Coluna / Columna v.15, n.1 /2016

ARTIGO ORIGINAL


FUNCTIONAL DISABILITY, SAGITTAL ALIGNMENT AND PELVIC BALANCE IN LUMBAR SPONDYLOLISTHESIS



Luis Muñiz Luna1 , Hugo Vilchis Sámano1 , Marcos Marban Heredia1 , Enrique Salcedo Oviedo1 , Juvenal Ordaz1 , Ana María Morales1 , Jorge Salvador De La Cruz Álvarez1 , José Antonio Canales Nájera1 , Yadira Bahena Salgado1 , Edgar Negrete-Mundo1

1 . Hospital de Traumatología y Ortopedia "Lomas Verdes" of the IMSS (Instituto Mexicano del Seguro Social), High Specialty Medical Unit, Spine Surgery Service, Naucalpan de Juárez, Mexico.

DOI: http://dx.doi.org/



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ABSTRACT

Objectives:
To demonstrate the recovery of lumbar sagittal pelvic alignment and sagittal pelvic balance after surgical reduction of lumbar spondylolisthesis and establish the benefits of the surgery for reduction and fixation of the lumbar spondylolisthesis with 360 circumferential arthrodesis for 2 surgical approaches by clinical and functional evaluation.

Method:
Eight patients with lumbar spondylolisthesis treated with surgical reduction and fixation of listhesis and segmental circumferential fusion with two surgical approaches were reviewed. They were evaluated before and after treatment with Oswestry, Visual Analogue for pain and Odom scales, performing radiographic measurement of lumbar sagittal alignment and pelvic sagittal balance with the technique of pelvic radius.

Results:
Oswestry scales and EVA reported improvement of symptoms after treatment in 8 cases; the Odom scale had six outstanding cases reported. The lumbar sagittal alignment presented a lumbosacral lordosis angle and a lumbopelvic lordosis angle reduced in 4 cases and increased in 4 other cases; pelvic sagittal balance increased the pelvic angle in 4 cases and decreased in 3 cases and the sacral translation of the hip axis to the promontory increased in 6 cases.

Conclusion:
The surgical procedure evaluated proved to be useful by modifying the lumbar sagittal alignment and the pelvic balance, besides reducing the symptoms, enabling the patient to have mobility and movement and the consequent satisfaction with the surgery.


Keywords: Lumbosacral region,Spinal fusion,Arthrodesis,Bone malalignment,Postural balance.

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