Problem of surgical priority choice at combined pathology of lumbar spine and hip joint (literature review)
DOI:
https://doi.org/10.15674/0030-598720223-4138-143Keywords:
degenerative spine disease, Hip joint arthritis, surgical treatmentAbstract
Pathological processes that affect the hip joint and the lumbar spine often coexist, leading to a significant loss of quality of life. Therefore, the problem of surgical treatment of degenerative diseases of the lumbar spine with conditions of hip joint arthritis is actual. Objective. To analyze the available scientific information regarding the priority of choosing a surgical intervention under the conditions of a combined pathology of the lumbar spine and hip joint. Methods. The research material was an analysis of relevant literature in specialized sources over the past 10 years. Results. The opinion of specialists about the possibility of direct influence of instability and sagittal spine balance on the functional orientation of acetabulum and, therefore, on the risk of impingement and dislocation of the hip joint was found. Conversely, flexion contracture in the hip joint can affect the sagittal balance of the spine and cause back pain. The indication for priority surgical treatment of the spine, in addition to acute or rapidly progressive neurological deficits, is the loss of sagittal balance, in particular, lumbar lordosis with subsequent changes in the sagittal profile. When, under the conditions of the hip joint arthritis, the pelvic tilt and the lordosis of the lumbar spine increase combined with the stenosis, spinal surgery is preferred. The combination of lumbar stenosis with hip joint arthritis may be a factor in increasing the risk of neurological deficits after hip arthroplasty. However, some authors in the case of combined pathology in any case recommend performing total joint arthroplasty in the first place because of its obvious excellent results, others did not find the best variant of the sequence of intervention based on the assessment of quality of life. Conclusions. Despite the long history of the study, the practical issues of treatment of the combined pathology of the lumbar spine and hip joint, the choice of optimal treatment tactics remain debatable and require further study
References
- Devin, C. J., McCullough, K. A., Morris, B. J., Yates, A. J., & Kang, J. D. (2012). Hip-spine Syndrome. Journal of the American Academy of Orthopaedic Surgeons, 20(7), 434–442. https://doi.org/10.5435/jaaos-20-07-434
- Redmond, J. M., Gupta, A., Hammarstedt, J. E., Stake, C. E., & Domb, B. G. (2014). The Hip-Spine Syndrome: How Does Back Pain Impact the Indications and Outcomes of Hip Arthroscopy? Arthroscopy: The Journal of Arthroscopic & Related Surgery, 30(7), 872–881. https://doi.org/10.1016/j.arthro.2014.02.033
- Buckland, A. J., Puvanesarajah, V., Vigdorchik, J., Schwarzkopf, R., Jain, A., Klineberg, E. O., Hart, R. A., Callaghan, J. J., & Hassanzadeh, H. (2017). Dislocation of a primary total hip arthroplasty is more common in patients with a lumbar spinal fusion. The Bone & Joint Journal, 99-B(5), 585–591. https://doi.org/10.1302/0301-620x.99b5.bjj-2016-0657.r1
- Salib, C. G., Reina, N., Perry, K. I., Taunton, M. J., Berry, D. J., & Abdel, M. P. (2019). Lumbar fusion involving the sacrum increases dislocation risk in primary total hip arthroplasty. The Bone & Joint Journal, 101-B(2), 198–206. https://doi.org/10.1302/0301-620x.101b2.bjj-2018-0754.r1
- Esposito, C. I., Carroll, K. M., Sculco, P. K., Padgett, D. E., Jerabek, S. A., & Mayman, D. J. (2018). Total Hip Arthroplasty Patients With Fixed Spinopelvic Alignment Are at Higher Risk of Hip Dislocation. The Journal of Arthroplasty, 33(5), 1449–1454. https://doi.org/10.1016/j.arth.2017.12.005
- Diebo, B. G., Beyer, G. A., Grieco, P. W., Liu, S., Day, L. M., Abraham, R., Naziri, Q., Passias, P. G., Maheshwari, A. V., & Paulino, C. B. (2018). Complications in Patients Undergoing Spinal Fusion After THA. Clinical Orthopaedics and Related Research, 476(2), 412–417. https://doi.org/10.1007/s11999.0000000000000009.
