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Correction of Lumbosacral Hyperlordosis in Achondroplasia

Authors
 Hui-Wan Park  ;  Hak-Sun Kim  ;  Soo-Bong Hahn  ;  Kyu-Hyun Yang  ;  Chong-Hyuk Choi  ;  Jin-Oh Park  ;  Sung-Hoon Jung 
Citation
 CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, Vol.414 : 242-249, 2003 
Journal Title
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH
ISSN
 0009-921X 
Issue Date
2003
MeSH
Achondroplasia/complications* ; Adolescent ; Bone Lengthening/methods* ; Child ; Child, Preschool ; Femur/diagnostic imaging ; Femur/surgery* ; Humans ; Lordosis/diagnostic imaging ; Lordosis/etiology ; Lordosis/surgery* ; Lumbar Vertebrae/physiopathology ; Radiography ; Sacrum/physiopathology ; Tibia/diagnostic imaging ; Tibia/surgery*
Keywords
12966299
Abstract
Anterior bulging of the abdomen and posterior protrusion of the buttocks are externally visible deformities reflecting lumbosacral hyperlordosis. Imbalance in pelvic femoral muscles may account for this posture. Despite the clinical significance of hyperlordosis, its surgical treatment has not been well-described. In the current preliminary study, the authors compare two techniques used at the authors' institution for lower limb lengthening, one of which affects the correction of lumbosacral hyperlordosis. Ten patients had bilateral lower extremity lengthening procedures. Seven patients had bilateral tibial lengthening and three patients had combined femoral and tibial lengthening. Ring external fixators were used. Correction of hyperlordosis was assessed by comparing four radiographs with measurements in the sagittal plane obtained preoperatively with those at the latest followup. In the femoral lengthening group, the average preoperative lumbar lordosis angle was 18 degrees, the lumbosacral joint angle was 12 degrees, the sacral inclination angle was 58.3 degrees, and the sacrohorizontal angle was 31 degrees. The mean changes at the latest followup were: lumbar lordosis angle (+1 degree), lumbosacral joint angle (+0.3 degrees), sacral inclination angle (-19 degrees), and sacrohorizontal angle (-15 degrees). In the tibia lengthening group, all parameters were relatively unaltered at the last followup compared with their preoperative levels. Tibial lengthening had no effect on lumbosacral hyperlordosis. However, femoral lengthening resulted in an improved apparent lumbosacral hyperlordosis, although the lumbar lordosis angle was not changed significantly. The change in sacrum tilting provides a likely explanation for the improvement in cosmetic hyperlordosis observed in patients who have had femoral lengthening.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00003086-200309000-00031&LSLINK=80&D=ovft
DOI
10.1097/01.blo.0000081936.75404.a4
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hak Sun(김학선) ORCID logo https://orcid.org/0000-0002-8330-4688
Park, Jin Oh(박진오)
Park, Hui Wan(박희완)
Yang, Kyu Hyun(양규현) ORCID logo https://orcid.org/0000-0001-7183-588X
Jung, Sung Hoon(정성훈)
Choi, Chong Hyuk(최종혁) ORCID logo https://orcid.org/0000-0002-9080-4904
Hahn, Soo Bong(한수봉)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/113450
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