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Erschienen in: European Spine Journal 3/2014

01.03.2014 | Original Article

Spinopelvic balance: new biomechanical insights with clinical implications for Parkinson’s disease

verfasst von: Luciano Bissolotti, Massimiliano Gobbo, Jorge Hugo Villafañe, Stefano Negrini

Erschienen in: European Spine Journal | Ausgabe 3/2014

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Abstract

Purpose

The aim of this study was to describe the disease-related sagittal balance changes in relation to the sacropelvic morphology of PD patients with different durations of disease.

Methods

Thirty-one consecutive Parkinson’s disease patients (26 males, 5 females; age 55–83 years) participated in the cross-sectional study. The clinical assessment included: Hoehn Yahr score; plumb line distance from the spinous process of C7, kyphosis apex, spinous process of L3 and S1. Lumbar lordosis (LL), thoracic kyphosis (TK), spinosacral angle, spinopelvic angle, spinal tilt, pelvic incidence, sacral slope (SS) and pelvic tilt were radiographically assessed.

Results

Radiographic spinopelvic angles appeared normal, but many patients presented variations from normality. In particular, pelvic tilt increased and SS decreased; spinosacral and spinopelvic angles were greatly reduced compared to healthy people, and spinal tilt increased. Unlike TK, LL was well correlated with most of the parameters.

