Liu Jiawei, Yu Shuai, Jia Di, Sun Guangfeng, Ding Ya, Wang Hongliang
Department of Orthopaedic, Fuyang Hospital Affiliated With Bengbu Medical University (Fuyang People's Hospital), No. 501 Sanqing Road, Yingzhou District, Fuyang City, Anhui Province, China.
Department of Orthopaedic, Anhui Provincial Clinical Medical Research Center For Spinal Deformities, No. 501 Sanqing Road, Yingzhou District, Fuyang City, Anhui Province, China.
J Orthop. 2024 Dec 16;65:100-105. doi: 10.1016/j.jor.2024.12.015. eCollection 2025 Jul.
A number of patients with hip osteoarthritis (HOA) have lower back pain (LBP) and hip joint pain, a symptom named hip spine syndrome (HSS). The purpose of this study is to analyze the efficacy of total hip arthroplasty (THA) in treating HSS using spinal pelvic parameters and multiple clinical scoring systems.
We prospectively collected HOA patients who underwent THA by surgeons from the same medical research center. 52 patients were included in the study according to the inclusion and exclusion criteria. Analyze patient baseline information, take full-length lateral radiographs of the spine before and 6 months after surgery, measure PI, PT, LL, SS, and SVA. Calculate the Oswestry Disability Index score (ODI), Visual Analog Scale score (VAS), and Hip Harris score (HHS) before and 6 months after surgery.
A total of 52 patients with hip spine syndrome were included for follow - up and were divided into two groups based on whether postoperative back pain was relieved: the group with continued in back pain and the group with improvement in back pain. Among them, 33 people (63 %) achieved relief in back pain. There were significant differences (p < 0.05) in postoperative LL, SVA, and PI-LL between the two groups. There were significant differences in spinal parameter changes among patients with improved LBP after THA, with increased LL, decreased SVA, and matched PI-LL. The postoperative clinical scoring scale showed that the HHS score of the group without improvement in LBP was significantly lower than that of the group with improvement in LBP, and all clinical scores of the group without improvement in LBP were poor after surgery.
There was a significant difference in the changes of spinal pelvic parameters in patients with improved LBP after THA, i.e., LL was elevated and SVA were decreased, PI-LL maintains matching. These spinal pelvic parameters may be key factors in the mechanism of low back pain improvement after THA surgery.
许多髋骨关节炎（HOA）患者同时存在下背痛（LBP）和髋关节疼痛，这种症状被称为髋脊柱综合征（HSS）。本研究旨在分析全髋关节置换术（THA）使用脊柱骨盆参数和多个临床评分系统治疗HSS的疗效。
我们前瞻性收集了由同一医学研究中心的外科医生进行THA手术的HOA患者。根据纳入和排除标准，52例患者被纳入研究。分析患者基线信息，在术前和术后6个月拍摄脊柱全长侧位X线片，测量骨盆入射角（PI）、骨盆倾斜角（PT）、腰椎前凸角（LL）、骶骨倾斜角（SS）和矢状面垂直轴（SVA）。计算术前和术后6个月的Oswestry功能障碍指数评分（ODI）、视觉模拟评分（VAS）和髋关节Harris评分（HHS）。
共纳入52例髋脊柱综合征患者进行随访，并根据术后背痛是否缓解分为两组：背痛持续组和背痛改善组。其中，33人（63%）背痛得到缓解。两组术后LL、SVA和PI-LL存在显著差异（p<0.05）。THA术后LBP改善的患者脊柱参数变化存在显著差异，LL增加，SVA降低，PI-LL匹配。术后临床评分量表显示，LBP未改善组的HHS评分显著低于LBP改善组，且LBP未改善组术后所有临床评分均较差。
THA术后LBP改善的患者脊柱骨盆参数变化存在显著差异，即LL升高，SVA降低，PI-LL保持匹配。这些脊柱骨盆参数可能是THA手术后下背痛改善机制的关键因素。
