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European Spine Journal

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30.01.2018 | Review

Focal disorders of the spine with compensatory deformities: how to define them

verfasst von: Andrea Redaelli, Pedro Berjano, Max Aebi

Erschienen in: European Spine Journal | Sonderheft 1/2018

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Abstract

Purpose

In this paper, the authors propose classifying the epiphenomenon of spinal deformity in two different categories: structural deformity, when the main driver of the observed deformity is a fixed and stiff alteration of the spinal segments, and compensatory deformity, which includes cases where the observed deformity is due to focal abnormalities. This last category comprises, but is not limited to, spinal stenosis, spondylolisthesis, disc herniation, infection or tumor, hip disease or neurological disease (such as Parkinson’s disease).

Method

Narrative review article.

Results

We analyzed the focal diseases of the spine that may cause a compensatory deformity inducing adaptation in the unaffected part of the spine.

Conclusion

The compensatory mechanisms involved in adaptive deformity represent an attempt to maintain a global alignment, to escape from pain or to control body posture.

Graphical abstract

These slides can be retrieved under Electronic Supplementary material.

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Ames CP, Scheer JK, Lafage V et al (2016) Adult spinal deformity: epidemiology, health impact, evaluation, and management. Spine Deform 4:310–322. https://doi.org/10.1016/j.jspd.2015.12.009 CrossRefPubMed

Smith JS, Shaffrey CI, Glassman SD et al (2011) Risk-benefit assessment of surgery for adult scoliosis: an analysis based on patient age. Spine (Phila Pa 1976) 36:817–824. https://doi.org/10.1097/brs.0b013e3181e21783 CrossRef

Bridwell KH, Glassman S, Horton W et al (2009) Does treatment (nonoperative and operative) improve the two-year quality of life in patients with adult symptomatic lumbar scoliosis: a prospective multicenter evidence-based medicine study. Spine (Phila Pa 1976) 34:2171–2178. https://doi.org/10.1097/brs.0b013e3181a8fdc8 CrossRef

Schwab F, Patel A, Ungar B et al (2010) Adult spinal deformity postoperative standing imbalance. Spine (Phila Pa 1976) 35:2224–2231. https://doi.org/10.1097/brs.0b013e3181ee6bd4 CrossRef

Bianco K, Norton R, Schwab F et al (2014) Complications and intercenter variability of three-column osteotomies for spinal deformity surgery: a retrospective review of 423 patients. Neurosurg Focus 36:E18. https://doi.org/10.3171/2014.2.FOCUS1422 CrossRefPubMed

Schwab FJ, Hawkinson N, Lafage V et al (2012) Risk factors for major peri-operative complications in adult spinal deformity surgery: a multi-center review of 953 consecutive patients. Eur Spine J 21:2603–2610. https://doi.org/10.1007/s00586-012-2370-4 CrossRefPubMedPubMedCentral

Pichelmann MA, Lenke LG, Bridwell KH et al (2010) Revision rates following primary adult spinal deformity surgery: six hundred forty-three consecutive patients followed-up to twenty-two years postoperative. Spine (Phila Pa 1976) 35:219–226. https://doi.org/10.1097/brs.0b013e3181c91180 CrossRef

Maier S, Smith JS, Schwab F et al (2014) Revision surgery after three-column osteotomy in 335 adult spinal deformity patients: inter-center variability and risk factors. Spine (Phila Pa 1976). https://doi.org/10.1097/brs.0000000000000304

Blondel B, Schwab F, Bess S et al (2013) Posterior global malalignment after osteotomy for sagittal plane deformity: it happens and here is why. Spine (Phila Pa 1976) 38:E394–E401. https://doi.org/10.1097/brs.0b013e3182872415 CrossRef

10.

Puvanesarajah V, Shen FH, Cancienne JM et al (2016) Risk factors for revision surgery following primary adult spinal deformity surgery in patients 65 years and older. J Neurosurg Spine. https://doi.org/10.3171/2016.2.SPINE151345 PubMed

11.

