Spinopelvic Parameters and Sagittal Alignment of Symptomatic Degenerative Adult Spinal Disorder Patients With 6 Lumbar Vertebrae

2019 ◽  
Vol 32 (1) ◽  
pp. E43-E49 ◽  
Author(s):  
Kati Kyrölä ◽  
Hannu Kautiainen ◽  
Jari Ylinen ◽  
Ristomatti Lehtola ◽  
Ilkka Kiviranta ◽  
...  
Keyword(s):  
Sagittal Alignment ◽  
Lumbar Vertebrae ◽  
Spinopelvic Parameters ◽  
Spinal Disorder

scholarly journals Assessment of Normal Sagittal Alignment of the Spine and Pelvis in Children and Adolescents

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Hasan Ghandhari ◽  
Hamid Hesarikia ◽  
Ebrahim Ameri ◽  
Abolfazl Noori
Keyword(s):  
Children And Adolescents ◽  
Sagittal Balance ◽  
Sagittal Alignment ◽  
Demographic Data ◽  
Lateral View ◽  
Old People ◽  
Spinopelvic Parameters ◽  
Spinopelvic Balance ◽  
History Of ◽  
Data History

Aim. We aimed to determine spinopelvic balance in 8–19-year-old-people in order to assess pelvic and spinal parameters in sagittal view.Methods. Ninety-eight healthy students aged 8–19 years, who lived in the central parts of Tehran, were assessed. Demographic data, history of present and past diseases, height (cm), and weight (kg) were collected. Each subject was examined by an orthopedic surgeon and spinal radiographs in lateral view were obtained. Eight spinopelvic parameters were measured by 2 orthopedic spine surgeons.Results. Ninety-eight subjects, among which 48 were girls (49%) and 50 boys (51%), with a mean age of13.6±2.9years (range: 8–19) were evaluated. Mean height and weight of children were153.6±15.6cm and49.9±13.1kgs, respectively. Mean TK, LL, TT, LT, and PI of subjects were 37.1 ± 9.9°, 39.6 ± 12.4°, 7.08 ± 4.9°, 12.0 ± 5.9°, and 45.37 ± 10.7°, respectively.Conclusion. Preoperation planning for spinal fusion surgeries via applying PI seems reasonable. Predicating “abnormal” to lordosis and kyphosis values alone without considering overall sagittal balance is incorrect. Mean of SS and TK in our population is slightly less than that in Caucasians.

scholarly journals Sacral incidence to pubis: a novel and alternative morphologic radiological parameter to pelvic incidence in assessing spinopelvic sagittal alignment

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yasuhito Takahashi ◽  
Kei Watanabe ◽  
Masashi Okamoto ◽  
Shun Hatsushikano ◽  
Kazuhiro Hasegawa ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Pelvic Incidence ◽  
Sagittal Alignment ◽  
Intraclass Correlation ◽  
Hip Dislocation ◽  
Standing Position ◽  
Regression Equation ◽  
Whole Body ◽  
Spinopelvic Parameters ◽  
Pelvic Inclination

Abstract Background Although pelvic incidence (PI) is a key morphologic parameter in assessing spinopelvic sagittal alignment, accurate measurements of PI become difficult in patients with severe hip dislocation or femoral head deformities. This study aimed to investigate the reliability of our novel morphologic parameters and the correlations with established sagittal spinopelvic parameters. Methods One hundred healthy volunteers (25 male and 75 female), with an average age of 38.9 years, were analysed. Whole-body alignment in the standing position was measured using a slot-scanning X-ray imager. We measured the established spinopelvic sagittal parameters and a novel parameter: the sacral incidence to pubis (SIP). The correlation coefficient of each parameter, regression equation of PI using SIP, and regression equation of lumbar lordosis (LL) using PI or SIP were obtained. The intraclass correlation coefficient (ICC) was calculated as an evaluation of the measurement reliability. Results Reliability analysis showed high intra- and inter-rater agreements in all the spinopelvic parameters, with ICCs > 0.9. The SIP and pelvic inclination angle (PIA) demonstrated strong correlation with PI (R = 0.96) and pelvic tilt (PT) (R = 0.92). PI could be predicted according to the regression equation: PI = − 9.92 + 0.905 * SIP (R = 0.9596, p < 0.0001). The ideal LL could be predicted using the following equation using PI and age: ideal LL = 32.33 + 0.623 * PI – 0.280 * age (R = 0.6033, p < 0.001) and using SIP and age: ideal LL = 24.29 + 0.609 * SIP – 0.309 * age (R = 0.6177, p < 0.001). Conclusions Both SIP and PIA were reliable parameters for determining the morphology and orientation of the pelvis, respectively. Ideal LL was accurately predicted using the SIP with equal accuracy as the PI. Our findings will assist clinicians in the assessment of spinopelvic sagittal alignment. Trial registration This study was retrospectively registered with the UMIN Clinical Trials Registry (UMIN000042979; January 13, 2021).

