Keywords
How to Cite
Abstract
Summary. In the structure of complications, pain syndrome, which is not associated with infection or instability of the components of the endoprosthesis, remains a serious problem due to the difficulties of diagnosis and treatment. The cause of the residual pain may be the presence of spondyloarthrosis of the lumbar spine in the patient. Objective: to determine the role of spondyloarthrosis of the lumbar spine in the structure of pain after hip arthroplasty. Materials and Methods. A sample and retrospective analysis of the case histories of 138 patients with hip-lumbar syndrome who underwent hip arthroplasty in the Department of Traumatology and Orthopedics of Adults of the SI “Institute of Traumatology and Orthopedics of NAMS of Ukraine” was carried out. All patients were examined clinically and radiographically. Additionally, all patients were examined by a neurologist with the determination of the neurological status and diagnosis. Evaluation of the effectiveness of hip arthroplasty in order to improve the clinical and functional characteristics of the link hip joint – spine was carried out according to the Haris and Oswestry functional scales. Results. The analysis of the database of patients in them proved that the lumbar vertebrae at the L2-L4 level are more often affected. In hyperlordosis, degenerative lesions occur in the posterior column of the lumbar spine in the form of spondyloarthrosis, which is clinically manifested by lumbodynia; with hypolordosis, the anterior column suffers more, which is clinically manifested by the presence of lumboishalgia. Total arthroplasty of patients with hip-lumbar syndrome contributes to statistically significant (p≤0.05) reduction in pain syndrome and improvement of function both in the hip joint and the lower back. Residual, less intense, pain syndrome after arthroplasty was most intensive in patients with hypolordosis (24.11 points according to Oswestry’s classification). Сonclusions. The studies carried out to determine the role of spondyloarthrosis of the lumbar spine in the structure of pain after hip arthroplasty will contribute to the further development of a clinical diagnostic and therapeutic algorithm for patients with hip-lumbar syndrome.
References
Попова ЛА, Сазонова НВ, Волокитина ЕА. Коксартроз в структуре заболеваний опорно – двигательной системы: современный взгляд на этиологию, патогенез и методы лечения (аналитический литературный обзор). Гений ортопедии. 2006;(4):91-8.
Popova LA, Sazanov NV, Volokitina EA. Coxarthrosis in the structure of locomotor system diseases: current view in to etiology, pathogenesis and methods of treatment (analytical review of literature). Genij ortopedii. 2006;4:91-98.
Matsui H, Shimizu M, Tsuji H. Cartilage and subchondral bone interaction in osteoarthrosis of human knee joint: A histological and histomorphometric study. Microsc. Res. Tech. 1997;37(4):333-42. DOI: 10.1002/(SICI)1097-0029(19970515)37:4%3C333::AID-JEMT8%3E3.0.CO;2-L.
Корж АА, Филиппенко ВА, Дедух НВ. Артроз: классификация, эпидемиология клиника, диагностика и лечение. Международный медицинский журнал. 2002;8(1/2):127-33.
Korzh AA, Filipenko VA, Dieduh NV. Arthrosis: classification, epidemiology, diagnostic and treatment. Intern. Med. J. 2002;8(1/2):127-33.
Chen D, Shen J, Zhao W, Wang T, Han L, Hamilton JL, et аl. Osteoarthritis: toward a comprehensive understanding of pathological mechanism. Bone Res. 2017;(5):1-13. DOI: 10.1038/boneres.2016.44.
Zhang Y. Jordan JM. Epidemiology of Osteoarthritis. Clin Geriatr Med. 2010;26(3):355-69. DOI:10.1016/j.cger.2010.03.001.
Денисов АО, Шильников ВА, Барнс СА. Коксо-вертебральный синдром и его значение при эндопротезировании тазобедренного сустава (обзор литературы). Травматология и ортопедия России. 2012:1(63);121-7. DOI: 10.21823/2311-2905-2012-0-1-144-149.
