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Does Laminectomy Affect Spino-Pelvic Balance in Lumbar Spinal Stenosis? A Study Based on the EOS X-Ray Imaging System – Lumbar Spinal Stenosis

This article discusses the impact of facet-sparing laminectomy on the spino-pelvic balance in patients with lumbar spinal stenosis (LSS). The study analyzed the spino-pelvic balance of 26 patients before and after surgery using the EOS X-ray Imaging System. Various parameters such as thoracic kyphosis, lumbar lordosis, pelvic incidence, pelvic tilt, and sacral slope were considered. The results showed a decrease in sacral slope and an increase in pelvic tilt after surgery, while lumbar lordosis and axial vertebral rotation remained unchanged. Pain and disability also significantly improved after surgery. The article suggests that achieving congruence between pelvic and spinal parameters is essential for a proper spinal posture and balance. The study highlights the need for defining a standard sagittal balance in LSS patients

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

CONCLUSION: The most important parameter seems to be a congruence between pelvic and spinal parameters, which achieves an economic posture with the physiologic position of the axis of gravity. According to the literature, a standard sagittal balance (SB) has not been defined.

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Acta Neurochir Suppl. 2023;135:405-412. doi: 10.1007/978-3-031-36084-8_62.ABSTRACTPURPOSE: Lumbar spinal stenosis (LSS) is a degenerative disorder causing the forward bending of the trunk and pelvic retroversion with the consequent loss of lumbar lordosis; surgical treatment is intended to enlarge the canal and foramina and decompress the nerve roots. The purpose of our study is to determine whether,

Acta Neurochir Suppl. 2023;135:405-412. doi: 10.1007/978-3-031-36084-8_62.

ABSTRACT

PURPOSE: Lumbar spinal stenosis (LSS) is a degenerative disorder causing the forward bending of the trunk and pelvic retroversion with the consequent loss of lumbar lordosis; surgical treatment is intended to enlarge the canal and foramina and decompress the nerve roots. The purpose of our study is to determine whether and to what extent facet-sparing laminectomy affects the spino-pelvic balance.

METHODS: The spino-pelvic balance of 26 patients was analysed before and after surgery through the EOS X-ray Imaging System. The following parameters were considered: thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS). Clinical data were expressed in numeric values according to the Oswestry Disability Index (ODI), the visual analogue scale (VAS) and the modified Japanese Orthopaedic Association (mJOA) scoring system.

RESULTS: Significant SS decreases and PT increases were noticed after surgery, without modification in LL, axial vertebral rotation (AVR) and the general alignment. Pain and disability had a significant improvement, as represented by a decrease in scores on the VAS and ODI scales and an increase in scores on the mJOA functional scale.

CONCLUSION: The most important parameter seems to be a congruence between pelvic and spinal parameters, which achieves an economic posture with the physiologic position of the axis of gravity. According to the literature, a standard sagittal balance (SB) has not been defined.

PMID:38153501 | DOI:10.1007/978-3-031-36084-8_62

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Does Laminectomy Affect Spino-Pelvic Balance in Lumbar Spinal Stenosis? A Study Based on the EOS X-Ray Imaging System

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Acta Neurochir Suppl. 2023;135:405-412. doi: 10.1007/978-3-031-36084-8_62.ABSTRACTPURPOSE: Lumbar spinal stenosis (LSS) is a degenerative disorder causing the forward bending of the trunk and pelvic retroversion with the consequent loss of lumbar lordosis; surgical treatment is intended to enlarge the canal and foramina and decompress the nerve roots. The purpose of our study is to determine whether

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