Year 2020 / Volume 27 / Number 3

Original

Biomechanical factors related to surgical outcomes on patients treated with lumbar arthrodesis in a high complexity center in Colombia

Rev. Soc. Esp. Dolor. 2020; 27(3): 160-167 / DOI: 10.20986/resed.2020.3759/2019

Carlos Alberto Lindado Pacheco, Santiago Gutiérrez, Sergio Iván Patiño, Juan Carlos Acevedo


ABSTRACT

Introduction: The importance of lumbar pain management lies in its recurrence and manifestations for both the patient and society. It is necessary to establish what factors lead to success in terms of pain and functionality at the time of a lumbar arthrodesis.
Material and methods: A retrospective descriptive study was conducted that sought to determine which spinopelvic parameters and their values in terms of pelvic incidence (PI), pelvic tilt (PT), sacral slope, lumbar lordosis (LL), sagittal vertical axis (SVA), and mismatch (PI-LL) might have a potential relationship with favorable postoperative outcomes. We included 44 patients who underwent MIS spinal approaches in our center between January 2016 to December 2017. Surgical outcomes of pain and functionality were assessed using visual analogue scale and Oswestry Disability Index (ODI). Follow up was conducted through three evaluations: one before surgical intervention and 2 at 3 and 6 months postop. Due to the sample size, the authors were unable to get statistically significant results.
Results: In our descriptive retrospective study on 44 patients, we found a big positive functional change in the group of patients who had a PI-LL > 10° with an increase of 50 percentage points in the group of patients with good functionality (ODI: 0-20). In SVA > 5 cm, the range of patients with good functionality had an increase of 44.6 percentage points. The range of good functionality in patients with a PT < 20° increased 54.1 percentage points.
Conclusions: In the present cohort, it was found that the radiological parameters that conditioned greater percentage change in the functionality of the patients after being taken to spine surgery were SVA of base > 5 cm and a PI-LL base > 10° and PT < 20°.



RESUMEN

Introducción: La importancia del manejo del dolor lumbar radica en su recurrencia y en las manifestaciones tanto para el paciente como para la sociedad. Se hace necesario establecer qué factores llevan al éxito en términos de dolor y funcionalidad al momento de realizarse una artrodesis lumbar.
Materiales y métodos: Se realizó un estudio descriptivo retrospectivo que buscó determinar qué parámetros espinopélvicos de balance sagital y sus valores en términos de incidencia pélvica (PI), inclinación pélvica (PT), inclinación sacra, lordosis lumbar (LL), eje sagital vertical (SVA) y la diferencia entre la PI y LL (PI-LL), pueden tener una potencial relación con desenlaces posquirúrgicos favorables. Se incluyeron 44 pacientes tratados en el Hospital Universitario San Ignacio entre enero de 2016 y diciembre de 2017. Se tomaron en cuenta desenlaces de dolor y funcionalidad en términos la escala visual analógica y el Oswestry Disability Index (ODI). Se realizó un seguimiento prequirúrgico, y 2 posquirúrgicos a los 3 y 6 meses. Debido al tamaño de la muestra, los autores no pudieron encontrar una significancia estadística, sin embargo, los resultados son concordantes con lo publicado anteriormente en el área.
Resultados: El mayor cambio porcentual se encontró en el grupo de pacientes que tuvieron una PI-LL > 10° con un aumento del 50 % en el grupo de pacientes con buena funcionalidad (ODI: 0-20). En SVA > 5 cm, el rango de pacientes con una buena funcionalidad tuvo un aumento del 44,6 %. El rango de buena funcionalidad en pacientes con una PT < 20° aumentó 54,1 puntos porcentuales.
Conclusiones: En la presente cohorte se encontró que los parámetros radiológicos que condicionaron un mayor cambio porcentual en la funcionalidad de los pacientes después de ser llevados a cirugía de columna fueron: SVA de base > 5 cm y una PI-LL base > 10° y PT < 20°.





