Kawai Toshiyuki, Shimizu Takayoshi, Okuzu Yaichiro, Kuroda Yutaka, Morita Yugo, Otsuki Bungo, Goto Koji, Fujibayashi Shunsuke, Matsuda Shuichi
Department of Orthopaedic Surgery, Graduate school of medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto City, 606-8507, Japan.
Department of Orthopaedic Surgery, Kindai University, Higashi-osaka, Japan.
Sci Rep. 2025 Jul 11;15(1):25035. doi: 10.1038/s41598-025-10806-4.
The aim of the study was to investigate the effects of coronal offset of C7 after spinal fusion on the discrepancy in joint space narrowing between the right and left hips. We retrospectively reviewed data from patients who underwent lumbar spinal fusion from 2011 to 2018 at our institute. The rate of hip joint space narrowing after spinal fusion was measured in 190 patients (380 hips). We assessed the effects of the distance between the C7 plumb line and the central sacral vertical line (C7-CSVL) on the discrepancy in joint space narrowing between the right and left hips. Using multivariate regression models, we controlled for the effects of age, sex, body mass index, fusion length, and several spinopelvic alignment parameters (sacral slope, pelvic incidence, lumbar lordosis, pelvic incidence minus lumbar lordosis, and sagittal vertical axis) on the joint space narrowing rate. Multivariate regression showed that the C7-CSVL was associated with the discrepancy of the joint space narrowing rate between right and left, indicating that when C7 deviated to right, the joint space narrowing was larger in the right than left hip (standardized coefficient, 0.203; p = 0.0005). A larger C7-CSVL was associated with a larger right-left discrepancy in hip joint space narrowing after spinal fusion. These findings indicate that spinal coronal balance affects the distribution of joint degeneration in the right and left hips. Surgeons should understand the potential risk of uneven progression of degeneration between the right and left hips in patients with large coronal offset.
本研究的目的是调查脊柱融合术后C7冠状面偏移对左右髋关节间隙狭窄差异的影响。我们回顾性分析了2011年至2018年在我院接受腰椎脊柱融合术患者的数据。测量了190例患者（380个髋关节）脊柱融合术后髋关节间隙狭窄的发生率。我们评估了C7铅垂线与骶骨中央垂直线（C7-CSVL）之间的距离对左右髋关节间隙狭窄差异的影响。使用多变量回归模型，我们控制了年龄、性别、体重指数、融合长度以及几个脊柱骨盆对线参数（骶骨倾斜度、骨盆入射角、腰椎前凸、骨盆入射角减去腰椎前凸以及矢状垂直轴）对关节间隙狭窄率的影响。多变量回归显示，C7-CSVL与左右关节间隙狭窄率的差异相关，表明当C7向右偏移时，右侧髋关节间隙狭窄比左侧更大（标准化系数，0.203；p = 0.0005）。较大的C7-CSVL与脊柱融合术后髋关节间隙狭窄的左右差异较大相关。这些发现表明脊柱冠状面平衡会影响左右髋关节退变的分布。外科医生应该了解冠状面偏移较大的患者左右髋关节退变进展不均的潜在风险。
