CHANGES IN SAGITTAL BALANCE IN THORACOLUMBAR POSTTRAUMATIC KYPHOSIS SURGERY

Abstract

ABSTRACT Objective: The analysis of the X-ray results of surgical treatment performed in patients with post-traumatic thoracolumbar kyphosis and identification of the compensatory mechanism for this deformity. Methods: The data of 140 patients surgically treated for painful post-traumatic kyphosis at the level of T12, L1, and L2 vertebrae was analyzed. Results: In the studied group, the initial kyphotic deformity was 23° to 81°, with a mean of 28.1°. All patients underwent staged surgical intervention in a single surgical session. Post-traumatic kyphosis (LK) was completely corrected, on average, to -0.25°. After kyphosis correction, increased thoracic kyphosis (TK) decreased lumbar lordosis (LL), including at the expense of low lumbar lordosis (LowLL), but no changes in pelvic balance parameters were observed. Statistically significant correlations of local kyphosis correction magnitude of 28.36±8.89°, with magnitudes of lumbar lordosis (LL), thoracic kyphosis (TK), low lumbar lordosis (LowLL) were obtained. The global sagittal and pelvic balance demonstrated no correlations with the magnitude of kyphosis correction. The X-ray parameters were studied in patients of Group I with no signs of initial sagittal imbalance and in Group II patients with signs of sagittal imbalance. The groups demonstrated statistically significant differences in global balance parameters and spinopelvic parameters both before and after correction surgery. Conclusion: The study revealed that the basic compensatory mechanism for post-traumatic thoracolumbar kyphosis is implemented by changes in the curves adjacent to kyphosis - a decrease in thoracic kyphosis and an increase in lumbar lordosis but not by changes in global or spinopelvic balance. Level of Evidence - III; A case-control study.

Keywords

• Spine
• Posture Control
• Kyphosis
• Lordosis