SUMMARY OF BACKGROUND DATA: A considerable proportion of patients with degenerative lumbar scoliosis (DLS) have concomitant hip osteoarthritis (OA). However, the effect of hip OA on DLS patients remains unclarified.
PURPOSE: To investigate the impact of concomitant hip OA on patient-reported outcome measures (PROMs) and global spinopelvic alignment in DLS.
METHODS: Patients were divided into severe and low OA groups based on the Kellgren-Lawrence (KL) classification, with grades 0 to 2 classified as low OA and grades 3 or 4 classified as severe OA. Radiographic parameters and PROMs including the Visual Analog Scale (VAS), Scoliosis Research Society-22 (SRS-22), and Oswestry Disability Index (ODI) were compared among 3 groups: Bilateral severe, Unilateral severe, or Bilateral low. Multivariable regression analysis was performed to assess the effect of hip OA on pelvic decompensation and PROMs.
RESULTS: A total of 134 patients were enrolled: 61 Bilateral severe, 25 Unilateral severe, and 48 Bilateral low. Bilateral severe hip OA was independently associated with pelvic decompensation (OR 1.37, 95% CI: 1.09-1.54, P=.016). At 2-year postoperatively, severe OA patients exhibited worse global sagittal malalignment and inferior clinical outcomes. Multivariate analysis showed that bilateral severe OA was significantly associated with worse baseline ODI (B=0.352, 95% CI: 0.082 to 0.622) and SRS-function (B=-0.405, 95% CI: -0.749 to -0.062), and 2-year VAS-back pain (B=0.223, 95% CI: 0.021 to 0.425), VAS-leg pain (B=0.365, 95% CI: 0.057 to 0.673), SRS-pain (B=-0.326,95% CI: -0.619 to -0.020 ), SRS-function (B=-0.337, 95% CI: -0.734 to -0.090) and ODI (B=0.323, 95% CI: 0.039 to 0.607).
CONCLUSIONS: Severe hip OA was associated with pelvic decompensation and reduced hip extension. Patients with severe hip OA had worse baseline sagittal malalignment and inferior PROMs that persisted 2 year following surgery. These findings underscore the importance of evaluating hip OA during preoperative planning for DLS.
STUDY DESIGN: Retrospective study.
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