Evaluation of sagittal balance and spinopelvic parameters in patients with lumbar disc herniation

Objective: The objective of this study was to analyze sagittal balance throughout with spinopelvic parameters, inpatients with a lumbar disc herniation and evaluate these patients with functional quality assessment questionnaires.Method: A total of 88 adult patients were evaluated in this study. All these patients were examined clinically in aphysical medicine and rehabilitation policlinic, from one physician in Sivas Numune State Hospital for a lumbar discherniation between 01 March-01 November 2018. The physical examination findings and records in the patient's fileswere evaluated. The Oswestry Disability Questionnaire (ODQ), Roland Morris Questionnaire (RDQ) and HealthAssessment Questionnaire (HAQ) were evaluated for all voluntary patients. All patients were confirmed with full spinalanteroposterior and lateral radiographs and lumbar MRI. Three group pathologies were evaluated in this study: Group1;disc herniation with bulging, Group 2; one level disc herniation and Group 3 multilevel disc herniation, includinglumbar disc protrusion, extrusion, and sequestration. Spino-pelvic parameters; lumbar lordosis (LL), pelvic incidence(PI), pelvic tilt (PT) and sacral slope (SS) were measured on full spine radiographs in a standing position.Results: LL was significantly less by multilevel disc herniation group as compared with bulging group and one leveldisc herniation group (p<0.05). It was a poor correlation between LL and waist circumference by multilevel discherniation group. When compared groups with functional assessment questionnaires, all groups were not statisticallydifferent each from other. We demonstrated not significantly different by all three groups between ODI, HAQ and RDIscores.Conclusions: The spinal sagittal imbalance caused by LDH is one type of compensatory response to prevent low backpain. This mechanism mainly includes a loss of LL and PT. Two important factors that need to be considered are theparavertebral muscles strengthening to prevent sagittal imbalance and keeping the body weight and waist circumferencein the normal range.