Lumbar Spine Fusion and symptoms of Leg Length discrepancy f
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Hip length discrepancy (HLD) is common following total hip arthroplasty (THA). This study tested the hypothesis that leg length discrepancy (LLD) symptoms are increased in patients who underwent lumbar spinal fusion and THA, compared to patients with THA only.

This retrospective cohort study included 67 patients who had both lumbar spinal fusion and THA, as well as 78 patients who had only THA. On post-operative standing AP pelvic, lateral lumbar, and AP lumbar spinal radiographs, hip and spine measurements were taken. A telephone survey was used to gauge people's perceptions of LLD symptoms.

Results:
--Between the spinal fusion and control groups, there was no significant difference in HLD.

--The spinal fusion patients reported more frequently noticing a difference in the length of their legs then the control group. and reported limping “all the time” compared to the control group.

--Among all patients with a HDL less than 10 mm, those in the spinal fusion group reported limping at a higher frequency than patients in the control group.

--Patients in the spinal fusion group were also more likely to report worsened back pain after THA than the control group.

Finally, even in a population with HLD traditionally considered to be subclinical, the frequency of a perceived LLD, limping, and worsened back pain following THA was higher in patients who had THA and a spinal fusion compared to patients who had THA only. The findings suggest that even mild LLD in the setting of THA should be avoided in patients with previous spinal fusion.

Source: https://www.sciencedirect.com/science/article/abs/pii/S0883540321004204?dgcid=rss_sd_all
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