Correlation between changes in spinal pelvic parameters and lower back pain in patients with hip spinal syndrome after total hip arthroplasty: A short-term follow-up study

Backgroud: A number of patients with hip osteoarthritis (HOA) have lower back pain (LBP) and hip joint pain, a symptom named hip spine syndrome (HSS). The purpose of this study is to analyze the efficacy of total hip arthroplasty (THA) in treating HSS using spinal pelvic parameters and multiple clinical scoring systems. Methods: We prospectively collected HOA patients who underwent THA by surgeons from the same medical research center. 52 patients were included in the study according to the inclusion and exclusion criteria. Analyze patient baseline information, take full-length lateral radiographs of the spine before and 6 months after surgery, measure PI, PT, LL, SS, and SVA. Calculate the Oswestry Disability Index score (ODI), Visual Analog Scale score (VAS), and Hip Harris score (HHS) before and 6 months after surgery. Results: A total of 52 patients with hip spine syndrome were included for follow - up and were divided into two groups based on whether postoperative back pain was relieved: the group with continued in back pain and the group with improvement in back pain. Among them, 33 people (63 %) achieved relief in back pain. There were significant differences (p < 0.05) in postoperative LL, SVA, and PI-LL between the two groups. There were significant differences in spinal parameter changes among patients with improved LBP after THA, with increased LL, decreased SVA, and matched PI-LL. The postoperative clinical scoring scale showed that the HHS score of the group without improvement in LBP was significantly lower than that of the group with improvement in LBP, and all clinical scores of the group without improvement in LBP were poor after surgery. Conclusion: There was a significant difference in the changes of spinal pelvic parameters in patients with improved LBP after THA, i.e., LL was elevated and SVA were decreased, PI-LL maintains matching. These spinal pelvic parameters may be key factors in the mechanism of low back pain improvement after THA surgery.