Diebo BG, Henry J, Lafage V, Berjano P (2014) Sagittal deformities of the spine: factors influencing the outcomes and complications. Eur Spine J 24:3–15. https://doi.org/10.1007/s00586-014-3653-8 CrossRef

12.

Roussouly P, Nnadi C (2010) Sagittal plane deformity: an overview of interpretation and management. Eur Spine J 19:1824–1836. https://doi.org/10.1007/s00586-010-1476-9 CrossRefPubMedPubMedCentral

13.

Legaye J (2014) Influence of age and sagittal balance of the spine on the value of the pelvic incidence. Eur Spine J 23:1394–1399. https://doi.org/10.1007/s00586-014-3207-0 CrossRef

14.

Cecchinato R, Redaelli A, Martini C et al (2017) Long fusions to S1 with or without pelvic fixation can induce relevant acute variations in pelvic incidence: a retrospective cohort study of adult spine deformity surgery. Eur Spine J. https://doi.org/10.1007/s00586-017-5154-z

15.

Lafage V, Schwab F, Patel A et al (2009) Pelvic tilt and truncal inclination: two key radiographic parameters in the setting of adults with spinal deformity. Spine (Phila Pa 1976) 34:E599–E606. https://doi.org/10.1097/brs.0b013e3181aad219 CrossRef

16.

Barrey C, Roussouly P, Le Huec JC et al (2013) Compensatory mechanisms contributing to keep the sagittal balance of the spine. Eur Spine J 22:834–841. https://doi.org/10.1007/s00586-013-3030-z CrossRefPubMedCentral

17.

Lamartina C, Berjano P (2014) Classification of sagittal imbalance based on spinal alignment and compensatory mechanisms. Eur Spine J 23:1177–1189. https://doi.org/10.1007/s00586-014-3227-9 CrossRefPubMed

18.

Berjano P, Lamartina C (2014) Classification of degenerative segment disease in adults with deformity of the lumbar or thoracolumbar spine. Eur Spine J 23:1815–1824. https://doi.org/10.1007/s00586-014-3219-9 CrossRefPubMed

19.

Bridwell KH (2006) Decision making regarding Smith-Petersen vs. pedicle subtraction osteotomy vs. vertebral column resection for spinal deformity. Spine (Phila Pa 1976) 31:S171–S178. https://doi.org/10.1097/01.brs.0000231963.72810.38 CrossRef

20.

Berjano P, Lamartina C (2013) Far lateral approaches (XLIF) in adult scoliosis. Eur Spine J 22:242–253. https://doi.org/10.1007/s00586-012-2426-5 CrossRef

21.

Berjano P, Cecchinato R, Sinigaglia A et al (2015) Anterior column realignment from a lateral approach for the treatment of severe sagittal imbalance: a retrospective radiographic study. Eur spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 24(Suppl 3):433–438. https://doi.org/10.1007/s00586-015-3930-1 CrossRef

22.

Aebi M (2005) The adult scoliosis. Eur Spine J 14:925–948. https://doi.org/10.1007/s00586-005-1053-9 CrossRefPubMed

23.

Barrey C, Jund J, Noseda O, Roussouly P (2007) Sagittal balance of the pelvis-spine complex and lumbar degenerative diseases. A comparative study about 85 cases. Eur spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 16:1459–1467. https://doi.org/10.1007/s00586-006-0294-6 CrossRef

24.

Schuller S, Charles YP, Steib J-P (2011) Sagittal spinopelvic alignment and body mass index in patients with degenerative spondylolisthesis. Eur spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 20:713–719. https://doi.org/10.1007/s00586-010-1640-2 CrossRef

25.

