Yoon Young-Hyun, Moon Seong-Hwan, Lee Byung Ho, Suk Kyung-Soo, Park Si Young, Park Sub-Ri, Kim Namhoo, Kim Hak-Sun, Kwon Ji-Won
Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
Int J Spine Surg. 2024 Nov 8;18(5):589-594. doi: 10.14444/8681.
Interest in the correlation between the spinopelvic complex and its radiographic parameters in early total hip arthroplasty has been increasing. This study investigated whether radiological spinopelvic parameters are risk factors for early total hip replacement (THR) within 1 year of spinal fusion surgery. The primary research question focused on identifying specific spinopelvic changes that may lead to early THR.
We retrospectively analyzed patients who underwent lumbar spinal fusion between 2016 and 2021. The patients were divided into 2 groups: patients who underwent early THR ( = 35) and patients who did not ( = 213). Spinopelvic parameters, including pelvic incidence (PI), sacral slope (SS), pelvic tilt, lumbar lordosis, thoracolumbar kyphosis (TLK), sagittal vertical axis, and thoracic kyphosis (TK), were measured before and after surgery. The statistical analyses included inverse probability of treatment weighting, independent tests, tests, and logistic regression analyses.
A total of 248 patients were included in the study. The pre- and postoperative TLK and TK angles were significantly smaller in the early THR group than in the late THR group. Increases in the PI and SS after surgery were significant risk factors. The use of interbody fusion techniques was associated with a higher rate of early THR. The difference in the PI minus lumbar lordosis before and after surgery was also significantly correlated with early THR.
Abnormal spinopelvic parameters, especially reduced TLK and TK angles and increased PI and SS, are risk factors for early THR.
Changes in spinopelvic parameters can lead to rapid hip joint destruction, which highlights the need for careful preoperative evaluation and postoperative monitoring of patients to prevent early THR.
在早期全髋关节置换术中，人们对脊柱骨盆复合体与其影像学参数之间的相关性的关注日益增加。本研究调查了脊柱骨盆影像学参数是否为脊柱融合手术后1年内早期全髋关节置换（THR）的危险因素。主要研究问题集中在识别可能导致早期THR的特定脊柱骨盆变化。
我们回顾性分析了2016年至2021年间接受腰椎融合术的患者。患者分为两组：接受早期THR的患者（n = 35）和未接受早期THR的患者（n = 213）。测量手术前后的脊柱骨盆参数，包括骨盆入射角（PI）、骶骨倾斜角（SS）、骨盆倾斜度、腰椎前凸、胸腰段后凸（TLK）、矢状垂直轴和胸椎后凸（TK）。统计分析包括治疗权重的逆概率、独立t检验、F检验和逻辑回归分析。
本研究共纳入248例患者。早期THR组术前和术后的TLK和TK角度明显小于晚期THR组。术后PI和SS的增加是显著的危险因素。椎间融合技术的使用与早期THR的发生率较高相关。手术前后PI减去腰椎前凸的差异也与早期THR显著相关。
异常的脊柱骨盆参数，特别是TLK和TK角度减小以及PI和SS增加，是早期THR的危险因素。
脊柱骨盆参数的变化可导致髋关节快速破坏，这凸显了对患者进行仔细的术前评估和术后监测以预防早期THR的必要性。
