Sagittal Spinal Deformity in Patients with Idiopathic Normal Pressure Hydrocephalus.

IF 0.9 4区医学 Q4 CLINICAL NEUROLOGY

Turkish neurosurgery Pub Date : 2023-01-01 DOI:10.5137/1019-5149.JTN.36555-22.3

Karina A Lenartowicz, Ryan M Naylor, Anthony L Mikula, Jonathan Graff-Radford, David T Jones, Jeremy K Cutsforth-Gregory, Niell R Graff-Radford, Jeremy L Fogelson, Petrice M Cogswell, Benjamin D Elder

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Abstract

Aim: To measure the baseline spinopelvic parameters and characterize the sagittal, and coronal plane deformities in patients with idiopathic normal pressure hydrocephalus (iNPH).

Material and methods: We analyzed a series of patients at one academic institution who underwent ventriculoperitoneal shunting for iNPH with pre-shunt standing full length x-rays. The series of patients was enrolled consecutively to minimize selection bias. We quantified comorbid sagittal plane spinal deformity based on the Scoliosis Research Society-Schwab classification system by assessing pelvic incidence and lumbar lordosis mismatch (PI-LL), pelvic tilt (PT), and sagittal vertical axis (SVA).

Results: Seventeen patients (59% male) were included in this study. Mean (± standard deviation) age was 74 ± 5.3 years with a body mass index (BMI) of 30 ± 4.5 kg/m 2 . Six patients (35%) had marked sagittal plane spinal deformity by at least one parameter: five (29%) had greater than 20˚ PI-LL mismatch, three (18%) had > 9.5 cm SVA, and one (6%) had PT greater than 30˚. Additionally, the thoracic kyphosis exceeded the lumbar lordosis in nine patients (53%).

Conclusion: Positive sagittal balance, with thoracic kyphosis exceeding lumbar lordosis, is common in iNPH patients. This may lead to postural instability, especially in patients whose gait does not improve following shunting. These patients may warrant further investigation and workup, including full length standing x-rays. Future studies should assess for improvement in the sagittal plane parameters following shunt placement.

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特发性正常压力性脑积水患者的矢状脊柱畸形。

目的：测量特发性常压脑积水（iNPH）患者的基线脊柱骨盆参数，并表征其矢状面和冠状面畸形。材料和方法：我们分析了一家学术机构的一系列患者，这些患者在分流前接受了脑室-腹膜分流，并进行了站立全长x射线检查。该系列患者是连续入组的，以尽量减少选择偏差。我们根据脊柱侧弯研究会Schwab分类系统，通过评估骨盆发病率和腰椎前凸失配（PI-LL）、骨盆倾斜（PT）和矢状垂直轴（SVA），量化了共病矢状面脊柱畸形。结果：17名患者（59%男性）纳入本研究。平均（±标准差）年龄为74±5.3岁，体重指数（BMI）为30±4.5 kg/m^{2^{。6名患者（35%）的矢状面脊柱畸形至少有一个参数：5名患者（29%）的PI-LL失配大于20˚，3名患者（18%）的SVA大于9.5 cm，1名患者（6%）的PT大于30˚。此外，9例（53%）患者的胸部后凸超过腰椎前凸。结论：正矢状位平衡，胸部后凸超出腰椎前凸，在iNPH患者中很常见。这可能导致姿势不稳定，尤其是分流后步态没有改善的患者。这些患者可能需要进一步的调查和检查，包括全身站立x光检查。未来的研究应评估分流后矢状面参数的改善情况。}}

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来源期刊

Turkish neurosurgery 医学-临床神经学

CiteScore

1.50

自引率

12.50%

发文量

126

审稿时长

2 months

期刊介绍： Turkish Neurosurgery is a peer-reviewed, multidisciplinary, open access and totally free journal directed at an audience of neurosurgery physicians and scientists. The official language of the journal is English. The journal publishes original articles in the form of clinical and basic research. Turkish Neurosurgery will only publish studies that have institutional review board (IRB) approval and have strictly observed an acceptable follow-up period. With the exception of reference presentation, Turkish Neurosurgery requires that all manuscripts be prepared in accordance with the Uniform Requirements for Manuscripts Submitted to Biomedical Journals.