Introduction: Hip-spine syndrome (HSS) was first described in 1983 to describe the symptomatology resulting from concomitant lumbar degenerative stenosis and hip osteoarthritis. Numerous studies have sought to understand the underlying pathology and appropriate management of this syndrome. The purpose of this article is to review the literature for specific imaging characteristics and the optimal surgical treatment of hip-spine syndrome (HSS).
Methods: A systematic review was conducted via an electronic database search through PubMed to identify all publications related to hip-spine syndrome. All publications that contained data on patients who underwent surgical treatment for hip-spine syndrome and reported patient-reported outcome measures (PROMs) or radiographic data were included. Exclusion criteria consisted of publications published in a language other than English, review articles, and technique articles.
Results: Fifteen articles that focused on the surgical management of HSS were identified. Of these 15 articles, eight reported radiographic outcomes with most reporting no significant change in spinopelvic parameters before and after surgery. Thirteen articles reported clinical outcomes, with eight of those thirteen articles identifying PROMs to be significantly improved following surgery.
Conclusions: Despite being first described almost forty years ago, the data on surgical management of HSS remains sparse. While there is some evidence that total hip arthroplasty in patients who previously underwent spinal fusion may have higher complication rates, there remains debate regarding which surgical problem to address first - the hip or the spine.
Keywords: Hip osteoarthritis; Lumbar degenerative disease; Lumbar spinal fusion; Total hip arthroplasty.
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