Denisov AO, Shilnikov VA, Barns SA. Coxa-vertebral syndrome and its significance in hip arthroplasty (review). Traumatology and Orthopedics of Russia. 2012;1:121-127. DOI: 10.21823/2311-2905-2012-0-1-144-149.
Offierski C, Macnab I. Hip-spine syndrome. Spine. 1983:8(3);316-21. DOI: 10.1097/00007632-198304000-00014.
Yang H, Liu H, Li Z, Zhang K, Wang J, Wang H, et al. Low back pain associated with lumbar disc herniation: role of moderately degenerative disc and annulus fibrous tears. Int J Clin Exp Med. 2015;8(2):1634-44. PMID: 25932092.
Rodeghero JR, Cook CE, Cleland JA, Mintken PE. Risk stratification of patients with low back pain seen in physical therapy practice. Man Ther. 2015;20(6):855-60. DOI: 10.1016/j.math.2015.04.007.
Кремер Ю. Заболевания межпозвонковых дисков: пер. с англ. М.: МЕДпрессинформ; 2015. 472 с.
Kremer Y. Intervertebral disc’s diseases: interpret. from english. MEDpresinform; 2015. 472 p.
Lange M. Die Wirbelgelenke. Stuttgart: Enke; 1936. 341 p.
Fogel GR, Esses SI. Hip spine syndrome: management of coexisting radiculopathy and arthritis of the lower extremity. Spine. 2003;3(3):238-41. DOI: 10.1016/s1529-9430(02)00453-9/.
Yoshimoto H, Sato S, Masuda T, Kanno T, Shundo M, Hyakumachi T, et al. Spinopelvic alignment in patients with osteoarthrosis of the hip. Spine. 2005;30(14):1650-7. DOI: 10.1097/01.brs.0000169446.69758.fa.
Ахтямов ИФ, Кузьмин ИИ. Ошибки и осложнения эндопротезирования тазобедренного сустава: рук. для врачей. Казань: Центр оперативной печати; 2006. 328 с.
Ahtiamov IF, Kuz`min II. Mistakes and complications after total hip replacement: doctor’s manual. Kazan`: Centr operativnoy pechati; 2006. 328 p.
Шубняков ИИ, Тихилов РМ, Николаев НС, Григоричева ЛГ, Овсянкин АВ, Черный АЖ, и др. Эпидемиология первичного эндопротезирования тазобедренного сустава на основании данных регистраартропластики РНИИТО им. Р.Р. Вредена. Травматология и ортопедия России. 2017;23(2):81-101. DOI: 10.21823/2311-2905-2017-23-2-81-101.
Shubniak II, Tihilin RM, Nikolaev NS, Grigiricheva LG, Ovsiankin AV, Chornij AJ et al. Epidemiology of primary hip arthroplasty: report from register of vreden russian research institute of traumatology and orthopedics. Traumatology and Orthopedics of Russia. 2017;23(2):81-101. DOI: 10.21823/2311-2905-2017-23-2-81-101.
Kellgren JH, Lawrence JS. Radiological assessment of osteoartrthrosis. Ann. Rheum. Dis. 1957;(16);494-501.
Harris WH. Traumatic artthritis of the hip after dislocation and acetabular fractures treatment by mold artroplasty. An end result study using a new method of ressult evalution. J. Bone Jt Surg. 1969;51(4):737-55.
Hashimoto H, Komagata M, Nakai O, Morishita M, Tokuhashi Y, Sano S, et al. Discriminative validity and responsiveness of the Oswestry Disability Index among Japanese outpatients with lumbar conditions. Eur Spine J. 2006;15:1645-50. DOI: 10.1007/s00586-005-0022-7.
Климовицкий ВГ, Колодежный АВ, Вертыло НА. Применение математической статистики в медико-биологических исследованиях. Донецк: Донеччина; 2004. 216 с.
Klimovitskij VG, Kolodiejnij AV, Vertilo NA. Math statistic application in medical and biological researches. Donetsk: Donetchina; 2004. 216 p.
This work is licensed under a Creative Commons Attribution 4.0 International License.