- An, V. V. G., Phan, K., Sivakumar, B. S., Mobbs, R. J., & Bruce, W. J. (2018). Prior Lumbar Spinal Fusion is Associated With an Increased Risk of Dislocation and Revision in Total Hip Arthroplasty: A Meta-Analysis. The Journal of Arthroplasty, 33(1), 297–300. https://doi.org/10.1016/j.arth.2017.08.040
- Lum, Z. C., Klineberg, E. O., Danielsen, B., Giordani, M., & Meehan, J. P. (2019). Female Sex and Longer Fusion Constructs Significantly Increase the Risk of Total Hip Arthroplasty Following Spinal Fusion. The Journal of Bone and Joint Surgery, 101(8), 675–681. https://doi.org/10.2106/jbjs.18.00667
- Abdel, M. P., von Roth, P., Jennings, M. T., Hanssen, A. D., & Pagnano, M. W. (2015). What Safe Zone? The Vast Majority of Dislocated THAs Are Within the Lewinnek Safe Zone for Acetabular Component Position. Clinical Orthopaedics and Related Research®, 474(2), 386–391. https://doi.org/10.1007/s11999-015-4432-5
- American Joint Replacement Registry. (2018) Annual Report, 2018. http://www.ajrr.net/ publications-data/annual-reports
- Perfetti, D. C., Schwarzkopf, R., Buckland, A. J., Paulino, C. B., & Vigdorchik, J. M. (2017). Prosthetic Dislocation and Revision After Primary Total Hip Arthroplasty in Lumbar Fusion Patients: A Propensity Score Matched-Pair Analysis. The Journal of Arthroplasty, 32(5), 1635–1640.e1. https://doi.org/10.1016/j.arth.2016.11.029
- Barrey, C., Perrin, G., Michel, F., Vital, J.-M., & Obeid, I. (2014). Pedicle subtraction osteotomy in the lumbar spine: indications, technical aspects, results and complications. European Journal of Orthopaedic Surgery & Traumatology, 24(S1), 21–30. https://doi.org/10.1007/s00590-014-1470-8
- Claßen, T., Scheid, C., Landgraeber, S., & Jäger, M. (2016). Besonderheiten beim elektiven Hüftgelenkersatz des älteren Menschen. Der Orthopäde, 46(1), 25–33. https://doi.org/10.1007/s00132-016-3364-4 (in Germain)
- Learmonth, I. D., Young, C., & Rorabeck, C. (2007). The operation of the century: total hip replacement. The Lancet, 370(9597), 1508–1519. https://doi.org/10.1016/s0140-6736(07)60457-7
- Sigmundsson, F. G. (2014). Determinants of outcome in lumbar spinal stenosis surgery. Acta Orthopaedica, 85(sup357), 1–45. https://doi.org/10.3109/17453674.2014.976807
- Buckland, A. J., Fernandez, L., Shimmin, A. J., Bare, J. V., McMahon, S. J., & Vigdorchik, J. M. (2019). Effects of Sagittal Spinal Alignment on Postural Pelvic Mobility in Total Hip Arthroplasty Candidates. The Journal of Arthroplasty, 34(11), 2663–2668. https://doi.org/10.1016/j.arth.2019.06.036
- Buckland, A. J., Puvanesarajah, V., Vigdorchik, J., Schwarzkopf, R., Jain, A., Klineberg, E. O., Hart, R. A., Callaghan, J. J., & Hassanzadeh, H. (2017). Dislocation of a primary total hip arthroplasty is more common in patients with a lumbar spinal fusion. The Bone & Joint Journal, 99-B(5), 585–591. https://doi.org/10.1302/0301-620x.99b5.bjj-2016-0657.r1
- Le Huec, J. C., Aunoble, S., Philippe, L., & Nicolas, P. (2011). Pelvic parameters: origin and significance. European Spine Journal, 20(S5), 564–571. https://doi.org/10.1007/s00586-011-1940-1
- Phan, D., Bederman, S. S., & Schwarzkopf, R. (2015). The influence of sagittal spinal deformity on anteversion of the acetabular component in total hip arthroplasty. The Bone & Joint Journal, 97-B(8), 1017–1023. https://doi.org/10.1302/0301-620x.97b8.35700
- Hurwitz, D. E., Hulet, C. H., Andriacchi, T. P., Rosenberg, A. G., & Galante, J. O. (1997b). Gait compensations in patients with osteoarthritis of the hip and their relationship to pain and passive hip motion. Journal of Orthopaedic Research, 15(4), 629–635. https://doi.org/10.1002/jor.1100150421
- McNamara, M. J., Barrett, K. G., Christie, M. J., & Spengler, D. M. (1993). Lumbar spinal stenosis and lower extremity arthroplasty. The Journal of Arthroplasty, 8(3), 273–277. https://doi.org/10.1016/s0883-5403(06)80089-6.
- Bohl, W. R., Steffee, A. D. (1979). Lumbar spinal stenosis. A cause of continued pain and disability in patients after total hip arthroplasty. Spine, 4 (2), 168–173.
