Changes in Coxo-Vertebral Parameters in Scoliotic Deformity of the Spine

Abstract

Considering the pathology of the spine and hip joint, it is necessary to take into account their biomechanical relationships under axial loading. Scoliotic deformity leads to the development of compensatory misalignment and inclination of the pelvis, resulting in a functional shortening of one of the lower extremities, which, in turn, leads to the formation of degenerative changes in the hip joint. The development of degenerative changes in the hip joint depends on the degree of scoliotic deformity, taking into account changes in the sagittal and frontal balance. However, research studies state that scoliotic spinal deformity 40 did not cause a pronounced degenerative process in the hip joint area. In our review we studied and analyzed clinical and radiological data of patients operated on for 4 years at the spine surgery department of the National Medical Research Center of Traumatology and Orthopedics named after R.R. Vreden for scoliotic deformity 3-4 degrees. All patients underwent a teleroentgenogram of the spine with the capture of the upper third of the thigh in two projections. According to X-ray data, the angles of the lumbar lordosis, the inclination of the sacrum, the inclination of the pelvis, the deviation of the pelvis from the vertical, the angles of misalignment of the pelvis, the determination of the angle of inclination of the acetabulum in the vertical plane (Sharpe's angle)), sagittal and frontal balance were assessed. The presence of concomitant diseases of the hip joints was separately registered. To assess the correlation, Kendall's coefficients and Student's t-test were used. The study involved 60 patients (47 women and 13 men), aged on average 29.7. When evaluating the correlation, it was found that the Sharpe angle on the left (S) correlates with the Sharpe angle on the right (R), the Sharpe angle (R) correlates with hip dysplasia, where Lumbar lordosis (GLL) correlates with Sacral slope (SS), Sacral slope (SS) correlates with the pelvic incidence (PI). Pelvic deviation from the vertical (PT) correlates with PI, PI before surgery most strongly correlates with PI after surgery (for all values p 0.01). In addition, PI in patients with unilateral lesions of the hip joint is higher than in patients with bilateral lesions, which proves that there is no relationship between PI and GLL in this category of patients. According to the results of our study, changes in coxo-vertebral parameters did not change significantly in the pre and postoperative period, with the exception of lumbar lordosis and sagittal balance.