Conclusions

Sagittal balance evaluation provides new valuable insights for biomechanical understanding of PD patients. Specific spinal parameters (spinosacral, spinopelvic and spinal tilt angles), and their clinical correlation, as well as pelvic parameters like pelvic tilt and sacral slope, appear particularly interesting for their clinical implications in terms of spinal deformities correction in PD population.
Literatur
1.
Zurück zum Zitat Roussouly P, Nnadi C (2010) Sagittal plane deformity: an overview of interpretation and management. Eur Spine J 19(11):1824–1836 (Epub 2010 Jun 22)PubMedCentralPubMedCrossRef Roussouly P, Nnadi C (2010) Sagittal plane deformity: an overview of interpretation and management. Eur Spine J 19(11):1824–1836 (Epub 2010 Jun 22)PubMedCentralPubMedCrossRef
2.
Zurück zum Zitat Labelle H, Roussouly P, Berthonnaud E, Dimnet J, O’Brien M (2005) The importance of spino-pelvic balance in L5-S1 developmental spondylolisthesis: a review of pertinent radiologic measurements. Spine (Phila Pa 1976) 30(6 Suppl):S27–S34CrossRef Labelle H, Roussouly P, Berthonnaud E, Dimnet J, O’Brien M (2005) The importance of spino-pelvic balance in L5-S1 developmental spondylolisthesis: a review of pertinent radiologic measurements. Spine (Phila Pa 1976) 30(6 Suppl):S27–S34CrossRef
3.
Zurück zum Zitat Obeid I, Hauger O, Aunoble S, Bourghli A, Pellet N, Vital JM (2011) Global analysis of sagittal spinal alignment in major deformities: correlation between lack of lumbar lordosis and flexion of the knee. Eur Spine J 20(Suppl 5):681–685PubMedCentralPubMedCrossRef Obeid I, Hauger O, Aunoble S, Bourghli A, Pellet N, Vital JM (2011) Global analysis of sagittal spinal alignment in major deformities: correlation between lack of lumbar lordosis and flexion of the knee. Eur Spine J 20(Suppl 5):681–685PubMedCentralPubMedCrossRef
4.
Zurück zum Zitat Mac-Thiong JM, Roussouly P, Berthonnaud E, Guigui P (2010) Sagittal parameters of global spinal balance: normative values from a prospective cohort of seven hundred nine Caucasian asymptomatic adults. Spine (Phila Pa 1976) 35(22):E1193–E1198CrossRef Mac-Thiong JM, Roussouly P, Berthonnaud E, Guigui P (2010) Sagittal parameters of global spinal balance: normative values from a prospective cohort of seven hundred nine Caucasian asymptomatic adults. Spine (Phila Pa 1976) 35(22):E1193–E1198CrossRef
5.
Zurück zum Zitat Mac-Thiong JM, Roussouly P, Berthonnaud E, Guigui P (2011) Age- and sex-related variations in sagittal sacropelvic morphology and balance in asymptomatic adults. Eur Spine J 20(Suppl 5):S572–S577CrossRef Mac-Thiong JM, Roussouly P, Berthonnaud E, Guigui P (2011) Age- and sex-related variations in sagittal sacropelvic morphology and balance in asymptomatic adults. Eur Spine J 20(Suppl 5):S572–S577CrossRef
6.
Zurück zum Zitat Roussouly P, Pinheiro-Franco JL (2011) Biomechanical analysis of the spino-pelvic organization and adaptation in pathology. Eur Spine J 20(Suppl 5):S609–S618CrossRef Roussouly P, Pinheiro-Franco JL (2011) Biomechanical analysis of the spino-pelvic organization and adaptation in pathology. Eur Spine J 20(Suppl 5):S609–S618CrossRef
7.
Zurück zum Zitat Koller H, Acosta F, Zenner J, Ferraris L, Hitzl W, Meier O, Ondra S, Koski T, Schmidt R (2010) Spinal surgery in patients with Parkinson’s disease: experiences with the challenges posed by sagittal imbalance and the Parkinson’s spine. Spine J 19(10):1785–1794CrossRef Koller H, Acosta F, Zenner J, Ferraris L, Hitzl W, Meier O, Ondra S, Koski T, Schmidt R (2010) Spinal surgery in patients with Parkinson’s disease: experiences with the challenges posed by sagittal imbalance and the Parkinson’s spine. Spine J 19(10):1785–1794CrossRef
8.
Zurück zum Zitat Mac-Thiong J-M, Labelle H, Charlebois M (2003) Sagittal plane analysis of the spine and pelvis in adolescent idiopathic scoliosis according to the coronal curve type. Spine 28:1404–1409PubMed Mac-Thiong J-M, Labelle H, Charlebois M (2003) Sagittal plane analysis of the spine and pelvis in adolescent idiopathic scoliosis according to the coronal curve type. Spine 28:1404–1409PubMed
