Relationship Between Lumbar Lordosis and Pelvic Incidence in the Adolescent Patient: Normal Cohort Analysis and Literature Comparison*

被引：0
作者：
Sullivan T.B. [1 ]
Marino N. [2 ]
Reighard F.G. [2 ]
Newton P.O. [1 ,2 ]
机构：
[1] University of California, San Diego, 9500 Gilman Dr, La Jolla, 92093, CA
[2] Rady Children's Hospital, San Diego, 3020 Children's Way, MC 5260, San Diego, 92123, CA
来源：
Spine Deformity | 2018年 / 6卷 / 5期
关键词：
Adolescent spine; Lumbar lordosis; Pelvic incidence;
D O I：
10.1016/j.jspd.2018.02.002
中图分类号：
学科分类号：
摘要：
Study Design: Retrospective review; literature comparison. Objectives: To review the literature on the relationship between lumbar lordosis (LL) and pelvic incidence (PI) and evaluate this relationship in asymptomatic adolescents while testing the validity of previously reported adult correlation models between LL and PI in an adolescent population. Summary of Background Data: Accurate understanding of the normal spinopelvic relationship is critical when considering surgical fusion of the lumbar spine. Many studies have reported relationships between pelvic measurements and LL in adult populations, but data in pediatric populations is lacking. Methods: A literature search was performed to identify previously reported relationships between pelvic parameters and LL in adults and pediatric patients. A cohort of 125 asymptomatic adolescent patients evaluated at our institution was evenly split into two cohorts for model development and validation. Linear regression between LL and PI was performed. The resultant regression model was tested in the validation cohort along with previously reported formulae with LL as a function of PI. Mean absolute error (MAE) was calculated and compared between prior models and the newly developed adolescent model using analysis of variance and post-hoc testing. Results: In our adolescent cohort (mean age: 13 ± 2), there was a strong correlation between PI and LL (r = 0.53). Regression analysis in the development cohort produced the following predictive model: LL = 0.66(PI) + 24.2. Testing in the validation cohort revealed a good correlation between predicted and actual LL (r = 0.51) and an MAE of 8.3. All but three previously reported models functioned with similar accuracy in the adolescent population, with only two methods having an MAE over 10. Conclusions: The majority of previously published formulae for predicting LL as a function of PI developed in adults can be extrapolated to adolescent populations. These relationships are important in understanding how to surgically restore the sagittal alignment in adolescents with spinal deformity. Level of Evidence: Level IV. © 2018 Scoliosis Research Society
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页码：529 / 536
页数：7
相关论文
共 36 条
[1]  
Glassman S.D., Bridwell K., Dimar J.R., Et al., The impact of positive sagittal balance in adult spinal deformity, Spine (Phila Pa 1976), 30, pp. 2024-2029, (2005)
[2]  
Rogala E.J., Drummond D.S., Gurr J., Scoliosis: incidence and natural history. A prospective epidemiological study, J Bone Joint Surg Am, 60, pp. 173-176, (1978)
[3]  
Schwab F., Lafage V., Boyce R., Et al., Gravity line analysis in adult volunteers: age-related correlation with spinal parameters, pelvic parameters, and foot position, Spine (Phila Pa 1976), 31, pp. E959-E967, (2006)
[4]  
Blondel B., Schwab F., Ungar B., Et al., Impact of magnitude and percentage of global sagittal plane correction on health-related quality of life at 2-years follow-up, Neurosurgery, 71, pp. 341-348, (2012)
[5]  
Lafage V., Schwab F., Patel A., Et al., Pelvic tilt and truncal inclination: two key radiographic parameters in the setting of adults with spinal deformity, Spine (Phila Pa 1976), 34, pp. E599-606, (2009)
[6]  
Lee J.H., Kim K.T., Lee S.H., Et al., Overcorrection of lumbar lordosis for adult spinal deformity with sagittal imbalance: comparison of radiographic outcomes between overcorrection and undercorrection, Eur Spine J, 25, pp. 2668-2675, (2016)
[7]  
Aurouer N., Obeid I., Gille O., Et al., Computerized preoperative planning for correction of sagittal deformity of the spine, Surg Radiol Anat, 31, pp. 781-792, (2009)
[8]  
Berjano P., Langella F., Ismael M.F., Et al., Successful correction of sagittal imbalance can be calculated on the basis of pelvic incidence and age, Eur Spine J, 23, pp. 587-596, (2014)
[9]  
Boissiere L., Bourghli A., Vital J.M., Et al., The lumbar lordosis index: a new ratio to detect spinal malalignment with a therapeutic impact for sagittal balance correction decisions in adult scoliosis surgery, Eur Spine J, 22, pp. 1339-1345, (2013)
[10]  
Boulay C., Tardieu C., Hecquet J., Et al., Sagittal alignment of spine and pelvis regulated by pelvic incidence: standard values and prediction of lordosis, Eur Spine J, 15, pp. 415-422, (2006)
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