Ramírez GR, Ramírez MJJ, Sánchez LM, Juárez LB

Language: Spanish
References: 5
Page: 126-133
PDF size: 702.74 Kb.

ABSTRACT

In the latest years, with the increasing number of aging people who requires spinal surgical treatment and with the increasing use of transpedicular screws in osteoporotic bone, sagittal imbalance has been taking relevance among spine surgeons. There are already a good amount of literature regarding the use of corrective osteotomies for major deformities, however, in daily practice, the typical patient is the one who has a degenerative disc disease who has lost minimal to moderate lordosis that is well tolerated by the rest of the spine. If we are to surgically treat this patient we must acknowledge this loss and aim to correct it to the maximum possible extent and avoid all the factors that might aggravate it. Spondhylolisthesis and spondylolysis treatment remains a therapeutic challenge for the orthopedic surgeons and neurosurgeons involved with the surgical treatment of these cases. In spondylolisthesis, it has been clearly demonstrated over the last decade that spino-pelvic morphology is abnormal and that it can be associated to an abnormal sacro-pelvic orientation as well as to a disturbed global sagittal balance of spine making it very important to assess the balance of the spine as a whole even when the planned procedure is a minor one or a minimal invasive one. In this document we aim for two main goals: to demonstrate the parameters to measure saggital imbalance and the strategies to restore it during surgical treatment.

REFERENCES

1. Molinari RW. Sagittal plane decompensation. Curr Opin Orthop. 2005; 16: 148-151.

2. Kim YJ, Bridwell KH, Lenke LG, Rhim S, Cheh G. An analysis of sagittal spinal alignment following long adult lumbar instrumentation and fusion to L5 or S1: can we predict ideal lumbar lordosis? Spine (Phila Pa 1976). 2006; 31 (20): 2343-2352.

3. Fujii K, Kawamura N, Ikegami M, Niitsuma G, Kunogi J. Radiological improvements in global sagittal alignment after lumbar decompression without fusion. Spine (Phila Pa 1976). 2015; 40 (10): 703-709.

4. Alcívar AE, Jaramillo BC, Villarroel RH. Balance sagital lumbopélvico en pacientes con enfermedad degenerativa lumbar (serie de casos)

5. Vital JM, García SA, Sauri BJC, Soderlund C, Gangnet N, Gille O. Equilibrio sagital y su aplicación en patologías de la columna vertebral. Rev Ortop Traumatol. 2006; 50: 447-454.