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Órgano Oficial de difusión científica de la Asociación Mexicana de Cirujanos de Columna A. C. y de la Sociedad Iberolatinoamericana de Columna. SILACO.

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Scielo

2026, Number 3

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Cir Columna 2026; 4 (3)

Hip-spine syndrome: diagnostic approach and algorithm for surgical sequence

Jiménez ÁJM, Vásquez RMI, Soria VA, García FE, Ibarra CAP, Ríos CAP

Language: Spanish
References: 15
Page: 227-234
PDF size: 649.56 Kb.


ABSTRACT

Introduction: hip-spine syndrome is a complex clinical entity in which degenerative hip and lumbar spine pathologies coexist, creating diagnostic and therapeutic uncertainty regarding the optimal surgical sequence. Objective: to review current evidence on hip-spine biomechanical interaction, propose a systematic diagnostic approach, and define criteria to prioritize hip versus spine surgery. Material and methods: a literature search was conducted in PubMed, Google Scholar, Ovid, and specialty journals using the terms "hip spine syndrome," "spinopelvic parameters," "total hip arthroplasty," "lumbar fusion," and "surgical sequence." Clinical studies, systematic reviews, and biomechanical investigations published between 1983 and 2025 were prioritized. Results: available evidence suggests that, in the absence of acute neurological deficit or severe spinal instability, prioritizing total hip arthroplasty is associated with lower rates of prosthetic dislocation (1.7 vs 4.6%) and surgical revision (3.7 vs 5.7%) compared with performing lumbar fusion first. Assessment of spinopelvic mobility using dynamic radiographs (standing and sitting) is essential for preoperative planning and risk stratification. Conclusion: decision-making should be individualized and multidisciplinary. Current trends favor addressing the hip first, reserving spine surgery for patients with severe neurological compromise. Comprehensive preoperative evaluation of sagittal balance and pelvic mobility is critical to optimize outcomes and minimize complications.


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