The Large Individual Differences in the Range of Hip Joint Motion Rather Than Lumbar Spine Motion Affect Dynamic Spinopelvic Rhythm

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  • Yoshioka Katsuhito
    Department of Orthopaedic Surgery, Kanazawa University, Graduate School of Medical Science Department of Orthopaedic Surgery, National Hospital Organization Kanazawa Medical Center
  • Murakami Hideki
    Department of Orthopaedic Surgery, Kanazawa University, Graduate School of Medical Science
  • Demura Satoru
    Department of Orthopaedic Surgery, Kanazawa University, Graduate School of Medical Science
  • Kato Satoshi
    Department of Orthopaedic Surgery, Kanazawa University, Graduate School of Medical Science
  • Kawashima Hiroki
    Department of Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University
  • Sanada Shigeru
    Department of Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University
  • Tsuchiya Hiroyuki
    Department of Orthopaedic Surgery, Kanazawa University, Graduate School of Medical Science

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<p>Introduction: Global spinal balance and its relationship to the pelvis have received much attention, and various formulae have been used to predict postoperative spinopelvic alignment for spinal surgery. However, previous studies had limitations because no consideration was given to the dynamic factor.</p><p>Methods: Fifteen healthy adults without any lumbar disorder (group A) and 9 L4-spondylolisthesis patients (Group B) volunteered to participate in the study. Sequential images were captured with the subjects in the standing position with maximal forward bending followed by backward bending using a dynamic flat panel detector system. Spinopelvic parameters (LL: lumbar lordosis, SA: sacrofemoral angle, SS: sacral slope, PI: pelvic incidence, DP: distance of the horizontal movement of the pelvis) were evaluated. We also investigated the relationship between LL and SA (lumbar/hip [L/H] ratio) as the spinopelvic rhythm.</p><p>Results: In group A, the mean change in LL was 83.2 ± 9.5°; change in SA, 45.4 ± 16.6°; SS, 42.6 ± 8.9°; PI, 43.2 ± 7.7°; DP, 15.7 ± 3.4 cm, and L/H ratio, 3.6 ± 2.7. However, spinopelvic rhythm changed over time, because the change in LL was larger than the change in SA from the middle of the rising motion to the upright position. In group B, the mean change in LL was 50.3 ± 8.0°; SA, 56.9 ± 16.0°; SS, 27.5 ± 13.5°; PI, 47.4 ± 10.4°; DP, 12.7 ± 6.8 cm; and L/H ratio, 1.0 ± 0.5.</p><p>Conclusions: When compared with the change in LL, individual differences were largely noted in the change in SA. These results demonstrated that the range of hip joint motion under physiological conditions, unlike anatomical motion, differed substantially between individuals. Therefore, spinopelvic rhythm is dependent on the change in SA.</p>

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