The association of lumbosacral transitional vertebral anomalies with acetabular dysplasia in adult patients with hip-spine syndrome: a cross-sectional evaluation of a prospective hip registry cohort

Joshua Sun, Avneesh Chhabra, Uma Thakur, Louis Vazquez, Yin Xi, Joel Wells

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

AIMS: Some patients presenting with hip pain and instability and underlying acetabular dysplasia (AD) do not experience resolution of symptoms after surgical management. Hip-spine syndrome is a possible underlying cause. We hypothesized that there is a higher frequency of radiological spine anomalies in patients with AD. We also assessed the relationship between radiological severity of AD and frequency of spine anomalies. METHODS: In a retrospective analysis of registry data, 122 hips in 122 patients who presented with hip pain and and a final diagnosis of AD were studied. Two observers analyzed hip and spine variables using standard radiographs to assess AD. The frequency of lumbosacral transitional vertebra (LSTV), along with associated Castellvi grade, pars interarticularis defect, and spinal morphological measurements were recorded and correlated with radiological severity of AD. RESULTS: Out of 122 patients, 110 (90.2%) were female and 12 (9.8%) were male. We analyzed the radiographs of 122 hips (59 (48.4%) symptomatic left hips, and 63 (51.6%) symptomatic right hips). Average age at time of presentation was 34.2 years (SD 11.2). Frequency of LSTV was high (39% to 43%), compared to historic records from the general population, with Castellvi type 3b being the most common (60% to 63%). Patients with AD have increased L4 and L5 interpedicular distance compared to published values. Frequency of pars interarticularis defect was 4%. Intraclass correlation coefficient for hip and spine variables assessed ranged from good (0.60 to 0.75) to excellent (0.75 to 1.00). Severity of AD did not demonstrate significant correlation with frequency of radiological spine anomalies. CONCLUSION: Patients with AD have increased frequency of spinal anomalies seen on standard hip radiographs. However, there exists no correlation between radiological severity of AD and frequency of spine anomalies. In managing AD patients, clinicians should also assess spinal anomalies that are easily found on standard hip radiographs. Cite this article: Bone Joint J 2021;103-B(8):1351-1357.

Original languageEnglish (US)
Pages (from-to)1351-1357
Number of pages7
JournalThe bone & joint journal
Volume103-B
Issue number8
DOIs
StatePublished - Aug 1 2021

Keywords

  • Acetabular dysplasia
  • Congenital lumbar canal stenosis
  • Hip pain
  • Hip-spine syndrome
  • Radiographs
  • Sacral dysplasia
  • X-ray

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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