Correlation of pelvic and spinal parameters in adult deformity patients with neutral sagittal balance

被引：6

作者：

Deinlein D. ^{[1
]}

Bhandarkar A. ^{[2
]}

Vernon P. ^{[2
]}

McGwin G. ^{[3
]}

Wall K. ^{[3
]}

Reece B. ^{[2
]}

McKay J. ^{[3
]}

Theiss S. ^{[2
]}

机构：

[1] Division of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL 35294-3409

[2] Division of Orthopaedics, University of Alabama at Birmingham, Birmingham, AL 35294-3409

[3] Division of Orthopaedics, University of Alabama at Birmingham School of Medicine, Birmingham, AL

来源：

Spine Deformity | 2013年 / 1卷 / 6期

基金：

美国国家卫生研究院;

关键词：

Coxo-spinal angle; Proximal thoracic slope; Proximal thoracic tilt; Spinal equation; Thoracic apical tilt;

D O I：

10.1016/j.jspd.2013.08.005

中图分类号：

学科分类号：

摘要：

Study Design Retrospective measurement of spinal and pelvic parameters in adult spinal deformity patients. Objective To correlate spinal and pelvic parameters in adult spinal deformity patients who were in neutral spinal balance. Summary and Background Data It is believed that sagittal spinal balance is influenced by both spinal and pelvic parameters, which are closely interrelated as manifested by the reciprocal changes seen when any of the interrelationships was altered. New parameters including proximal thoracic slope (PTS), proximal thoracic tilt, thoracic apical tilt, and coxo-spinal angle (CSA) were studied and correlated with previously studied spinal and pelvic parameters. Methods One thousand patients who had undergone standing scoliosis views from 2007 to 2010 were screened. A total of 70 patients, 29 with a diagnosis of degenerative scoliosis and 41 with the diagnosis of adult idiopathic scoliosis, were analyzed for various spinal and spinopelvic parameters. Linear regression analysis was performed. Results Thoracic kyphosis (TK) plus sacral slope (SS) had as strong a correlation with lumbar lordosis (LL) (r = 0.871; p <.000) as with pelvic incidence. The ratio LL / (TK + SS) yielded a constant ratio of 0.74 for the balanced spine. Pelvic incidence ± 9 = LL. Lumbar lordosis × 0.74 = TK. Coxo-spinal angle correlated with TK (r = 0.404; p =.000) and CSA / TK yielded a constant ratio in balanced spines. Proximal thoracic slope and thoracic apical tilt strongly correlated with TK (R = 0.793; p = 0.000). Proximal thoracic slope allows introduction of the spinal equation, PTS + LL = SS + TK, which is based on the geometric principle that when measuring angles between 2 horizontal parallel lines the sum of the angles in opposite directions is equal. Conclusion The spinal equation may predict ideal spinal and pelvic parameters that may aid in preventing complications such as proximal junctional failure. © 2013 Scoliosis Research Society.

引用

页码：458 / 463

页数：5

共 17 条

[1]

Glassman S.D., Berven S., Bridwell K., Correlation of radiographic parameters and clinical symptoms in adult scoliosis, Spine (Phila Pa 1976), 30, pp. 682-688, (2005)

[2]

Schwab F.J., Smith V.A., Biserni M., Adult scoliosis: A quantitative radiographic and clinical analysis, Spine (Phila Pa 1976), 27, pp. 387-392, (2002)

[3]

Glassman S.D., Bridwell K., Dimar J.R., The impact of positive sagittal balance in adult spinal deformity, Spine (Phila Pa 1976), 30, pp. 2024-2029, (2005)

[4]

Booth K.C., Bridwell K.H., Lenke L.G., Complications and predictive factors for the successful treatment of flatback deformity (fixed sagittal imbalance), Spine (Phila Pa 1976), 24, pp. 1712-1720, (1999)

[5]

Schwab F., Patel A., Unger B., Adult spinal deformity postoperative standing imbalance, Spine (Phila Pa 1976), 35, pp. 2224-2231, (2010)

[6]

Lafage V., Schwab F., Vira S., Spino-pelvic parameters after surgery can be predicted: A preliminary formula and validation of standing alignment, Spine (Phila Pa 1976), 36, pp. 1037-1045, (2011)

[7]

Jackson R.P., Hales C., Congruent spinopelvic alignment on standing lateral radiographs of adult volunteers, Spine (Phila Pa 1976), 25, pp. 2808-2815, (2000)

[8]

Lafage V., Schwab F., Patel A., Pelvic tilt and truncal inclination: Two key radiographic parameters in the setting of adults with spinal deformity, Spine (Phila Pa 1976), 34, (2009)

[9]

Vialle R., Levassor N., Rillardon L., Radiographic analysis of the sagittal alignment and balance of the spine in asymptomatic subjects, J Bone Joint Surg Am, 87, pp. 260-267, (2005)

[10]

Bernhardt M., Bridwell K.H., Segmental analysis of the sagittal plane alignment of the normal thoracic and lumbar spines and thoracolumbar junction, Spine (Phila Pa 1976), 14, pp. 717-721, (1989)

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