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The Influencing Factors On The Spinal Sagittal Alignment And Global Balance Status Of Degenerative Thoracolumbar Kyphosis London Spine Lumbar Stenosis

The article explores the effect of degenerative thoracolumbar kyphosis (DTLK) on the sagittal alignment of the spine and its impact on spinal parameters and imbalance secondary to thoracolumbar kyphosis. A case-control study was conducted with 128 DTLK patients and 73 control patients. The study found that loss of lumbar lordosis and osteoporosis are more likely to cause imbalance and kyphosis in DTLK patients. In the balanced group, lumbar spine plays a crucial role in regulating the proximal spine and maintaining balance. The study provides valuable insights into the factors influencing sagittal balance in DTLK patients

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : finest day surgery unit on Harley Street UK

Published article

Objective: To explore the effect of degenerative thoracolumbar kyphosis (DTLK) on the sagittal alignment of the spine, as well as the impact on spinal parameters and imbalance secondary to thoracolumbar kyphosis. Methods: A case-control study. A total of 128 DTLK patients who aged over 50 years [thoracolumbar kyphosis (TLK)>15°] treated in Peking University People’s Hospital from January 2018 to December 2021 (DTLK group) were retrospectively included in this study. Other 73 contemporaneous…

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Abstract in English, Chinese Objective: To explore the effect of degenerative thoracolumbar kyphosis (DTLK) on the sagittal alignment of the spine, as well as the impact on spinal parameters and imbalance secondary to thoracolumbar kyphosis. Methods: A case-control study. A total of 128 DTLK patients who aged over 50 years [thoracolumbar kyphosis (TLK)>15°] treated in,

Abstract

Objective: To explore the effect of degenerative thoracolumbar kyphosis (DTLK) on the sagittal alignment of the spine, as well as the impact on spinal parameters and imbalance secondary to thoracolumbar kyphosis. Methods: A case-control study. A total of 128 DTLK patients who aged over 50 years [thoracolumbar kyphosis (TLK)>15°] treated in Peking University People’s Hospital from January 2018 to December 2021 (DTLK group) were retrospectively included in this study. Other 73 contemporaneous patients with lumbar spinal stenosis or disc herniation without thoracolumbar kyphosis (TLK=0°±15°) were enrolled into the control group. The following parameters were obtained on spine X-ray: TLK, thoracic kyphosis (TK), lumbar lordosis (LL) and sagittal vertical axis (SVA). In addition, the osteoporosis (OP) was evaluated by dual-emission X-ray absorptiometry (DXA), and the L5/S1 disc signal grading (Pfirrmann grading) was evaluated on MRI. Based on the age, the Lafage formula SVA=2× (age-55)+25 was used to distinguish balance/imbalance, and the DTLK patients were divided into balanced and an imbalanced group, the characteristics and influencing factors of the loss of sagittal balance in this population were clarified, and the interaction among various parts of the spine under a state of balance was analyzed too. Results: The TK (30.0°±13.5° vs 24.2°±7.4°) and TLK (26.6°±9.7° vs 6.0°±6.6°) in the DTLK group were both larger than those in control group while LL was smaller (34.4°±17.7° vs 44.2°±10.3°) (all P<0.001). TK was correlated to TLK (r=0.234, P=0.008) and LL (r=0.539, P<0.001) in DTLK group. LL loss was positively correlated to L5/S1 disc signal reduction (r=0.253, P=0.044). LL loss[[RR=1.04(1.01-1.08)]and OP[[RR=3.97(1.09, 14.50)]were influencing factors for the occurrence of imbalance in DTLK patients. The influencing factors for TK in DTLK balance group were LL (β=0.572, P<0.001) and age (β=0.351, P=0.045). The positive influencing factor for TK in imbalanced group is LL (β=0.209, P=0.015), and the impact is weaker than balanced group. Conclusions: Loss of LL and osteoporosis are more likely to cause imbalance and kyphosis in DTLK patients. In DTLK balance group, the proximal spine is regulated by lumbar spine, and the synergistic effect between the two parts maintains balance.

Purpose: To explore the impact of degenerative thoracolumbar kyphosis (DTLK) on the sagittal position of the spine and the impact of secondary changes in thoracolumbar kyphosis on the sagittal balance. method: Case-control study. The clinical data of 128 patients (DTLK group) diagnosed with DTLK[thoracic and lumbar kyphosis angle (TLK) >15°]at Peking University People’s Hospital from January 2018 to December 2021 were retrospectively included. At the same time, 73 surgical patients who were simply diagnosed with lumbar spinal stenosis or disc herniation without thoracolumbar kyphosis (TLK=0°±15°) during the same period were included as the control group. The following parameters were obtained on the lateral X-ray of the whole spine: TLK, thoracic kyphosis angle (TK), lumbar lordosis angle (LL), and the sagittal balance parameter is the sagittal offset distance (SVA). In addition, through dual energy X-ray absorptiometry (DXA) was used to measure the presence of osteoporosis (OP), and L was measured on MRI.5/S1Intervertebral disc signal grading (Pfirrmann grade). Based on age differences, the Lafage formula used to evaluate spinal balance SVA=2×(age-55)+25 is used as the threshold. For patients with thoracolumbar kyphosis, they are divided into a balance group and an imbalance group according to their balance status (SVA) to clarify this group. Characteristics and influencing factors of overall sagittal balance, and analysis of the interaction between various parts of the spine in a balanced state. result: The TK (30.0°±13.5° vs. 24.2°±7.4°) and TLK (26.6°±9.7° vs. 6.0°±6.6°) in the DTLK group were greater than those in the control group (P<0.01),LL小于对照组(34.4°±17.7°比44.2°±10.3°),差异均有统计学意义(均P<0.001)。DTLK组TK与TLK(r=0.234,P=0.008) and LL (r=0.539,P<0.001)存在相关性;LL减低与L5/S1There is a positive correlation between disc signal reduction (r=0.253,P=0.044). LL lost[RR=1.04 (1.01~1.08)]and there is OP[RR=3.970 (1.09~14.50)]is the factor that makes TLK patients susceptible to imbalance. The influencing factor of TK in patients in the DTLK balance group was LL (β=0.572,P<0.001)和年龄(β=0.351,P=0.045). The positive influencing factor of TK in patients in the imbalance group is LL (β=0.209,P=0.015), the influence of LL on TK is weaker than that of the balanced group. in LL loss and OP in DTLK patients are more likely to lead to imbalance and kyphosis progression, and the proximal spine and lumbar spine work together to maintain sagittal balance in this population. .

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The influencing factors on the spinal sagittal alignment and global balance status of degenerative thoracolumbar kyphosis

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Abstract in English, Chinese Objective: To explore the effect of degenerative thoracolumbar kyphosis (DTLK) on the sagittal alignment of the spine, as well as the impact on spinal parameters and imbalance secondary to thoracolumbar kyphosis. Methods: A case-control study. A total of 128 DTLK patients who aged over 50 years [thoracolumbar kyphosis (TLK)>15°] treated in

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