Complete Article

Nuevo comentario

Security code:
CAPTCHA code image
Speak the codeChange the code
 

Comentarios

No comments in this article

Bibliografía

1. Last AR, Hulbert K. Chronic low back pain: Evaluation and management. Am Fam Physician. 2009;79(12):1067-74.
2. Hoy D, Brooks P, Blyth F, Buchbinder R. The epidemiology of low back pain. Best Pract Res Clin Rheumatol [Internet]. 2010;24(6):769-81. DOI: 10.1016/j.berh.2010.10.002.
3. Berbeo M, Diaz R, Perez JC, Giraldo-Grueso M, Gutierrez S, Villegas MC, et al. Minimally invasive surgical approach for spinal canal tumors—Technique description and experience from a reference center. J Cancer Ther [Internet]. 2017;8(3):268-77. DOI: 10.4236/jct.2017.83022.
4. Von Korff M, Crane P, Lane M, Miglioretti DL, Simon G, Saunders K, et al. Chronic spinal pain and physical-mental comorbidity in the United States: Results from the national comorbidity survey replication. Pain. 2005;113(3):331-9. DOI: 10.1016/j.pain.2004.11.010.
5. Salvetti MDG, Pimenta CADM, Braga PE, Corrêa CF. Disability related to chronic low back pain: Prevalence and associated factors. Rev Esc Enferm USP [Internet]. 2012;46 Spec:16-23. DOI: 10.1590/S0080-62342012000700003.
6. Adams MA. Biomechanics of back pain. Acupunct Med. 2004;22(4):178-88. DOI: 10.1136/aim.22.4.178.
7. Deyo RA, Weinstein JN. Low back pain. N Engl J Med [Internet]. 2001;344(5):363-70. DOI: 10.1056/NEJM200102013440508.
8. Ames CP, Smith JS, Scheer JK, Bess S, Bederman SS, Deviren V, et al. Impact of spinopelvic alignment on decision making in deformity surgery in adults. J Neurosurg Spine [Internet]. 2012;16(6):547-64. DOI: 10.3171/2012.2.SPINE11320.
9. Payares K, Lugo LH, Morales V, Londoño A. Validation in Colombia of the Oswestry disability questionnaire in patients with low back pain. Spine (Phila Pa 1976). 2011;36(26):E1730-5. DOI: 10.1097/BRS.0b013e318219d184.
10. Acevedo J. Síndrome facetario lumbar. Nuevo signo de diagnóstico clínico. Rehabilitación [Internet]. 2004;38(4):168-74. doi: 10.1016/S0048-7120(04)73452-0. Disponible en: http://www.elsevier.es/es-revista-rehabilitacion-120-articulo-sindrome-facetario-lumbar-nuevo-signo-13064724
11. Lindado Pacheco CA, Gutierrez S, Acevedo González JC. Factores pronósticos para artrodesis lumbar. Univ Médica [Internet]. 2018;60(1):1-8. DOI: 10.11144/Javeriana.umed60-1.artr.
12. Sardi JP, Camacho JE, Diaz RC, Berbeo ME. The Berbeo-Sardi Angle (BSA): An innovative method to effectively estimate pelvic retroversion in anteroposterior radiographs-A correlation with traditional parameters. Spine Deform [Internet]. 2017;6(2):105-11. DOI: 10.1016/j.jspd.2017.08.011.
13. Matsumoto T, Okuda S, Maeno T, Yamashita T, Yamasaki R, Sugiura T, et al. Spinopelvic sagittal imbalance as a risk factor for adjacent-segment disease after single-segment posterior lumbar interbody fusion. J Neurosurg Spine [Internet]. 2017;26(4):435-40. DOI: 10.3171/2016.9.SPINE16232.
14. Lamartina C, Berjano P, Petruzzi M, Sinigaglia A, Casero G, Cecchinato R, et al. Criteria to restore the sagittal balance in deformity and degenerative spondylolisthesis. Eur Spine J. 2012; 21 Suppl 1:S27-31. DOI: 10.1007/s00586-012-2236-9.
15. Than KD, Park P, Fu K, Nguyen S, Wang MY, Chou D, et al. Clinical and radiographic parameters associated with best versus worst clinical outcomes in minimally invasive spinal deformity surgery. J Neurosurg Spine. 2016;25(1):21-5. DOI: 10.3171/2015.12.SPINE15999.
16. Smith JS, Shaffrey CI, Lafage V, Schwab F, Scheer JK, Protopsaltis T, et al. Comparison of best versus worst clinical outcomes for adult spinal deformity surgery: a retrospective review of a prospectively collected, multicenter database with 2-year follow-up. J Neurosurg Spine [Internet]. 2015;23(3):349-59. DOI: 10.3171/2014.12.SPINE14777.

Artículos relacionados

Effect of therapeutic exercise in persons with sacroiliac joint dysfunction: a systematic review and meta-analysis

Rev. Soc. Esp. Dolor. 2023; 30(2): 95-108 / DOI: 10.20986/resed.2023.4034/2022

Not just low back pain: atypical manifestation of aortic aneurysm

Rev. Soc. Esp. Dolor. 2023; 30(1): 60-62 / DOI: 10.20986/resed.2022.3983/2022

Effectiveness of cluneal nerve block for the treatment of chronic low back pain

Rev. Soc. Esp. Dolor. 2023; 30(1): 30-35 / DOI: 10.20986/resed.2023.4023/2022

Usefulness of percutaneous basivertebral nerve thermorizotomy for the treatment of chronic low back pain. Literature review

Rev. Soc. Esp. Dolor. 2022; 29(3): 169-174 / DOI: 10.20986/resed.2022.4044/2022

Psychological intervention program to promoted active coping in patients with chronic back pain

Rev. Soc. Esp. Dolor. 2022; 29(3): 149-156 / DOI: 10.20986/resed.2022.3993/2022

Cross-sectional study on factors related to chronic pain and its care, according to sex

Rev. Soc. Esp. Dolor. 2022; 29(2): 61-70 / DOI: 10.20986/resed.2022.3968/2022

Use of 8 % capsaicin patches for the treatment of lumbar neuropathic pain

Rev. Soc. Esp. Dolor. 2022; 29(1): 28-33 / DOI: 10.20986/resed.2022.3995/2022

Evolution of low back pain in cancer patients treated with interventional pain management

Rev. Soc. Esp. Dolor. 2021; 28(2): 76-81 / DOI: 10.20986/resed.2021.3901/2021

Impact of group psychological intervention on conventional radiofrequency tributary patients

Rev. Soc. Esp. Dolor. 2020; 27(6): 349-360 / DOI: 10.20986/resed.2020.3830/2020

Therapeutic failure of the lumbar medial branch block and its relation to obesity. Retrospective cohort study

Rev. Soc. Esp. Dolor. 2020; 27(5): 298-305 / DOI: 10.20986/resed.2020.3829/2020

Identification of signs and symptoms for the diagnosis of discogenic low back pain: mapping review

Rev. Soc. Esp. Dolor. 2020; 27(5): 292-297 / DOI: 10.20986/resed.2020.3803/2020

Pain: a "hotchpotch"

Rev. Soc. Esp. Dolor. 2020; 27(4): 278-280 / DOI: 10.20986/resed.2016.3507/2016

Sociodemographic and clinical characterization in patients with chronic back pain, Cienfuegos 2019

Rev. Soc. Esp. Dolor. 2020; 27(4): 239-245 / DOI: 10.20986/resed.2020.3798/2020

Review of the impact of acupuncture treatment on the management of nonspecific low back pain

Rev. Soc. Esp. Dolor. 2020; 27(1): 53-58 / DOI: 10.20986/resed.2020.3762/2019

News in the treatment of back pain: are the future cell therapies?

Rev. Soc. Esp. Dolor. 2020; 27(1): 3-4 / DOI: 10.20986/resed.2020.3792/2020

Epidural injections: caudal, interlaminar or transforaminal. More than a shot

Rev. Soc. Esp. Dolor. 2019; 26(5): 255-258 / DOI: 10.20986/resed.2019.3764/2019

New ACP guidelines for non-radicular low back pain

Rev. Soc. Esp. Dolor. 2019; 26(4): 254-254 / DOI: 10.20986/resed.2017.3590/2017

Motor block after caudal epidural infiltration: a case report

Rev. Soc. Esp. Dolor. 2019; 26(2): 120-123 / DOI: 10.20986/resed.2018.3669/2018

Prevalence of breakthrough pain associated with chronic low back pain in Andalusia (COLUMBUS study)

Rev Soc Esp Dolor 2017; 24(3):116-124 / DOI: 10.20986/resed.2017.3548/2016

Instrucciones para citar

Lindado Pacheco C, Gutiérrez S, Patiño S, Acevedo J. Biomechanical factors related to surgical outcomes on patients treated with lumbar arthrodesis in a high complexity center in Colombia. Rev Soc Esp Dolor 2020; 27(3): 160-167 / DOI: 1020986/resed20203759/2019


Descargar a un gestores de citas

Descargue la cita de este artículo haciendo clic en uno de los siguientes gestores de citas:

Métrica

Este artículo ha sido visitado 27126 veces.
Este artículo ha sido descargado 0 veces.

Estadísticas de Dimensions


Estadísticas de Plum Analytics

Ficha Técnica

Recibido: 22/08/2019

Aceptado: 26/01/2020

Prepublicado: 16/03/2020

Publicado: 16/06/2020

Tiempo de revisión del artículo: 126 días

Tiempo de prepublicación: 207 días

Tiempo de edición del artículo: 299 días


Compartir

Este artículo aun no tiene valoraciones.
Reader rating:
Rate this article:
© 2024 Revista de la Sociedad Española del Dolor
ISSN: 1134-8046   e-ISSN: 2254-6189

      Indexada en: