CLINICAL AND ROENTGENOLOGICAL CRITERIA OF SPINE-PELVIS RATIOS IN CHILDREN WITH DYSPLASTIC FEMUR SUBLUXATION

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Abstract

Aim of the study — to identify clinical and roentgenological criteria of the sagittal profile status of spine-pelvis segment in children with dysplastic femur subluxation.

Material and Methods. The present study included 40 female patients (50 hip joints) aged from 12 to 17 years (14.7±1.58) with unilateral and bilateral hip joint instability due to dysplasia. Children were divided into two groups – the first group included 30 patients (30 hip joints) with unilateral femur subluxation, the second group – 10 patients (20 hip joints) with bilateral femur subluxation. All patients underwent a standard orthopaedic clinical examination using a specialized scale to objectify complaints. All patients underwent X-ray examination of hip joints in AP and Lauenstein projections, CT scanning as well as lateral panoramic roentgenography of C1-S1 including femoral bones in standing position of the patient.

Results. The authors observed a strong positive correlation between sacrum inclination and lumbar lordosis curvature, antetorsion angle of proximal femur and sacrum inclination angle, severity of pain syndrome during impingement test and sacrum tilt: Pearson correlation coefficient was 0.71, 0.81 and 0.88 respectively. The authors reported in all patients a thoracic normokyphosis and lumbar hyperlordosis with excessive pelvis anteversion. Global sagittal disbalance was observed in all patients.

Conclusion. Apart from typical anatomical and roentgenological changes in pelvic and femoral componentsof the joint the children with dysplastic femur subluxation are characterized by excessive pelvic anteversion. Criteria of above parameters are identical and do not depend on the number of joints involved into the pathological process. Cranial dislocation of femoral head results to abnormalities of sagittal spine-pelvis ratios. Pathological process in hip joints and abnormality of spine-pelvis ratios results in negative changes of sagittal spine profile in the form of hyperlordosis, of physiological criteria of thoracic kyphosis and of the global sagittal disbalance. All of the above leads to overload of spinal motion segments and development of spine degenerative and dystrophic changes at early age.

About the authors

P. I. Bortulev

Turner Scientific and Research Institute for Children’s Orthopedics.

Author for correspondence.
Email: fake@neicon.ru

Pavel I. Bortulev — research associate, Department of Hip Pathology.

Parkovaya ul., 64 68, 196603, Pushkin, St. Petersburg.

Россия

S. V. Vissarionov

Turner Scientific and Research Institute for Children’s Orthopedics; Mechnikov North-Western State Medical University.

Email: fake@neicon.ru

Sergei V. Vissarionov — Dr. Sci. (Med.), professor, deputy director for science, head of the Department of Spinal Pathology and Neurosurgery; professor of Traumatology and Orthopaedics Department,

Parkovaya ul., 64 68, 196603, Pushkin, St. Petersburg; 41, Kirochnaya ul., 191015, St. Petersburg.

Россия

V. E. Baskov

Turner Scientific and Research Institute for Children’s Orthopedics.

Email: fake@neicon.ru

Vladimir E. Baskov — Cand. Sci. (Med.), head of the Department of Hip Pathology.

Parkovaya ul., 64 68, 196603, Pushkin, St. Petersburg.

Россия

A. V. Ovechkina

Turner Scientific and Research Institute for Children’s Orthopedics.

Email: fake@neicon.ru

Alla V. Ovechkina — Cand. Sci. (Med.), academic secretary.

Parkovaya ul., 64 68, 196603, Pushkin, St. Petersburg.

Россия

D. B. Barsukov

Turner Scientific and Research Institute for Children’s Orthopedics.

Email: fake@neicon.ru

Dmitry B. Barsukov — Cand. Sci. (Med.), senior research associate, the Department of Hip Pathology.

Parkovaya ul., 64 68, 196603, Pushkin, St. Petersburg.

Россия

I. Y. Pozdnikin

Turner Scientific and Research Institute for Children’s Orthopedics.

Email: fake@neicon.ru

Ivan Y. Pozdnikin — Cand. Sci. (Med.), research associate of the Department of Hip Pathology.

Parkovaya ul., 64 68, 196603, Pushkin, St. Petersburg/

Россия

References

  1. Sternheim A., Rogers B.A., Kuzyk P.R., Safir O.A., Backstein D., Gross A.E. Segmental proximal femoral bone loss and revision total hip replacement in patients with developmental dysplasia of the hip: the role of allograft prosthesis composite. J Bone Joint Surg Br. 2012;94(6):762-767. doi: 10.1302/0301-620X.94B6.27963.
  2. Васкуленко В.М. Концепция ведения больных кок-сартрозом на фоне дегенеративно-дистрофического поражения пояснично-крестцового отдела позвоночника. Травма. 2008;(1):6-12.
  3. Ben-Galim P., Ben-Galim T., Rand N., Haim A., Hipp J., Dekel S., Floman Y. Hip-spine syndrome: the effect of total hip replacement surgery on low back pain in severe osteoarthritis of the hip. Spine (Phila Pa 1976). 2007;32(19):2099-2102. doi: 10.1097/BRS.0b013e318145a3c5.
  4. Burns S.A., Burshteyn M., Mintken P.E. Sign of the buttock following total hip arthroplasty. J Orthop Sports Phys Ther. 2010;40(6):377. doi: 10.2519/jospt.2010.0410.
  5. Грязева Е.Д., Желтков В.И., Портненко И.А. Кинематическая модель движения человека и идентификация ее параметров. Известия Тульского государственного университета. Естественные науки. 2013;(2-2):107-111.
  6. Duval-Beaupère G., Robain G. Visualization on full spine radiographs of the anatomical connections of the centres of the segmental body mass supported by each vertebra and measured in vivo. Int Orthop. 1987;11(3):261-269.
  7. Виссарионов С.В., Кокушин Д.Н., Картавенко К.А., Ефремов А.М. Хирургическое лечение детей с врож-денной деформацией поясничного и пояснично-крестцового отделов позвоночника. Хирургия позвоночника. 2012;(3):33-37.
  8. Legaye J., Duval-Beaupère G., Hecquet J., Marty C. Pelvic incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves. Eur Spine J. 1998;7(2):99-103.
  9. Бортулев П.И. Басков В.Е. Барсуков Д.Б., Поздникин И.Ю., Овсянкин А.В., Дроздецкий А.П. и др. Результаты лечения детей с переломами шейки бедренной кости. Ортопедия, травматология и восстановительная хирургия детского возраста. 2018;6(2):63-72. doi: 10.17816/PTORS6263-72.
  10. Басков В.Е., Камоско М.М., Барсуков Д.Б., Поздникин И.Ю., Кожевников В.В., Григорьев И.В., Бортулев П.И. Транспозиция вертлужной впадины после подвздошно-седалищной остеотомии таза при лечении дисплазии тазобедренного сустава. Ортопедия, травматология и восстановительная хи-рургия детского возраста. 2016;(2):5-11.
  11. Камоско М.М., Баиндурашвили А.Г. Диспластический коксартроз у детей и подростков (клиника, патоге-нез, хирургическое лечение). СПб., 2010. С. 54-72.
  12. Кралина С.Э. Лечение высокого врожденного вывиха бедра у детей младшего возраста. Клинические рекомендации. М., 2013. С. 7-10.
  13. Vaz G., Roussouly P., Berthonnaud E., Dimnet J. Sagittal morphology and equilibrium of pelvis and spine. Eur Spine J. 2002;(11):80-87. doi: 10.1007/s005860000224.
  14. Продан А.И., Радченко В.А., Хвисюк А.Н., Куценко В.А. Закономерности формирования вертикальной осанки и параметров сагиттального позвоночно-та-зового баланса у пациентов с хронической люмбалгией и люмбоишиалгией. Хирургия позвоночника. 2006;(4):61-69.
  15. Аверкиев В.А., Кудяшев А.Л., Артюх В.А., Надулич К.А., Теремшонок А.В., Нагорный Е.Б. Особенности сагиттальных позвоночно-тазовых взаимоотноше-ний у пациентов с коксовертебральным синдромом. Хирургия позвоночника. 2012;(4):49-54.
  16. Lenke L.G., Betz R.R., Clements D., Merola A., Haher T., Lowe T. et al. Curve prevalence of a new classification of operative adolescent idiopathic scoliosis: does classification correlate with treatment? Spine (Phila Pa 1976). 2002;27(6):604-611.
  17. Shefi S, Soudack M, Konen E, Been E. Development of the lumbar lordotic curvature in children from age 2 to 20 years. Spine (Phila Pa 1976). 2013;38(10):E602-E608. doi: 10.1097/BRS.0b013e31828b666b.
  18. Glassman S.D., Bridwell K., Dimar J.R., Horton W., Berven S., Schwab F. The impact of positive sagittal balance in adult spinal deformity. Spine. 2005;5(18):2024-2029. doi: 10.1097/01.brs.0000179086.30449.96.
  19. Ozer A.F. Kaner T., Bozdogan C. Sagittal Balance in the Spine. Turkish Neurosurgery. 2014;24(1):13-19.
  20. Zheng X., Chaudhari R., Wu C., Mehbod A.A., Transfeldt E.E., Winter R.D. Repeatability test of C7 plumb line and gravity line on asymptomatic volunteers using an optical measurement technique. Spine. 2010;35(18):E889-E894. doi: 10.1097/brs.0b013e3181db7432.
  21. Liu S., Schwab F., Smith J.S., Klineberg E., Ames C.P., Mundis G. et al. Likelihood of reaching minimal clinically important difference in adult spinal deformity: a comparison of operative and nonoperative treatment. Ochsner J. 2014;14(1):67-77.
  22. Roussouly P., Berthonnaud E., Dimnet J. [Geometrical and mechanical analysis of lumbar lordosis in an asymptomatic population: proposed classification]. Rev Chir Orthop Reparatrice Appar Mot. 2003;89(7):632-629. (in French).
  23. Roussouly P., Pinheiro-Franco J.L. Biomechanical analysis of the spino-pelvic organization and adaptation in pathology. Eur Spine J. 2011;20 Suppl 5:609-618. doi: 10.1007/s00586-011-1928-x.

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