• Takuhei Kozaki, Hiroshi Hashizume, Hiroyuki Oka, Junji Katsuhira, Koichi Kawabata, Mana Takashi, Hiroshi Iwasaki, Shunji Tsutsui, Masanari Takami, Keiji Nagata, Yuyu Ishimoto, Takaya Taniguchi, Daisuke Nishiyama, Daisuke Fukui, Manabu Yamanaka, Ryo Taiji, Shizumasa Murata, Yuki Matsuyama, Yusuke Noda, Takahiro Kozaki, Fumihiro Tajima, and Hiroshi Yamada.
• Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama-City, Wakayama, 641-8510, Japan. t.kozaki@wakayama-med.ac.jp.
• Eur Spine J. 2023 Feb 1; 32 (2): 727733727-733.

PurposeSpinal fusion surgery is often performed with pelvic fixation to prevent distal junctional kyphosis. The inclusion of spinopelvic fixation has been reported to induce progression of hip joint arthropathy in a radiographic follow-up study. However, its biomechanical mechanism has not yet been elucidated. This study aimed to compare the changes in hip joint moment before and after spinal fusion surgery.MethodsThis study was an observational study and included nine patients (eight women and one man) who were scheduled to undergo spinopelvic fusion surgery. We calculated the three-dimensional external joint moments of the hip during gait, standing, and climbing stairs before and 1 year after surgery.ResultsDuring gait, the maximum extension moment was 0.51 ± 0.29 and 0.63 ± 0.40 before and after spinopelvic fusion surgery (p = 0.011), and maximum abduction moment was 0.60 ± 0.33 and 0.83 ± 0.34 before and after surgery (p = 0.004), respectively. During standing, maximum extension moment was 0.76 ± 0.32 and 1.04 ± 0.21 before and after spinopelvic fusion surgery (p = 0.0026), and maximum abduction moment was 0.12 ± 0.20 and 0.36 ± 0.22 before and after surgery (p = 0.0005), respectively. During climbing stairs, maximum extension moment was - 0.31 ± 0.30 and - 0.48 ± 0.15 before and after spinopelvic fusion surgery (p = 0.040), and maximum abduction moment was 0.023 ± 0.18 and - 0.02 ± 0.13 before and after surgery (p = 0.038), respectively.ConclusionThis study revealed that hip joint flexion-extension and abduction-adduction moments increased after spinopelvic fixation surgery in the postures of standing, walking, and climbing stairs. The mechanism was considered to be adjacent joint disease after spinopelvic fusion surgery including sacroiliac joint fixation.© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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