scholarly journals Sacral incidence to pubis: a novel and alternative morphologic radiological parameter to pelvic incidence in assessing spinopelvic sagittal alignment

2021 ◽  
Author(s):  
Yasuhito Takahashi ◽  
Kei Watanabe ◽  
Masashi Okamoto ◽  
Shun Hatsushikano ◽  
Kazuhiro Hasegawa ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Pelvic Incidence ◽  
Sagittal Alignment ◽  
Intraclass Correlation ◽  
Hip Dislocation ◽  
Standing Position ◽  
Regression Equation ◽  
Whole Body ◽  
Spinopelvic Parameters ◽  
Pelvic Inclination

Abstract Background: Although pelvic incidence (PI) is a key morphologic parameter in assessing spinopelvic sagittal alignment, accurate measurements of PI become difficult in patients with severe hip dislocation or femoral head deformities. This study aimed to investigate the reliability of our novel morphologic parameters and the correlations with established sagittal spinopelvic parameters. Methods: One hundred healthy volunteers (25 male and 75 female), with an average age of 38.9 years, were analysed. Whole-body alignment in the standing position was measured using a slot-scanning X-ray imager. We measured the established spinopelvic sagittal parameters and a novel parameter: the sacral incidence to pubis (SIP). The correlation coefficient of each parameter, regression equation of PI using SIP, and regression equation of lumbar lordosis (LL) using PI or SIP were obtained. The intraclass correlation coefficient (ICC) was calculated as an evaluation of the measurement reliability. Results: Reliability analysis showed high intra- and inter-rater agreements in all the spinopelvic parameters, with ICCs > 0.9. The SIP and pelvic inclination angle (PIA) demonstrated strong correlation with PI ( R = 0.96) and pelvic tilt (PT) ( R = 0.92). PI could be predicted according to the regression equation: PI = –9.92 + 0.905 * SIP ( R = 0.9596, p < 0.0001). The ideal LL could be predicted using the following equation using PI and age: ideal LL = 32.33 + 0.623 * PI – 0.280 * age ( R = 0.6033, p < 0.001) and using SIP and age: ideal LL = 24.29 + 0.609 * SIP – 0.309 * age ( R = 0.6177, p < 0.001). Conclusion: Both SIP and PIA were reliable parameters for determining the morphology and orientation of the pelvis, respectively. Ideal LL was accurately predicted using the SIP with equal accuracy as the PI. Our findings will assist clinicians in the assessment of spinopelvic sagittal alignment.

scholarly journals Changes of Fixed Anatomical Spinopelvic Parameter in Patients with Lumbosacral Transitional Vertebrae: A Matched Pair Analysis

Diagnostics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 59
Author(s):  
Henryk Haffer ◽  
Luis Becker ◽  
Michael Putzier ◽  
Mats Wiethölter ◽  
Katharina Ziegeler ◽  
...  
Keyword(s):  
Lumbar Vertebrae ◽  
Matched Pair ◽  
Control Group ◽  
Spinopelvic Parameters ◽  
Measuring Point ◽  
Matched Pair Analysis ◽  
Significant Difference ◽  
Spinopelvic Parameter ◽  
Lumbosacral Transitional Vertebrae ◽  
Pair Analysis

