Radiological Evaluation of Thoracolumbar Junctional Degenerative Kyphosis in Sufferers with Lumbar Degenerative Kyphosis.
Chin Med J (Engl). 2017 Nov 05;130(21):2535-2540
Authors: Liu CJ, Zhu ZQ, Wang KF, Duan S, Xu S, Liu HY
BACKGROUND: Thoracolumbar junction (TLJ) is the transitional space between the decrease thoracic backbone and the higher lumbar backbone. Vertebral compression fractures and proximal junctional kyphosis following backbone surgical procedure typically happen on this space. Subsequently, the examine of growth and mechanisms of thoracolumbar junctional degeneration is necessary for planning surgical administration. This examine aimed to evaluate radiological parameters of thoracolumbar junctional degenerative kyphosis (TLJDK) in sufferers with lumbar degenerative kyphosis and to investigate compensatory mechanisms of sagittal steadiness.
METHODS: From January 2016 to March 2017, sufferers with lumbar degenerative kyphosis have been enrolled on this radiographic examine. Sufferers have been divided into two teams in accordance with thoracolumbar junctional angle (TLJA): the non-TLJDK (NTLJDK) group (TLJA <10°) and the TLJDK group (TLJA ?10°). Full spinopelvic radiographic parameters have been analyzed and in contrast between two teams. Pearson or Spearman correlation coefficients and impartial two-sample t-test or Mann-Whitney U-test have been used.
RESULTS: A complete of 77 sufferers with symptomatic sagittal imbalance as a consequence of lumbar degenerative kyphosis have been enrolled on this examine. There have been 34 sufferers in NTLJDK group (TLJA <10°) and 43 sufferers in TLJDK group (TLJA ?10°). The median angle of lumbar lordosis (LL) within the NTLJDK or TLJDK teams was 23.40° (18.50°, 29.48°) or 19.50° (13.30°, 24.55°), respectively. The median TLJAs in all sufferers and each teams have been -11.20° (-14.60°, -Four.80°), -Three.70° (-7.53°, -1.73°), and -14.30° (-17.45°, -13.00°), respectively. Within the NTLJDK group, LL was correlated with thoracic kyphosis (TK; r = -Zero.400, P = Zero.Zero19), sacral slope (SS; r = Zero.681, P < Zero.001), and C7-sagittal vertical axis (r = -Zero.402, P = Zero.Zero18). Within the TLJDK group, LL was correlated with TK (r = -Zero.345, P = Zero.024), SS (r = Zero.595, P < Zero.001), and pelvic tilt (r = -Zero.363, P = Zero.017). There have been important variations in LL, TLJA, TK, SS, and pelvic incidence (PI) between two teams.
CONCLUSIONS: Though TLJDK is frequent in sufferers with lumbar degenerative kyphosis, it is likely to be generated by particular traits of morphology and biomechanics of the TLJ. To take care of sagittal steadiness, pelvis again tilt is likely to be extra necessary in sufferers with TLJDK, whereas thoracic curve adjustments is likely to be extra necessary in sufferers with out TLJDK.
PMID: 29067951 [PubMed – indexed for MEDLINE]