Biomechanical aspects of spinal sagittal balance in achondroplasia patients during Ilizarov limb lengthening
https://doi.org/10.14531/2018.4.7-14
Abstract
Objective. To review specific features of spinal sagittal balance in achondroplasia patients at stages of lower limb lengthening using the Ilizarov method.
Material and Methods. Cross-sectional clinical and radiological study was performed in 29 achondroplasia patients prior to lower limb lengthening and at lengthening stages using the Ilizarov method. Parameters of sagittal balance of the spine and pelvis were evaluated radiologically. Clinical evaluation included examination, and assessment of neurological status and pain level.
Results. Clinical manifestations of sagittal imbalance included hypokyphosis of the thoracic spine in 44.8 % of cases and increased lumbar lordosis in 55.2 %. No neurological disorders were diagnosed in patients. Pain scores 2 to 4 were observed in 17.2 % ofcases. After staged lower limb lengthening by 19.8 ± 3.3 cm, it was revealed that the values of the thoracic kyphosis, lumbar lordosis and the angle of the sacrum tilt improved and approached those of healthy peers. Vertical sagittal alignment measurements correlated with those of thoracic kyphosis. Thoracic kyphosis showed a correlation with lumbar lordosis. Pelvic indices had a moderate correlation with lumbar lordosis.
Conclusion. Biomechanically substantiated transosseous compression-distraction osteosynthesis by Ilizarov technique used for lower limb lengthening in achondroplasia patients improves spinal sagittal balance parameters.
About the Authors
O. G. Prudnikova
Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics
Russian Federation
Russian Federation
DMSc, senior researcher at scientific-clinical laboratory of axial skeleton pathology and neurosurgery, head of traumatologicorthopedic department No. 10
M. Ulyanovoy str., 6, 640014, Kurgan
A. M. Aranovich
Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics
Russian Federation
Russian Federation
DMSc, Prof., chief researcher of the scientific and clinical laboratory for deformity correction and limb lengthening, head of traumatologic-orthopedic department. No 17
M. Ulyanovoy str., 6, 640014, Kurgan
Yu. A. Mushtaeva
Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics
Russian Federation
Russian Federation
PhD in technical sciences, specialist of information and analytical department
M. Ulyanovoy str., 6, 640014, Kurgan
A. V. Gubin
Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics
Russian Federation
Russian Federation
DMSc, Director
M. Ulyanovoy str., 6, 640014, Kurgan
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Review
For citations:
Prudnikova O.G., Aranovich A.M., Mushtaeva Yu.A., Gubin A.V. Biomechanical aspects of spinal sagittal balance in achondroplasia patients during Ilizarov limb lengthening. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2018;15(4):7-14. https://doi.org/10.14531/2018.4.7-14
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