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Degenerative changes of sagittal alignment in patients with Roussouly type 1

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Abstract

Study design

A cross-sectional radiological study.

Objectives

We aimed to examine the degenerative changes of sagittal alignment in patients with Roussouly type 1.

Summary of background data

Roussouly type 1 is unique in shape, characterized by short lumbar lordosis (LL) with the apex at L5 and thoracolumbar kyphosis (TLK). Because of the unique shape of sagittal alignment and the small pelvic incidence (PI) in Roussouly type 1, the degenerative changes of sagittal alignment may differ.

Methods

A total of 145 patients with Roussouly type 1 were recruited and distributed into three age groups; Group I (N = 40) were young patients (20–40 years of age), Group II (N = 47) were middle-aged patients (45–60 years of age), and Group III (N = 48) were elderly patients (>65 years of age). Sagittal parameters including sagittal vertical axis (SVA), PI, pelvic tilt (PT), L1S1 LL, L4S1 LL, thoracic kyphosis (TK), and TLK were measured using Surgimap® software. The occurrence of lumbar retrolisthesis was also examined.

Results

The SVA, PI, PT, L1S1 LL, L4S1 LL, TK, and TLK in group I were − 25.9° ± 23.4 mm, 37.1° ± 5.3°, 10.3° ± 5.5°, 42.7° ± 8.8°, 35.5° ± 6.9°, 29.5° ± 23.5°, and 9.7° ± 5.9°, respectively. Among the Groups I, II, and III, there was a stepwise increase in the SVA, PT, TLK, and lumbar retrolisthesis (all P < 0.001). The PI, L4S1 LL, and TK were identical among the three groups.

Conclusions

Degenerative changes of Roussouly type 1 include increase in the SVA, PT, TLK, and lumbar retrolisthesis, while the PI, L4S1 LL, and TK remain unchanged.

Level of Evidence

Level IV.

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References

  1. Roussouly P, Gollogly S, Berthonnaud E, Dimnet J (2005) Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position. Spine (Phila Pa 1976) 30(3):346–353

    Article  Google Scholar 

  2. Laouissat F, Sebaaly A, Gehrchen M, Roussouly P (2018) Classification of normal sagittal spine alignment: refounding the Roussouly classification. Eur Spine J 27(8):2002–2011

    Article  Google Scholar 

  3. Berjano P (2018) Reviewer's comment concerning "Classification of normal sagittal spine alignment: refounding the Roussouly classification" by F. Laouissat et al. (2017). Eur Spine J 27(8):2012–2013

  4. Sebaaly A, Grobost P, Mallam L, Roussouly P (2018) Description of the sagittal alignment of the degenerative human spine. Eur Spine J 27(2):489–496

    Article  Google Scholar 

  5. Lee CS, Chung SS, Kang KC, Park SJ, Shin SK (2011) Normal patterns of sagittal alignment of the spine in young adults radiological analysis in a Korean population. Spine 36(25):E1648–E1654

    Article  Google Scholar 

  6. Roussouly P, Nnadi C (2010) Sagittal plane deformity: an overview of interpretation and management. Eur Spine J 19(11):1824–1836

    Article  Google Scholar 

  7. Scemama C, Laouissat F, Abelin-Genevois K, Roussouly P (2017) Surgical treatment of thoraco-lumbar kyphosis (TLK) associated with low pelvic incidence. Eur Spine J 26(8):2146–2152

    Article  CAS  Google Scholar 

  8. Shen M, Razi A, Lurie JD, Hanscom B, Weinstein J (2007) Retrolisthesis and lumbar disc herniation: a preoperative assessment of patient function. Spine J 7(4):406–413

    Article  Google Scholar 

  9. Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33(1):159–174

    Article  CAS  Google Scholar 

  10. Yilgor C, Sogunmez N, Boissiere L et al (2017) Global Alignment and Proportion (GAP) Score: development and validation of a new method of analyzing spinopelvic alignment to predict mechanical complications after adult spinal deformity surgery. J Bone Joint Surg Am 99(19):1661–1672

    Article  Google Scholar 

  11. Pizones J, Martin MB, Perez-Grueso FJS et al (2019) Impact of adult scoliosis on Roussouly sagittal shape classification. Spine (Phila Pa 1976) 44(4):270–279

    Article  Google Scholar 

  12. Bakouny Z, Assi A, Massaad A et al (2017) Roussouly's sagittal spino-pelvic morphotypes as determinants of gait in asymptomatic adult subjects. Gait Posture 54:27–33

