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Prevalence of hip pathology in patients over age 50 with spinal conditions requiring surgery.

Lee BH, Moon SH, Lee HM, Kim TH, Lee SJ - Indian J Orthop (2012)

Bottom Line: Patients were categorized into four groups according to height (less than 150 cm, 150-159 cm, 160-169 cm, greater than 170 cm).The hip visualization rates differed significantly among these four groups (P<0.05).Hence, spinal surgeons should pay attention to hip pathology in surgically indicated spinal patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT

Background: The objective of this study was to evaluate of prevalence of co-existing spine and hip disease using initial screening kidney-ureter-bladder (KUB) radiograph in patients over 50 who underwent spinal surgery.

Materials and methods: The study subjects were 388 patients (male: female=117:271; mean age 62.0 years) who underwent spinal surgery between 2008 and 2010. We retrospectively reviewed the initial KUB radiographs used to diagnose the spine and hip disease. Depending on the extent of acetabular and hip joint visualization in KUB, we divided the subjects into three groups: Acetabulum, hip joint, and femoral neck visualization. The hip visualization rate was also assessed with respect to patient height. χ(2) and logistic regression test were used for statistical analysis.

Results: 126 (32.5%) cases had significant hip pathology including hip osteoarthritis (Kellgren/Lawrence grade 3 in 123 cases, grade 4 in 3 cases) and avascular necrosis (1 case each of Ficat stage IIA and IIB), and 8 cases had other morphologic abnormalities. Regarding acetabulum-hip visualization in KUB, 7 (1.8%) cases had acetabulum visualization only, 16 (4.1%) had hip joint visualization, and 365 (94.1%) had femoral neck including lesser trochanter visualization. Patients were categorized into four groups according to height (less than 150 cm, 150-159 cm, 160-169 cm, greater than 170 cm). The hip visualization rates differed significantly among these four groups (P<0.05).

Conclusions: The prevalence of discernible hip pathology in patients who underwent spinal surgery was 32.5%. Hip joint visualization was excellent (98.2%) in KUB radiographs. Hence, spinal surgeons should pay attention to hip pathology in surgically indicated spinal patients.

No MeSH data available.


Related in: MedlinePlus

KUB lumbar spine AP and radiographic grades. (a) Acetabulum visualization: Entire (partial) acetabula are visible. (b) Hip joint visualization: Entire acetabula and femoral head areas are visible. (c) Femoral neck including lesser trochanter visualization: Entire hip joints including femoral necks and lesser trochanter areas are visible
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Figure 1: KUB lumbar spine AP and radiographic grades. (a) Acetabulum visualization: Entire (partial) acetabula are visible. (b) Hip joint visualization: Entire acetabula and femoral head areas are visible. (c) Femoral neck including lesser trochanter visualization: Entire hip joints including femoral necks and lesser trochanter areas are visible

Mentions: Between 2008 and 2010, 388 patients who had low back pain with or without pain in the lower extremities were enrolled in this study. This study was approved by the Institutional Review Board (IRB No. 4-2010-0615). All patients underwent spinal surgery for corresponding spinal conditions. After collecting medical history and performing a physical examination, diagnostic image tests such as KUB and lumbosacral lateral radiographs were performed in each supine and lateral decubitus position using a 14 × 17 inch cassette according to Rowe and Yohum's technique.2 Then, in all surgically indicated patients, magnetic resonance imaging (MRI) of the spine was performed. We retrospectively reviewed the corresponding 388 medical records to retrieve basic information of the patients. The rate and extent of visualization of both hip joints was assessed using KUB radiographs. To assess the extent of hip joint visualization, we divided the subjects into three groups depending on the extent of acetabular and hip joint visualization: acetabulum, hip joint, and femoral neck including lesser trochanter visualization [Figure 1a–c]. The hip visualization rate was also assessed with respect to patient's height.


Prevalence of hip pathology in patients over age 50 with spinal conditions requiring surgery.

Lee BH, Moon SH, Lee HM, Kim TH, Lee SJ - Indian J Orthop (2012)

KUB lumbar spine AP and radiographic grades. (a) Acetabulum visualization: Entire (partial) acetabula are visible. (b) Hip joint visualization: Entire acetabula and femoral head areas are visible. (c) Femoral neck including lesser trochanter visualization: Entire hip joints including femoral necks and lesser trochanter areas are visible
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3377139&req=5

Figure 1: KUB lumbar spine AP and radiographic grades. (a) Acetabulum visualization: Entire (partial) acetabula are visible. (b) Hip joint visualization: Entire acetabula and femoral head areas are visible. (c) Femoral neck including lesser trochanter visualization: Entire hip joints including femoral necks and lesser trochanter areas are visible
Mentions: Between 2008 and 2010, 388 patients who had low back pain with or without pain in the lower extremities were enrolled in this study. This study was approved by the Institutional Review Board (IRB No. 4-2010-0615). All patients underwent spinal surgery for corresponding spinal conditions. After collecting medical history and performing a physical examination, diagnostic image tests such as KUB and lumbosacral lateral radiographs were performed in each supine and lateral decubitus position using a 14 × 17 inch cassette according to Rowe and Yohum's technique.2 Then, in all surgically indicated patients, magnetic resonance imaging (MRI) of the spine was performed. We retrospectively reviewed the corresponding 388 medical records to retrieve basic information of the patients. The rate and extent of visualization of both hip joints was assessed using KUB radiographs. To assess the extent of hip joint visualization, we divided the subjects into three groups depending on the extent of acetabular and hip joint visualization: acetabulum, hip joint, and femoral neck including lesser trochanter visualization [Figure 1a–c]. The hip visualization rate was also assessed with respect to patient's height.

Bottom Line: Patients were categorized into four groups according to height (less than 150 cm, 150-159 cm, 160-169 cm, greater than 170 cm).The hip visualization rates differed significantly among these four groups (P<0.05).Hence, spinal surgeons should pay attention to hip pathology in surgically indicated spinal patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT

Background: The objective of this study was to evaluate of prevalence of co-existing spine and hip disease using initial screening kidney-ureter-bladder (KUB) radiograph in patients over 50 who underwent spinal surgery.

Materials and methods: The study subjects were 388 patients (male: female=117:271; mean age 62.0 years) who underwent spinal surgery between 2008 and 2010. We retrospectively reviewed the initial KUB radiographs used to diagnose the spine and hip disease. Depending on the extent of acetabular and hip joint visualization in KUB, we divided the subjects into three groups: Acetabulum, hip joint, and femoral neck visualization. The hip visualization rate was also assessed with respect to patient height. χ(2) and logistic regression test were used for statistical analysis.

Results: 126 (32.5%) cases had significant hip pathology including hip osteoarthritis (Kellgren/Lawrence grade 3 in 123 cases, grade 4 in 3 cases) and avascular necrosis (1 case each of Ficat stage IIA and IIB), and 8 cases had other morphologic abnormalities. Regarding acetabulum-hip visualization in KUB, 7 (1.8%) cases had acetabulum visualization only, 16 (4.1%) had hip joint visualization, and 365 (94.1%) had femoral neck including lesser trochanter visualization. Patients were categorized into four groups according to height (less than 150 cm, 150-159 cm, 160-169 cm, greater than 170 cm). The hip visualization rates differed significantly among these four groups (P<0.05).

Conclusions: The prevalence of discernible hip pathology in patients who underwent spinal surgery was 32.5%. Hip joint visualization was excellent (98.2%) in KUB radiographs. Hence, spinal surgeons should pay attention to hip pathology in surgically indicated spinal patients.

No MeSH data available.


Related in: MedlinePlus