9.
Zurück zum Zitat Tanguay F, Mac-Thiong J-M, de Guise JA (2007) Relation between the sagittal pelvic and lumbar spine geometries following surgical correction of adolescent idiopathic scoliosis. Eur Spine J 16:531–536PubMedCentralPubMedCrossRef Tanguay F, Mac-Thiong J-M, de Guise JA (2007) Relation between the sagittal pelvic and lumbar spine geometries following surgical correction of adolescent idiopathic scoliosis. Eur Spine J 16:531–536PubMedCentralPubMedCrossRef
10.
Zurück zum Zitat Le Huec JC, Charosky S, Barrey C, Rigal J, Aunoble S (2011) Sagittal imbalance cascade for simple degenerative spine and consequences: algorithm of decision for appropriate treatment. Eur Spine J 20(Suppl 5):S699–S703CrossRef Le Huec JC, Charosky S, Barrey C, Rigal J, Aunoble S (2011) Sagittal imbalance cascade for simple degenerative spine and consequences: algorithm of decision for appropriate treatment. Eur Spine J 20(Suppl 5):S699–S703CrossRef
11.
Zurück zum Zitat Upadhyaya CD, Starr PA, Mummaneni PV (2010) Spinal deformity and Parkinson disease: a treatment algorithm. Neurosurg Focus 28(3):E5PubMedCrossRef Upadhyaya CD, Starr PA, Mummaneni PV (2010) Spinal deformity and Parkinson disease: a treatment algorithm. Neurosurg Focus 28(3):E5PubMedCrossRef
12.
Zurück zum Zitat Barrey C, Roussouly P, Perrin G, Le Huec JC (2011) Sagittal balance disorders in severe degenerative spine. Can we identify the compensatory mechanisms? Eur Spine J 20(Suppl 5):626–633PubMedCentralPubMedCrossRef Barrey C, Roussouly P, Perrin G, Le Huec JC (2011) Sagittal balance disorders in severe degenerative spine. Can we identify the compensatory mechanisms? Eur Spine J 20(Suppl 5):626–633PubMedCentralPubMedCrossRef
13.
Zurück zum Zitat Chaléat-Valayer E, Mac-Thiong JM, Paquet J, Berthonnaud E, Siani F, Roussouly P (2011) Sagittal spino-pelvic alignment in chronic low back pain. Eur Spine J 20(Suppl 5):634–640PubMedCentralPubMedCrossRef Chaléat-Valayer E, Mac-Thiong JM, Paquet J, Berthonnaud E, Siani F, Roussouly P (2011) Sagittal spino-pelvic alignment in chronic low back pain. Eur Spine J 20(Suppl 5):634–640PubMedCentralPubMedCrossRef
14.
Zurück zum Zitat Schuller S, Charles YP, Steib JP (2011) Sagittal spinopelvic alignment and body mass index in patients with degenerative spondylolisthesis. Eur Spine J 20(5):713–719PubMedCentralPubMedCrossRef Schuller S, Charles YP, Steib JP (2011) Sagittal spinopelvic alignment and body mass index in patients with degenerative spondylolisthesis. Eur Spine J 20(5):713–719PubMedCentralPubMedCrossRef
15.
Zurück zum Zitat Stagnara P, DeMauroy JC, Dran G, Gonon G, Costanzo G, Dimnet J, Pasquet A (1982) Reciprocal angulation of vertebral bodies in a sagittal plane: approach to references for the evaluation of kyphosis and lordosis. Spine (Phila Pa 1976) 7(4):335–342CrossRef Stagnara P, DeMauroy JC, Dran G, Gonon G, Costanzo G, Dimnet J, Pasquet A (1982) Reciprocal angulation of vertebral bodies in a sagittal plane: approach to references for the evaluation of kyphosis and lordosis. Spine (Phila Pa 1976) 7(4):335–342CrossRef
16.
Zurück zum Zitat Hughes AJ, Daniel SE, Kilford L, Lees AJ (1992) Accuracy of clinical diagnosis of idiopathic Parkinson’s disease. A clinico-pathological study of 100 cases. JNNP 55:181–184 Hughes AJ, Daniel SE, Kilford L, Lees AJ (1992) Accuracy of clinical diagnosis of idiopathic Parkinson’s disease. A clinico-pathological study of 100 cases. JNNP 55:181–184
17.
Zurück zum Zitat Hoehn MM, Yahr MD (1967) Parkinsonism: onset, progression and mortality. Neurology 17:427–442PubMedCrossRef Hoehn MM, Yahr MD (1967) Parkinsonism: onset, progression and mortality. Neurology 17:427–442PubMedCrossRef
18.
Zurück zum Zitat Scalzo PL, Flores CR, Marques JR, Robini SC, Teixeira AL (2012) Impact of changes in balance and walking capacity on the quality of life in patients with Parkinson’s disease. Arq Neuropsiquiatr 70(2):119–124PubMedCrossRef Scalzo PL, Flores CR, Marques JR, Robini SC, Teixeira AL (2012) Impact of changes in balance and walking capacity on the quality of life in patients with Parkinson’s disease. Arq Neuropsiquiatr 70(2):119–124PubMedCrossRef