    Article  Google Scholar 

  13. Laouissat F, Scemama C, Delecrin J (2016) Does the type of sagittal spinal shape influence the clinical results of lumbar disc arthroplasty? Orthop Traumatol Surg Res 102(6):765–768

    Article  CAS  Google Scholar 

  14. Ferrero E, Liabaud B, Henry JK et al (2017) Sagittal alignment and complications following lumbar 3-column osteotomy: does the level of resection matter? J Neurosurg Spine 27(5):560–569

    Article  Google Scholar 

  15. Sebaaly A, Riouallon G, Obeid I et al (2018) Proximal junctional kyphosis in adult scoliosis: comparison of four radiological predictor models. Eur Spine J 27(3):613–621

    Article  Google Scholar 

  16. Hu P, Yu M, Sun Z et al (2016) Analysis of global sagittal postural patterns in asymptomatic Chinese adults. Asian Spine J 10(2):282–288

    Article  Google Scholar 

  17. Theologis AA, Iyer S, Lenke LG, Sides BA, Kim HJ, Kelly MP (2019) Cervical and cervicothoracic sagittal alignment according to Roussouly thoracolumbar subtypes. Spine (Phila Pa 1976) 44(11):E634–E639

    Article  Google Scholar 

  18. Bernhardt M, Bridwell KH (1989) Segmental analysis of the sagittal plane alignment of the normal thoracic and lumbar spines and thoracolumbar junction. Spine (Phila Pa 1976) 14(7):717–721

    Article  CAS  Google Scholar 

  19. Stagnara P, De Mauroy JC, Dran G et al (1982) Reciprocal angulation of vertebral bodies in a sagittal plane: approach to references for the evaluation of kyphosis and lordosis. Spine (Phila Pa 1976) 7(4):335–342

    Article  CAS  Google Scholar 

  20. Vialle R, Levassor N, Rillardon L, Templier A, Skalli W, Guigui P (2005) Radiographic analysis of the sagittal alignment and balance of the spine in asymptomatic subjects. J Bone Joint Surg Am 87(2):260–267

    Article  Google Scholar 

  21. Barrey C, Roussouly P, Perrin G, Le Huec JC (2011) Sagittal balance disorders in severe degenerative spine. Can we identify the compensatory mechanisms? Eur Spine J 20(Suppl 5):626–633

    Article  Google Scholar 

  22. Jeon CH, Park JU, Chung NS, Son KH, Lee YS, Kim JJ (2013) Degenerative retrolisthesis: is it a compensatory mechanism for sagittal imbalance? Bone Joint J 95-b(9):1244–1249

    Article  Google Scholar 

  23. Saleem S, Aslam HM, Rehmani MA, Raees A, Alvi AA, Ashraf J (2013) Lumbar disc degenerative disease: disc degeneration symptoms and magnetic resonance image findings. Asian Spine J 7(4):322–334

    Article  Google Scholar 

  24. Modic MT, Ross JS (2007) Lumbar degenerative disk disease. Radiology 245(1):43–61

    Article  Google Scholar 

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Funding

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this article.

The ethical committee of the hospital reviewed and approved the design of the present study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Ajou University School of Medicine, 164 World Cup-ro, Yeongtong-gu, Suwon, Geyounggi-do, 16499, South Korea

    Nam-Su Chung, Han-Dong Lee & Chang- Hoon Jeon

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  1. Nam-Su Chung
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  2. Han-Dong Lee
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  3. Chang- Hoon Jeon
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Contributions

Nam-Su Chung: conception or design of the work; the acquisition, analysis, interpretation of data for the work, drafting the work or revising it critically for important intellectual content, final approval of the version to be published. Han-Dong Lee: the acquisition, analysis, interpretation of data for the work, drafting the work or revising it critically for important intellectual content, final approval of the version to be published. Chang-Hoon Jeon: conception or design of the work, drafting the work or revising it critically for important intellectual content, final approval of the version to be published.

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Correspondence to Chang- Hoon Jeon.

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Chung, NS., Lee, HD. & Jeon, C.H. Degenerative changes of sagittal alignment in patients with Roussouly type 1. Spine Deform 8, 1325–1331 (2020). https://doi.org/10.1007/s43390-020-00151-z

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  • DOI: https://doi.org/10.1007/s43390-020-00151-z

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