Liu H, Li S, Zheng Z et al (2015) Pelvic retroversion is the key protective mechanism of L4–5 degenerative spondylolisthesis. Eur Spine J 24:1204–1211. https://doi.org/10.1007/s00586-014-3395-7 CrossRefPubMed

26.

Försth P, Ólafsson G, Carlsson T et al (2016) A randomized, controlled trial of fusion surgery for lumbar spinal stenosis. N Engl J Med 374:1413–1423. https://doi.org/10.1056/NEJMoa1513721 CrossRefPubMed

27.

Ahmad S, Hamad A, Bhalla A et al (2017) The outcome of decompression alone for lumbar spinal stenosis with degenerative spondylolisthesis. Eur Spine J 26:414–419. https://doi.org/10.1007/s00586-016-4637-7 CrossRefPubMed

28.

Kim MK, Lee S-H, Kim E-S et al (2011) The impact of sagittal balance on clinical results after posterior interbody fusion for patients with degenerative spondylolisthesis: a Pilot study. BMC Musculoskelet Disord 12:69. https://doi.org/10.1186/1471-2474-12-69 CrossRefPubMedPubMedCentral

29.

Jon Lurie CT-L (2015) Management of lumbar spinal stenosis. BMJ Br Med J 78:154–164. https://doi.org/10.1136/bmj.h6234

30.

Abbas J, Hamoud K, May H et al (2010) Degenerative lumbar spinal stenosis and lumbar spine configuration. Eur Spine J 19:1865–1873. https://doi.org/10.1007/s00586-010-1516-5 CrossRefPubMedPubMedCentral

31.

Shin EK, Kim CH, Chung CK et al (2017) Sagittal imbalance in patients with lumbar spinal stenosis and outcomes after simple decompression surgery. Spine J 17:175–182. https://doi.org/10.1016/j.spinee.2016.08.023 CrossRefPubMed

32.

Fujii K, Kawamura N, Ikegami M et al (2015) Radiological improvements in global sagittal alignment after lumbar decompression without fusion. Spine (Phila Pa 1976) 40:703–709. https://doi.org/10.1097/brs.0000000000000708 CrossRef

33.

Dohzono S, Toyoda H, Matsumoto T et al (2015) The influence of preoperative spinal sagittal balance on clinical outcomes after microendoscopic laminotomy in patients with lumbar spinal canal stenosis. J Neurosurg Spine 23:49–54. https://doi.org/10.3171/2014.11.SPINE14452 CrossRefPubMed

34.

Hikata T, Watanabe K, Fujita N et al (2014) Impact of sagittal spinopelvic alignment for clinical outcome after decompression surgery for lumbar spinal canal stenosis. Spine J 14:S67. https://doi.org/10.3171/2015.1.SPINE14642.Disclosure CrossRef

35.

Buckland AJ, Vira S, Oren JH et al (2016) When is compensation for lumbar spinal stenosis a clinical sagittal plane deformity? Spine J 16:971–981. https://doi.org/10.1016/j.spinee.2016.03.047 CrossRefPubMed

36.

Endo K, Suzuki H, Tanaka H et al (2010) Sagittal spinal alignment in patients with lumbar disc herniation. Eur Spine J 19:435–438. https://doi.org/10.1007/s00586-009-1240-1 CrossRefPubMed

37.

Liang C, Sun J, Cui X et al (2016) Spinal sagittal imbalance in patients with lumbar disc herniation: its spinopelvic characteristics, strength changes of the spinal musculature and natural history after lumbar discectomy. BMC Musculoskelet Disord 17:305. https://doi.org/10.1186/s12891-016-1164-y CrossRefPubMedPubMedCentral

38.

Lamartina C, Berjano P, Petruzzi M et al (2012) Criteria to restore the sagittal balance in deformity and degenerative spondylolisthesis. Eur Spine J 21:27–31. https://doi.org/10.1007/s00586-012-2236-9 CrossRefPubMedCentral

39.