19.
Zurück zum Zitat Kegelmeyer DA, Kloos AD, Thomas KM, Kostyk SK (2007) Reliability and validity of the Tinetti Mobility Test for individuals with Parkinson disease. Phys Ther 87(10):1369–1378PubMedCrossRef Kegelmeyer DA, Kloos AD, Thomas KM, Kostyk SK (2007) Reliability and validity of the Tinetti Mobility Test for individuals with Parkinson disease. Phys Ther 87(10):1369–1378PubMedCrossRef
20.
Zurück zum Zitat Brusse KJ, Zimdars S, Zalewski KR, Steffen TM (2005) Testing functional performance in people with Parkinson disease. Phys Ther 85:134–141PubMed Brusse KJ, Zimdars S, Zalewski KR, Steffen TM (2005) Testing functional performance in people with Parkinson disease. Phys Ther 85:134–141PubMed
21.
Zurück zum Zitat Horton WC, Brown CW, Bridwell KH (2005) The effect of arm position on sagittal plane alignment. Spine 30:427–433PubMedCrossRef Horton WC, Brown CW, Bridwell KH (2005) The effect of arm position on sagittal plane alignment. Spine 30:427–433PubMedCrossRef
22.
Zurück zum Zitat Cohen J (1998) Statistical power analysis for the behavioural sciences, 2nd edn. Lawrence Erlbaum Associates, Hillsdale, pp 100–110 Cohen J (1998) Statistical power analysis for the behavioural sciences, 2nd edn. Lawrence Erlbaum Associates, Hillsdale, pp 100–110
23.
Zurück zum Zitat Kashihara K, Imamura T (2012) Clinical correlates of anterior and lateral flexion of the thoracolumbar spine and dropped head in patients with Parkinson’s disease. Parkinsonism Relat Disord 18(3):290–293PubMedCrossRef Kashihara K, Imamura T (2012) Clinical correlates of anterior and lateral flexion of the thoracolumbar spine and dropped head in patients with Parkinson’s disease. Parkinsonism Relat Disord 18(3):290–293PubMedCrossRef
24.
Zurück zum Zitat Hammerberg EM, Wood KB (2003) Sagittal profile of the elderly. J Spinal Disord 16:44–50CrossRef Hammerberg EM, Wood KB (2003) Sagittal profile of the elderly. J Spinal Disord 16:44–50CrossRef
25.
Zurück zum Zitat Le Huec JC, Saddiki R, Franke J, Rigal J, Aunoble S (2011) Equilibrium of the human body and the gravity line: the basics. Eur Spine J Suppl 5:558-63 Le Huec JC, Saddiki R, Franke J, Rigal J, Aunoble S (2011) Equilibrium of the human body and the gravity line: the basics. Eur Spine J Suppl 5:558-63
26.
Zurück zum Zitat McLean IP, Gillan MG, Ross JC, Aspden RM, Porter RW (1996) A comparison of methods for measuring trunk list. A simple plumbline is the best. Spine 21(14):1667–1670PubMedCrossRef McLean IP, Gillan MG, Ross JC, Aspden RM, Porter RW (1996) A comparison of methods for measuring trunk list. A simple plumbline is the best. Spine 21(14):1667–1670PubMedCrossRef
27.
Zurück zum Zitat Zaina F, Atanasio S, Ferraro C, Fusco C, Negrini A, Romano M, Negrini S (2009) Review of rehabilitation and orthopedic conservative approach to sagittal plane diseases during growth: hyperkyphosis, junctional kyphosis, and Scheuermann disease. Eur J Phys Rehabil Med 45(4):595–603PubMed Zaina F, Atanasio S, Ferraro C, Fusco C, Negrini A, Romano M, Negrini S (2009) Review of rehabilitation and orthopedic conservative approach to sagittal plane diseases during growth: hyperkyphosis, junctional kyphosis, and Scheuermann disease. Eur J Phys Rehabil Med 45(4):595–603PubMed
28.
Zurück zum Zitat Negrini S (2009) Focus on flexed posture and hyperkyphosis: prevention and rehabilitation to reduce disability and increase quality of life. Eur J Phys Rehabil Med 45(4):567–569PubMed Negrini S (2009) Focus on flexed posture and hyperkyphosis: prevention and rehabilitation to reduce disability and increase quality of life. Eur J Phys Rehabil Med 45(4):567–569PubMed
Metadaten
Titel
Spinopelvic balance: new biomechanical insights with clinical implications for Parkinson’s disease
verfasst von
Luciano Bissolotti
Massimiliano Gobbo
Jorge Hugo Villafañe
Stefano Negrini
Publikationsdatum
01.03.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
European Spine Journal / Ausgabe 3/2014
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-013-3068-y

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