Importance of Radiological Evaluation of Global Spinal Balance Together with Lower Limb Alignment in Planning Lumbar Spine Deformity Surgery - Illustrative Case Presentation

Mariusz Głowacki; Jerzy Walecki; Przemysław Kołakowski; Danuta Kolońska

doi:10.12659/PJR.899975

Importance of Radiological Evaluation of Global Spinal Balance Together with Lower Limb Alignment in Planning Lumbar Spine Deformity Surgery - Illustrative Case Presentation

Pol J Radiol. 2017 May 28:82:287-292. doi: 10.12659/PJR.899975. eCollection 2017.

Authors

Mariusz Głowacki^{1

2}, Jerzy Walecki³, Przemysław Kołakowski², Danuta Kolońska⁴

Affiliations

¹ Department of Neurosurgery, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland.
² Department of Neurosurgery, St. Elisabeth Hospital, Warsaw, Poland.
³ Department of Radiology, Medical Centre for Postgraduate Education, Warsaw, Poland.
⁴ Department of Neurosurgery, 2 Medical Faculty, Medical University of Warsaw, Warsaw, Poland.

Abstract

Background: The presented case illustrates the critical role of a detailed preoperative radiological evaluation in complex spine surgery.

Case report: A 49-year-old patient was admitted for a revision surgery after L3-L5 fusion. Preoperative assessment showed preserved sagittal balance, coronal imbalance and valgus knee deformity. The patient reported pain of 8-10 in VAS (Visual Analogue Scale) and had an ODI (Oswestry Disability Index) of 60%. The first step of the surgery was L2-S1 fusion with decompression and spine deformity correction. The second step involved anti-valgus osteotomy of the right tibial bone.

Conclusions: The assessment of global spinal balance together with lower extremity alignment should be strongly recommended.

Keywords: Joint Deformities, Acquired; Pelvis; Spine.

Publication types

Case Reports