Labelle H, Mac-Thiong JM, Roussouly P (2011) Spino-pelvic sagittal balance of spondylolisthesis: a review and classification. Eur Spine J 20:1–6. https://doi.org/10.1007/s00586-011-1932-1 CrossRef

40.

Labelle H, Roussouly P, Berthonnaud E et al (2005) The importance of spino-pelvic balance in L5-s1 developmental spondylolisthesis: a review of pertinent radiologic measurements. Spine (Phila Pa 1976) 30:S27–S34. https://doi.org/10.1097/01.brs.0000155560.92580.90 CrossRef

41.

Vidal J, Marnay T (1983) Morphology and anteroposterior body equilibrium in spondylolisthesis L5-S1. Rev Chir Orthop Reparatrice Appar Mot 69:17–28PubMed

42.

Lamartina C (2001) A square to indicate the unstable zone in severe spondylolisthesis. Eur Spine J 10:444–448. https://doi.org/10.1007/s005860100284 CrossRefPubMedPubMedCentral

43.

Learmonth ID, Young C, Rorabeck C (2007) The operation of the century: total hip replacement. Lancet (London, England) 370:1508–1519. https://doi.org/10.1016/s0140-6736(07)60457-7 CrossRef

44.

Offierski CM, MacNab I (1983) Hip–spine syndrome. Spine (Phila Pa 1976) 8:316–321CrossRef

45.

Nashner LM, McCollum G (1985) The organization of human postural movements: a formal basis and experimental synthesis. Behav Brain Sci 8:135. https://doi.org/10.1017/S0140525X00020008 CrossRef

46.

Weng WJ, Wang WJ, Da WuM et al (2015) Characteristics of sagittal spine–pelvis–leg alignment in patients with severe hip osteoarthritis. Eur Spine J 24:1228–1236. https://doi.org/10.1007/s00586-014-3700-5 CrossRefPubMed

47.

Eyvazov K, Eyvazov B, Basar S et al (2016) Effects of total hip arthroplasty on spinal sagittal alignment and static balance: a prospective study on 28 patients. Eur Spine J 25:3615–3621. https://doi.org/10.1007/s00586-016-4696-9 CrossRefPubMed

48.

Weng W, Wu H, Wu M et al (2016) The effect of total hip arthroplasty on sagittal spinal–pelvic–leg alignment and low back pain in patients with severe hip osteoarthritis. Eur spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 25:3608–3614. https://doi.org/10.1007/s00586-016-4444-1 CrossRef

49.

Raczkowski JW, Daniszewska B, Zolynski K (2010) Functional scoliosis caused by leg length discrepancy. Arch Med Sci 6:393–398. https://doi.org/10.5114/aoms.2010.14262 CrossRefPubMedPubMedCentral

50.

Ferrero E, Vira S, Ames CP et al (2016) Analysis of an unexplored group of sagittal deformity patients: low pelvic tilt despite positive sagittal malalignment. Eur Spine J 25:3568–3576. https://doi.org/10.1007/s00586-015-4048-1 CrossRefPubMed

51.

Ekbom K, Lindholm H, Ljungberg L (1972) New dystonic syndrome associated with butyrophenone therapy. Z Neurol 202:94–103PubMed

52.

Oh JK, Smith JS, Shaffrey CI et al (2014) Sagittal spinopelvic malalignment in Parkinson disease. Spine (Phila Pa 1976) 39:E833–E841. https://doi.org/10.1097/brs.0000000000000366 CrossRef

53.

Choi HJ, Smith JS, Shaffrey CI et al (2015) Coronal plane spinal malalignment and Parkinson’s disease: prevalence and associations with disease severity. Spine J 15:115–121. https://doi.org/10.1016/j.spinee.2014.07.004 CrossRefPubMed

54.

Babat LB, McLain RF, Bingaman W et al (2004) Spinal surgery in patients with Parkinson’s disease: construct failure and progressive deformity. Spine (Phila Pa 1976) 29:2006–2012CrossRef

55.

Schlösser TPC, Janssen MMA, Vrtovec T et al (2014) Evolution of the ischio-iliac lordosis during natural growth and its relation with the pelvic incidence. Eur Spine J. https://doi.org/10.1007/s00586-014-3358-z

56.

Mangione P, Gomez D, Senegas J (1997) Study of the course of the incidence angle during growth. Eur Spine J 6:163–167. https://doi.org/10.1007/BF01301430 CrossRefPubMedPubMedCentral

57.

La Maida GA, Zottarelli L, Mineo GV, Misaggi B (2013) Sagittal balance in adolescent idiopathic scoliosis: radiographic study of spino-pelvic compensation after surgery. Eur Spine J. https://doi.org/10.1007/s00586-013-3018-8 PubMedPubMedCentral

58.

Mac-Thiong JM, Labelle H, Berthonnaud E et al (2007) Sagittal spinopelvic balance in normal children and adolescents. Eur Spine J 16:227–234. https://doi.org/10.1007/s00586-005-0013-8 CrossRefPubMed

59.

Yokoyama K, Kawanishi M, Yamada M et al (2016) Spinopelvic alignment and sagittal balance of asymptomatic adults with 6 lumbar vertebrae. Eur Spine J 25:3583–3588. https://doi.org/10.1007/s00586-015-4284-4 CrossRefPubMed

60.

Lee S-H, Kim K-T, Seo E-M et al (2012) The influence of thoracic inlet alignment on the craniocervical sagittal balance in asymptomatic adults. J Spinal Disord Tech 25:E41–E47. https://doi.org/10.1097/BSD.0b013e3182396301 CrossRefPubMed

61.

Janik TJ, Harrison DD, Cailliet R et al (1998) Can the sagittal lumbar curvature be closely approximated by an ellipse? J Orthop Res 16:766–770. https://doi.org/10.1002/jor.1100160620 CrossRefPubMed

62.

Hardacker JW, Shuford RF, Capicotto PN, Pryor PW (1997) Radiographic standing cervical segmental alignment in adult volunteers without neck symptoms. Spine (Phila Pa 1976) 22:1472–1480CrossRef

63.

Scheer JK, Tang JA, Smith JS et al (2013) Cervical spine alignment, sagittal deformity, and clinical implications. J Neurosurg Spine 19:141–159. https://doi.org/10.3171/2013.4.SPINE12838 CrossRefPubMed

64.

Dubousset J (1990) CD instrumentation in pelvic tilt. Orthopade 19:300–308PubMed

65.

Suzuki H, Endo K, Mizuochi J et al (2010) Clasped position for measurement of sagittal spinal alignment. Eur Spine J 19:782–786. https://doi.org/10.1007/s00586-010-1352-7 CrossRefPubMedPubMedCentral

66.

Vedantam R, Lenke LG, Bridwell KH et al (2000) The effect of variation in arm position on sagittal spinal alignment. Spine (Phila Pa 1976) 25:2204–2209CrossRef

67.

Horton WC, Brown CW, Bridwell KH et al (2005) Is there an optimal patient stance for obtaining a lateral 36” radiograph? A critical comparison of three techniques. Spine (Phila Pa 1976) 30:427–433CrossRef

68.

Dubousset J, Challier V, Farcy JP, Schwab FJ, Lafage V (2015) Spinal alignment versus spinal balance. In: Haid RW, Schwab FJ, Shaffrey CI, Youssef J (eds) Global spinal alignment: principles, pathologies, and procedures. Quality Medical Publishing, St. Louis, pp 3–9

Titel: Focal disorders of the spine with compensatory deformities: how to define them
verfasst von: Andrea Redaelli
Pedro Berjano
Max Aebi
Publikationsdatum: 30.01.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: European Spine Journal / Ausgabe Sonderheft 1/2018
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-018-5501-8

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