caa a22 4500 445834463 CHVBK 20180317145326.0 cr unu---uuuuu 170323e20110901xx s 000 0 eng 10.1007/s00586-011-1933-0 doi (NATIONALLICENCE)springer-10.1007/s00586-011-1933-0 Sagittal balance parameters influence indications for lumbar disc arthroplasty or ALIF [Elektronische Daten] [N. Pellet, S. Aunoble, R. Meyrat, J. Rigal, J. Le Huec] Chronic lower back pain is a potentially incapacitating condition associated with disc degeneration. Although therapy is primarily pharmaceutical, surgery comprising arthrodesis constitutes an alternative. Anterior intersomatic lumbar arthrodesis (ALIF, anterior interbody lumbar fusion) is the reference approach, although total disc arthroplasty may also be undertaken. Analysis of pelvic and spinal parameters provides the best indication of sagittal balance. Materials and methods: This was a prospective study in a continuous series of 99 patients presenting chronic lower back pain due to disc disease. Pelvic incidence, sacral slope, pelvic tilt, spino-sacral angle (SSA) and the four back types in the Roussouly classification were studied in radiographs of the whole spine under load using an EOS imaging system. Results: The pre-operative SSA value for the study population was 126.09°±8.45° and the mean spine tilt angle was 90° compared with 95° in healthy subjects. Following surgery, the SSA was considerably increased in the discal arthroplasty, resulting in a significantly more balanced spinal position. In the group of patients undergoing arthrodesis using the ALIF technique, no such significant improvement was found despite the use of a lordosis cage. We showed that in cases of low pelvic incidence, it was necessary to maintain a Roussouly type 1 or 2 back without increasing lordosis. The results demonstrated the value of L4-L5 disc prostheses in these subjects. L5-S1 arthrodesis seemed a more suitable approach for treating patients with elevated sacral slope (back type 3 or 4). This new type of analysis of sagittal parameters should be performed prior to all surgical procedures involving lumbar prostheses. Springer-Verlag, 2011 Lumbar disc degeneration nationallicence ALIF nationallicence Total disc prosthesis nationallicence Sagittal balance nationallicence Spino-pelvic organisation nationallicence Spino-sacral angle nationallicence Pellet N. Spine Unit 2, CHU Pellegrin, Orthopaedic Department, University of Bordeaux, 33076, Bordeaux, France aut Aunoble S. Spine Unit 2, CHU Pellegrin, Orthopaedic Department, University of Bordeaux, 33076, Bordeaux, France aut Meyrat R. Dallas Presbyterian Spine Center, Dallas, TX, USA aut Rigal J. Spine Unit 2, CHU Pellegrin, Orthopaedic Department, University of Bordeaux, 33076, Bordeaux, France aut Le Huec J. Spine Unit 2, CHU Pellegrin, Orthopaedic Department, University of Bordeaux, 33076, Bordeaux, France aut European Spine Journal Springer-Verlag 20(2011-09-01), 647-662 0940-6719 20<647 2011 20 586 https://doi.org/10.1007/s00586-011-1933-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-011-1933-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Pellet N. Spine Unit 2, CHU Pellegrin, Orthopaedic Department, University of Bordeaux, 33076, Bordeaux, France aut NATIONALLICENCE 700 1- Aunoble S. Spine Unit 2, CHU Pellegrin, Orthopaedic Department, University of Bordeaux, 33076, Bordeaux, France aut NATIONALLICENCE 700 1- Meyrat R. Dallas Presbyterian Spine Center, Dallas, TX, USA aut NATIONALLICENCE 700 1- Rigal J. Spine Unit 2, CHU Pellegrin, Orthopaedic Department, University of Bordeaux, 33076, Bordeaux, France aut NATIONALLICENCE 700 1- Le Huec J. Spine Unit 2, CHU Pellegrin, Orthopaedic Department, University of Bordeaux, 33076, Bordeaux, France aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20(2011-09-01), 647-662 0940-6719 20<647 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer