Does laminectomy Affect Spino-Pelvic Balance in Lumbar Spinal Stenosis?
A Study Based on Eos® X Ray Imaging System
Manuela D’Ercole1*, Gualtiero Innocenzi2, Paola Lattuada3, Francesco Ricciardi2 and Simona Bistazzoni4
1Department of Neurosurgery, IRCCS Fondazione Policlinico Universitario “Agostino Gemelli” Università Cattolica del Sacro Cuore largo Agostino Gemelli, Roma Italy
2Department of Neurosurgery, IRCCS Neuromed Via Atinense, Pozzilli (IS), Italy
3Medical Physics Department Ospedale S Anna, Via Ravona, San Fermo della Battaglia (Co), Italy
4Department of Neurosurgery Ospedale S Anna, Via Ravona, San Fermo della Battaglia (Co), Italy
*Corresponding Author: Manuela D’Ercole, Department of Neurosurgery, IRCCS Fondazione Policlinico Universitario “Agostino Gemelli” Università Cattolica del Sacro Cuore largo Agostino Gemelli, Roma Italy.
February 19, 2022; Published: March 11, 2022
Purpose: Lumbar spinal stenosis (LSS) is a degenerative disorder, causing forward bending of trunk and pelvic retroversion with consequent loss of lumbar lordosis; surgical treatment is intended to enlarge the canal and foramina and decompress the nerve roots. The purpose of our study is to analyse if and to what extent facets-sparing laminectomy affects the spino-pelvic balance.
Methods: Spino-pelvic balance was analyzed before and after surgery through EOS® X-Ray Imaging System on 26 patients. Parameters considered were: thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS). Clinical data were expressed in numeric values through Oswestry Disability Index (ODI), Visual Analogue Scale (VAS), modified Japanese Orthopaedic Association scoring system (mJOA).
Results: Significant SS decrease and PT increase were noticed after surgery, without modification in LL, axial vertebral rotation (AVR) and the general alignment. Pain and disability had a significant improvement, as represented by decrease of scores in VAS and ODI scales and increase in mJOA functional scale.
Conclusion: The most important parameter seems to be a congruence between pelvic and spinal parameters in order to achieve an economic posture with physiologic position of the axis of gravity. According to literature, a standard SB is not defined.
Keywords: Lumbar Spinal Stenosis; Sagittal Balance; EOS System; Spino-Pelvic Parameters
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