Spinopelvic sagittal alignment of patients with transfemoral amputation

European spine journal

article

Julia Facione¹  Coralie Villa²  Xavier Bonnet²  Cédric Barrey⁴  Marie Thomas-Pohl¹  Eric Lapeyre¹  François Lavaste²  Hélène Pillet²  Wafa Skalli² 

[1] Physical Medicine and Rehabilitation Unit, Hôpital d’Instruction des Armées Percy;Institut de Biomécanique Humaine Georges Charpak;Centre d’Etude et de Recherche sur l’Appareillage des Handicapés;Department of Neurosurgery and Spine Surgery, P. Wertheimer Hospital, Université Claude Bernard Lyon 1

关键词: Amputation;    Low back pain;    Posture;    Sagittal alignment;    Spine;   

DOI  :  10.1007/s00586-019-06017-x

来源: Springer

【 摘 要 】

This study aims to describe the spinopelvic sagittal alignment in transfemoral amputees (TFAs) from a radiologic study of the spine with a postural approach to better understand the high prevalence of low back pain (LBP) in this population. TFAs underwent X-rays with 3-D reconstructions of the full spine and pelvis. Sagittal parameters were analyzed and compared to the literature. Differences between TFAs with and without LBP were also observed. Twelve subjects have been prospectively included (TFA-LBP group (n = 5) and TFA-NoP group (n = 7)). Four of the five subjects of the TFA-LBP group and two of the seven in TFAs-NoP group had an imbalanced sagittal posture, especially regarding the T9-tilt, significantly higher in the TFA-LBP group than in the TFA-NoP (p = 0.046). Eight subjects (6 TFA-NoP and 2 TFA-LBP) had abnormal low value of thoracic kyphosis (TK). Moreover, the mean angle of TK in the TFA-NoP group was lower than in the TFA-LBP group (p = 0.0511). In the considered sample, TFAs often present a sagittal imbalance. A low TK angle seems to be associated with the absence of LBP. It can be hypothesized that this compensatory mechanism of the sagittal imbalance is the most accessible in this population. This study emphasizes the importance of considering the sagittal balance of the pelvis and the spine in patients with a TFA to better understand the high prevalence of LBP in this population. It should be completed by the analysis of the spinopelvic balance and the lower limbs in 3D. These slides can be retrieved under Electronic Supplementary Material.

【 授权许可】

Unknown