Sagittal Alignment and Coronal Plane Deformity of the Spine in Lumbar Disc Herniation Patients
Kongtush Choovongkomol MD1, Gun Keorochana MD2, Chaiwat Kraiwattanapong MD2, Pongsthorn Chanplakorn MD2, Pittavat Leelapatana MD2, Supaneewan Jaovisidha MD3, Tulyapruek Tawonsawatruk MD2, Wiwat Wajanavisit MD2
Affiliation : 1 Department of Orthopaedics, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand 2 Department of Orthopaedics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand 3 Department of Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Objective : To evaluate sagittal and coronal alignment changes of the lumbar spine in lumbar disc herniation [LDH] patients.
Materials and Methods : A retrospective review was conducted measuring changes in sagittal and pelvic parameters as well
as coronal plane deformity changes in sixty-two lumbar disc herniation patients who had been operated on at Ramathibodi
Hospital including calculation of differences in changes of the sagittal alignment inpatients with and without coronal plane
deformity.
Results : The median interquartile range of pelvic incidence, sacral slope, and pelvic tilt were 48.25+12.63, 30+10.75 and
17.5+11.63 degrees, respectively. The mean lumbar lordosis was 41+17.25 degrees. Coronal plain analysis found 16.39% of
the patients had a significant coronal deformity (defined as a Cobb angle >10 degrees). In 70% of the patients, the deformity
was on the curve side (convex side), the same side as the disc lesion, and 90% of the coronal deformities had minimal rotation
(Nash & Moe grade 0 or 1). There were no statistically significant differences in sagittal parameters between groups with and
without coronal plane deformity with the exception of lumbar inclination.
Conclusion : Lumbar disc herniation can exhibit changes in both sagittal and coronal alignment. Herniation probably decreases
sacral slope and lumbar lordosis,but increases pelvic tilt. Coronal deformity was found in about 16% of patients,while most
patients had minimal spinal rotation. There was no significant correlation between sagittal and coronal imbalance in the two
groups of patients.
Keywords : Sagittal alignment, Coronal alignment, Lumbar disc herniation, Deformity
