthroplasty (THA).
In this prospective study, a series of patients without back pain or lumbar complaints who were scheduled to undergo THA underwent lateral lumbar radiography prior to and nine months after elective THA. Radiographic measurements of lumbar alignment included sacral slope, lumbar lordosis, and L1 axis S1 distance (L1 ASD). All measurements were performed on upright, standing, lateral radiographs. A control group of patients underwent serial radiography over the same period for evaluation of lumbar degenerative disease. The independent sample t-test was used to compare the mean sacral slope, lumbar lordosis, and L1 ASD in the THA and control groups.
There were 12 patients in the THA group and 34 in the control group. Mean follow-up was 9 months. Average age in the control group was 63 years and in the THA group 64.2 years. The sacral slope was greater in the THA group (mean, 23°) than in the lumbar patients (control group) and this difference was statistically significant (mean, 11°, P = 0.001). There were no statistically significant differences between THA and control patients in lumbar lordosis or L1 ASD. Change before and after THA was measured. There were no statistically significant differences in assessed radiographic variables preoperatively versus postoperatively.
There is no significant change in spinal alignment after unilateral THA. At baseline, patients with symptomatic spine complaints have less sacral slope than their hip arthroplasty counterparts.
本研究假设：（i）患有髋关节骨关节炎症状的患者与患有腰椎退行性椎间盘疾病的患者在矢状面排列上存在差异；（ii）全髋关节置换术（THA）后，腰椎矢状面排列会发生变化。
在这项前瞻性研究中，一系列无腰痛或腰椎主诉的患者在接受择期 THA 术前和术后 9 个月接受了腰椎侧位 X 线摄影。腰椎排列的放射学测量包括骶骨倾斜度、腰椎前凸和 L1 轴 S1 距离（L1 ASD）。所有测量均在直立、站立的侧位 X 线片上进行。对照组患者在同一时期接受了一系列 X 线摄影，以评估腰椎退行性疾病。采用独立样本 t 检验比较 THA 组和对照组的平均骶骨倾斜度、腰椎前凸和 L1 ASD。
THA 组有 12 例患者，对照组有 34 例患者。平均随访时间为 9 个月。对照组的平均年龄为 63 岁，THA 组为 64.2 岁。THA 组的骶骨倾斜度（平均 23°）大于腰椎患者（对照组），且差异具有统计学意义（平均 11°，P=0.001）。THA 组和对照组患者的腰椎前凸和 L1 ASD 之间无统计学显著差异。测量了 THA 前后的变化。术前与术后评估的放射学变量无统计学显著差异。
单侧 THA 后脊柱排列无明显变化。在基线时，有脊柱症状的患者的骶骨倾斜度小于髋关节置换术患者。
