Suboptimal Age-Adjusted Lumbo-Pelvic Mismatch Predicts Negative Cervical-Thoracic Compensation in Obese Patients.
compensation
ideal alignment
lower extremity
obese
sagittal alignment
Journal
International journal of spine surgery
ISSN: 2211-4599
Titre abrégé: Int J Spine Surg
Pays: Netherlands
ID NLM: 101579005
Informations de publication
Date de publication:
Jun 2019
Jun 2019
Historique:
entrez:
23
7
2019
pubmed:
23
7
2019
medline:
23
7
2019
Statut:
epublish
Résumé
Given the paucity of literature regarding compensatory mechanisms used by obese patients with sagittal malalignment, it is necessary to gain a better understanding of the effects of obesity on compensation after comparing the degree of malalignment to age-adjusted ideals. This study aims to compare baseline alignment of obese and nonobese patients using age-adjusted spino-pelvic alignment parameters, describing associated spinal changes. Patients ≥ 18 years with full-body stereoradiographs were propensity-score matched for sex, baseline pelvic incidence (PI), and categorized as nonobese (body mass index < 30kg/m Included: 800 obese, 800 nonobese patients. Both groups recruited lower-extremity compensation: sacrofemoral angle ( Regardless of malalignment severity, obese patients recruited lower-limb compensation more than nonobese patients. Obese patients with PI-LL mismatch larger than age-adjusted ideal also develop upper-cervical and cervicothoracic compensation for malalignment. III. Clinical evaluation should extend to the cervical spine in obese patients not meeting age-adjusted sagittal alignment ideals.
Sections du résumé
BACKGROUND
BACKGROUND
Given the paucity of literature regarding compensatory mechanisms used by obese patients with sagittal malalignment, it is necessary to gain a better understanding of the effects of obesity on compensation after comparing the degree of malalignment to age-adjusted ideals. This study aims to compare baseline alignment of obese and nonobese patients using age-adjusted spino-pelvic alignment parameters, describing associated spinal changes.
METHODS
METHODS
Patients ≥ 18 years with full-body stereoradiographs were propensity-score matched for sex, baseline pelvic incidence (PI), and categorized as nonobese (body mass index < 30kg/m
RESULTS
RESULTS
Included: 800 obese, 800 nonobese patients. Both groups recruited lower-extremity compensation: sacrofemoral angle (
CONCLUSIONS
CONCLUSIONS
Regardless of malalignment severity, obese patients recruited lower-limb compensation more than nonobese patients. Obese patients with PI-LL mismatch larger than age-adjusted ideal also develop upper-cervical and cervicothoracic compensation for malalignment.
LEVEL OF EVIDENCE
METHODS
III.
CLINICAL RELEVANCE
CONCLUSIONS
Clinical evaluation should extend to the cervical spine in obese patients not meeting age-adjusted sagittal alignment ideals.
Identifiants
pubmed: 31328089
doi: 10.14444/6034
pii: IJSSURGERY-D-17-00158
pmc: PMC6625713
doi:
Types de publication
Journal Article
Langues
eng
Pagination
252-261Déclaration de conflit d'intérêts
Disclosures and COI: The authors report no conflicts of interest concerning the materials or methods used in this study or the findings specified in this paper. Ethics Review Committee Statement: Institutional Review Board approval was obtained for this study, prior to patient enrollment.
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