- Yin, T.-C., Wegner, A. M., Lu, M.-L., Yang, Y.-H., Wang, Y.-C., Kung, W.-M., & Lo, W.-C. (2021). Do Orthopedic Surgeons or Neurosurgeons Detect More Hip Disorders in Patients with Hip-Spine Syndrome? A Nationwide Database Study. Brain Sciences, 11(4), 485. https://doi.org/10.3390/brainsci11040485
- Fogel, G. R., & Esses, S. I. (2003). Hip spine syndrome. The Spine Journal, 3(3), 238–241. https://doi.org/10.1016/s1529-9430(02)00453-9.
- Manchikanti, L., Kosanovic, R., Pampati, V., Cash, K. A., Soin, A., Kaye, A. D., Hirsch, J. A. (2020). Low Back Pain and Diagnostic Lumbar Facet Joint Nerve Blocks: Assessment of Prevalence, FalsePositive Rates, and a Philosophical Paradigm Shift from an Acute to a Chronic Pain Model. Pain Physician, 23(5), 519–529. https://doi.org/10.36076/ppj.2020/23/519
- Pritchett, J. W. (2018). Hip resurfacing with a highly cross-linked polyethylene acetabular liner and a titanium nitride-coated femoral component. HIP International, 28(4), 422–428. https://doi.org/10.1177/1120700017752334
- Watanabe, N., Takada, R., Ogawa, T., Miyatake, K., Hirao, M., Hoshino, C., Jinno, T., Koga, H., Yoshii, T., & Okawa, A. (2022). Short stature and short distance between the anterior acetabular rim to the femoral nerve are risk factors for femoral nerve palsy following primary total hip arthroplasty using the modified Watson-Jones approach. Orthopaedics & Traumatology: Surgery & Research, 108 (6), 103351. https://doi.org/10.1016/j.otsr.2022.103351
- Markman, J. D., Gewandter, J. S., Frazer, M. E., Pittman, C., Cai, X., Patel, K. V., Jahromi, B. S., Dworkin, R. H., Burke, L. B., & Farrar, J. T. (2015). Evaluation of outcome measures for neurogenic claudication. Neurology, 85(14), 1250–1256. https://doi.org/10.1212/wnl.0000000000002000
- Lee, M. J., Dettori, J. R., Standaert, C. J., Brodt, E. D., & Chapman, J. R. (2012). The Natural History of Degeneration of the Lumbar and Cervical Spines. Spine, 37, S18—S30. https://doi.org/10.1097/brs.0b013e31826cac62
- Xia, X.-P., Chen, H.-L., & Cheng, H.-B. (2013). Prevalence of Adjacent Segment Degeneration After Spine Surgery. Spine, 38(7), 597–608. https://doi.org/10.1097/brs.0b013e318273a2ea
- Herkowitz, H. N., & Kurz, L. T. (1991). Degenerative lumbar spondylolisthesis with spinal stenosis. A prospective study comparing decompression with decompression and intertransverse process arthrodesis. The Journal of Bone & Joint Surgery, 73(6), 802–808. https://doi.org/10.2106/00004623-199173060-00002
- Amundsen, T., Weber, H., Nordal, H. J., Magnaes, B., Abdelnoor, M., & Lilleås, F. (2000). Lumbar Spinal Stenosis: Conservative or Surgical Management? Spine, 25(11), 1424–1436. https://doi.org/10.1097/00007632-200006010-00016
- Gunzburg, R., Keller, T., Szpalski, M., Vandeputte, K., & Spratt, K. (2003). Clinical and psychofunctional measures of conservative decompression surgery for lumbar spinal stenosis: a prospective cohort study. European Spine Journal, 12(2), 197–204. https://doi.org/10.1007/s00586-002-0479-6
- Hee, H. T., Wong, H. K. (2003). The long-term results of surgical treatment for spinal stenosis in the elderly. Singapore medical journal, 44, 175–180.
- Fokter, S. K., & Yerby, S. A. (2005). Patient-based outcomes for the operative treatment of degenerative lumbar spinal stenosis. European Spine Journal, 15(11), 1661–1669. https://doi.org/10.1007/s00586-005-0033-4
- Spratt, K. F., Keller, T. S., Szpalski, M., Vandeputte, K., & Gunzburg, R. (2004). A predictive model for outcome after conservative decompression surgery for lumbar spinal stenosis. European Spine Journal, 13(1), 14–21. https://doi.org/10.1007/s00586-003-0583-2
- Dai, L., Xu, Y. (1998). Lumbar spinal stenosis: a review of biomechanical studies. Chinese medical sciences journal, 13 (1), 56–60.
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