Ann Rehabil Med.  2016 Aug;40(4):682-691. 10.5535/arm.2016.40.4.682.

Static and Dynamic Parameters in Patients With Degenerative Flat Back and Change After Corrective Fusion Surgery

• Lee JH
• Lee SH

• KMID: 2356654
• DOI: http://doi.org/10.5535/arm.2016.40.4.682

Abstract

OBJECTIVE
To evaluate characteristics of static and dynamic parameters in patients with degenerative flat back (DFB) and to compare degree of their improvement between successful and unsuccessful surgical outcome groups
METHODS
Forty-seven patients with DFB were included who took whole spine X-ray and three-dimensional motion analysis before and 6 months after corrective surgery. Forty-four subjects were selected as a control group. As static parameters, thoracic kyphosis (TK), thoracolumbar junction (TLJ), lumbar lordosis (LL), pelvic incidence (PI), sacral slope (SS), and pelvic tilt (PT) were measured. As dynamic parameters, maximal and minimal angle of pelvic tilt, lower limb joints, and thoracic and lumbar vertebrae column (dynamic TK and LL) in sagittal plane were obtained.
RESULTS
The DFB group showed smaller TK and larger LL, pelvic posterior tilt, hip flexion, knee flexion, and ankle dorsiflexion than the control group. Most of these parameters were significantly corrected by fusion surgery. Dynamic spinal parameters correlated with static spinal parameters. The successful group obtained significant improvement in maximal and minimal dynamic LL than the unsuccessful group.
CONCLUSION
The DFB group showed characteristic lower limb and spinal angles in dynamic and static parameters. Correlation between static and dynamic parameters was found in spinal segment. Dynamic LL was good predictor of successful surgical outcomes.

Keyword

Degeneration; Motion; Spinal fusion; Treatment outcome

MeSH Terms

Animals
Ankle
Hip
Humans
Incidence
Joints
Knee
Kyphosis
Lordosis
Lower Extremity
Lumbar Vertebrae
Spinal Fusion
Spine
Treatment Outcome

Figure

• 

  Fig. 1 Spinal and pelvic parameters. (A) Spinal parameters including thoracic kyphosis (TK), thoracolumbar junction (TLJ), and lumbar lordosis (LL). (a) TK was measured from the T5 superior end plate to T12 inferior end plate. (b) TLJ was measured from the T10 superior end plate to L2 inferior end plate. (c) LL was measured from the T12 inferior end plate to S1 superior end plate by the Cobb method. (B) Pelvic parameters including pelvic tilt (PT), pelvic incidence (PI), and sacral slope (SS). (a) PT is defined as the angle between a vertical line originating at the center of the bicoxofemoral axis and a line drawn between the same point and the middle of the superior end plate of S1. (b) PI is defined as the angle between the line perpendicular to the sacral plate and the line connecting the midpoint of the sacral plate to the bicoxofemoral axis. (c) SS is the angle between the S1 superior end plate and a horizontal line.

• 

  Fig. 2 Location of markers for motion analysis.

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