A.N. LIKHOLETOV

Donetsk National Medical University named after M. Gorky, Donetsk

Republic Traumatology Center, Donetsk

 Contact details:

Likholetov A.N. — PhD (medicine), Associate Professor of the Department of Traumatology, Orthopedics and Emergency Surgery

Address: 16 prospekt Ilyicha, Donetsk People’s Republic, 283003, tel.: +380710077771, e-mail: likholetov-an@rambler.ru

The article provides an analysis of degenerative-dystrophic pathology of the lumbosacral spine in orthopedic patients with coxovertebral syndrome and a predominance of the hip joints pathology. The manifestations of vertebral pathology during the HSS development can be divided into 5 main subgroups: 1) segmental instability; 2) degenerative scoliosis; 3) spondylolisthesis; 4) anterior (disc) stenosis of the spinal canal; 5) circular stenosis of the spinal canal. When analyzing pathological changes, anterior (disc) stenosis 35,9 (3,0)% and segmental instability 27,5 (2,8)% prevailed, which mainly determined the severity of the vertebral component and its prevalence in the hip-spine syndrome clinic in orthopedic patients. The analysis showed that a significant number of patients have different degrees of hip joints involvement in the process. The data obtained indicate that the asymmetry of the load on the hip joints is a triggering mechanism in the development of the vertebral component of this pathology.

Key words: osteoarthritis, hip joints, lumbosacral spine, hip-spine syndrome, limb shortening.

REFERENCES

1. Vakulenko V.M., Khudobin V.Yu., Bublik L.A. Degenerative-dystrophic lesions of the hip joints and spine. Travma, 2000, vol. 1, no. 1, pp. 24–26 (in Russ.).
2. Sikilinda V.D., Alabut A.V. Problems of diagnosis and treatment of patients with Hip-spine syndrome. Glavnyy vrach Yuga Rossii, 2015, no. 4 (46), pp. 24– 26.
3. Kotel’nikov A.O. Differentsirovannyy podkhod k lecheniyu patsientov s degenerativnoy patologiey kompleksa «poyasnichnyy otdel — taz — tazobedrennye sustavy» s pozitsii otsenki sagittal’nogo balansa tulovishcha: dis. kand. med. nauk [Differentiated approach to the treatment of patients with degenerative pathology of the «lumbar — pelvis — hip joints» complex from the perspective of assessing the sagittal balance of the trunk. Dis. PhD med. sciences]. Kurgan, 2021. Pp. 6–23.
4. Ben-Galim P., Ben-Galim T., Rand N. The effect of total hip replacement surgery on low back pain in severe osteoarthritis of the hip. Spine, 2007, vol. 32 (19), pp. 2099–2102.
5. Khvisyuk A.N. Tazobedrenno-poyasnichnyy sindrom (patogenez, diagnostika, printsipy lecheniya): dis. … dokt. med. nauk [Hip-lumbar syndrome (pathogenesis, diagnosis, principles of treatment). Dis. Dr med. sciences]. Kharkov, 2002. Pp. 114–119.
6. Burns S., Mintken P. Sign of the buttock in a patient status post total hip arthroplasty. J Orthop Sports, 2010, vol. 40 (6), p. 377.
7. Prather H. The hip-spine syndrome: a prospective descriptive study of clinical presentation and diagnostic tests for patients with coexisting hip and spine disorders, 2010, available at: http://ortho.wustl.edu/content/
8. Roussouly P., Gollogly S., Berthonnaud E. et al. Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position. Spine, 2005, vol. 30, pp. 346–353.
9. Schwab F., Patel A., Ungar B. et. al. Adult spinal deformity-postoperative standing imbalance: how much can you tolerate? An overview of key parameters in assessing alignment and planning corrective surgery. Spine, 2010, vol. 35 (25), pp. 2224–2231.
10. Rajnics P., Templier A., Skalli W. The association of sagittal spinal and pelvic parameters in asymptomatic persons and patients with isthmic spondylolisthesis. J Spin Disord Tech, 2002, vol. 15 (1), pp. 24–30.
11. Zhou S., Sun Z. The standing and sitting sagittal spinopelvic alignment of Chinese young and elderly population: does age infuence the differences between the two positions? European Spine Journal, 2020, vol. 29, pp. 405–412.
12. Kellgren J.H., Lawrence J.S. Radiological assessment of osteo-arthrosis. Ann Rheum Dis., 1957, Dec., vol. 16 (4), pp. 494–502. DOI: 10.1136/ard.16.4.494