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Sagittal balance parameters in achondroplasia
H Cai1, C Omara1,2, R Castelein3
1Department of Neurosurgery, Leiden University Medical Centre, Leiden, the Netherlands.
Brain & Spine
|November 29, 2023
Summary
Adult achondroplasia patients with spinal sagittal imbalance struggle with lumbar spinal stenosis. Maintaining balance requires significant lumbar lordosis to counteract increased sacral slope and thoracolumbar kyphosis.
Area of Science:
- Orthopedics
- Neurosurgery
- Genetics
Background:
- Adult achondroplasia (Ach) frequently presents with lumbar spinal stenosis (LSS).
- Spinal sagittal imbalance may contribute to LSS and neurogenic claudication in Ach patients.
Purpose of the Study:
- To characterize sagittal balance parameters in adult achondroplasia patients.
Main Methods:
- Retrospective single-center study of Ach patients (2019-2022).
- Sagittal imbalance defined by C7 sagittal vertical axis (SVA) > 10 mm.
Main Results:
- 13 patients had sagittal imbalance, 15 had balanced spines.
- Both groups showed increased sacral slope (SS) and thoracolumbar kyphosis (TLK) compared to non-achondroplasts.
- Lumbar lordosis (LL) was significantly greater in the balanced group and correlated with SS.
Conclusions:
- Ach patients require substantial LL to compensate for increased SS and TLK to maintain sagittal balance.
- Degenerative processes may impair the lumbar spine's ability to achieve sufficient lordosis, leading to imbalance.
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