Functional spinopelvic parameters are crucial for describing spinal alignment (SA), but this is susceptible to variation. Anatomically fixed pelvic shape is defined by the parameters pelvic radius (PR), pelvic incidence (PI), and sacral table angle (STA). In patients with lumbosacral transitional vertebrae (LSTV), the spinopelvic alignment may be altered by changes of these parameters and influences of SA. There have been no reports studying the relation between LSTV, four (4 LV) and six (6 LV) lumbar vertebrae, and fixed anatomical spinopelvic parameters. A retrospective analysis of 819 abdomen–pelvis CT scans was performed, identifying 53 patients with LSTV. In a matched-pair analysis, we analyzed the influence of LSTV and the subgroups 4 LV (n = 9) and 6 LV (n = 11) on PR, PI, and STA. LSTV were classified according to Castellvi classification. In patients with 6 LV, measurement points at the superior endplates of S1 and S2 were compared. The prevalence of LSTV was 6.5% (53/819), 6 LV was 1.3% (11/819), and 4 LV was 1.1% (9/819) in our study population. PI significantly increased (p < 0.001), STA significantly decreased (p < 0.001), and PR (p = 0.051) did not differ significantly in the LSTV group (n = 53). Similar findings were observed in the 4 LV subgroup, with an increase in PI (p < 0.021), decrease in STA (p < 0.011), and no significant difference in PR (p < 0.678). The same results were obtained in the 6 LV subgroup at measuring point S2 (true S1) PI (p = 0.010), STA (p = 0.004), and PR (p = 0.859), but not at measuring point S1 (true L6). Patients with LSTV, 4 LV, and 6 LV showed significant differences in PI and STA compared to the matched control group. PR showed no significant differences. The altered spinopelvic anatomy in LSTV patients need to be reflected in preoperative planning rebalancing the sagittal SA.

Spinopelvic Sagittal Alignment after Microendoscopic Laminotomy in Patients with Lumbar Degenerative Spondylolisthesis

2018 ◽  
Vol 79 (06) ◽  
pp. 479-485
Author(s):  
Sho Dohzono ◽  
Yusuke Hori ◽  
Shinji Takahashi ◽  
Akinobu Suzuki ◽  
Hidetomi Terai ◽  
...  
Keyword(s):  
Sagittal Alignment ◽  
Degenerative Spondylolisthesis ◽  
Group Versus ◽  
Leg Pain ◽  
Sacral Slope ◽  
Sagittal Imbalance ◽  
Low Grade ◽  
Spinopelvic Parameters ◽  
Spinal Sagittal Alignment ◽  
Global Sagittal Alignment

Background and Study Aims Spinopelvic sagittal balance is important in managing lumbar diseases. We evaluated the change in spinal sagittal alignment after microendoscopic laminotomy in patients with low-grade degenerative spondylolisthesis (DS). Material and Methods We retrospectively reviewed the records of 87 patients who underwent microendoscopic laminotomy. We enrolled 35 patients with DS and 52 patients without DS. Spinopelvic parameters were evaluated, including the sagittal vertical axis (SVA), lumbar lordosis (LL), sacral slope, pelvic tilt, and pelvic incidence (PI). Primary outcome was a change in spinopelvic alignment between the baseline and latest follow-up values (DS group versus non-DS group). Secondary outcomes were the relationships between improved global sagittal alignment and preoperative spinopelvic parameters. Results Both groups showed significantly alleviated low back pain (LBP), leg pain, and leg numbness. Preoperative SVA and PI were significantly higher in the DS group than in the non-DS group (p < 0.05). SVA significantly decreased and LL significantly increased in the DS group (p < 0.05), whereas those parameters did not differ significantly from before versus after surgery in the non-DS group. In both groups, SVA improvement correlated significantly with preoperative SVA (DS: r = 0.702; non-DS: r = 0.397). There was also a significant intergroup difference in the correlation coefficient (z = 1.98; r = 0.048). Conclusions SVA and LL significantly improved after microscopic laminotomy in patients with low-grade DS and neurologic symptoms. SVA improvement in the DS group was correlated with preoperative spinopelvic sagittal imbalance. The strength of those correlations was greater in the DS group than in the non-DS group.

scholarly journals Sacral incidence to pubis: a novel and alternative morphologic radiological parameter to pelvic incidence in assessing spinopelvic sagittal alignment

2020 ◽  
Author(s):  
Yasuhito Takahashi ◽  
Kei Watanabe ◽  
Masashi Okamoto ◽  
Shun Hatsushikano ◽  
Kazuhiro Hasegawa ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Pelvic Incidence ◽  
Sagittal Alignment ◽  
Intraclass Correlation ◽  
Hip Dislocation ◽  
Standing Position ◽  
Regression Equation ◽  
Whole Body ◽  
Spinopelvic Parameters ◽  
Pelvic Inclination

Abstract Background: Although pelvic incidence (PI) is a key morphologic parameter in assessing spinopelvic sagittal alignment, accurate measurements of PI become difficult in patients with severe hip dislocation or femoral head deformities. This study aimed to investigate the reliability of our novel morphologic parameters and the correlations with established sagittal spinopelvic parameters.Methods: One hundred healthy volunteers (25 male and 75 female), with an average age of 38.9 years, were analysed. Whole-body alignment in the standing position was measured using a slot-scanning X-ray imager. We measured the established spinopelvic sagittal parameters and a novel parameter: the sacral incidence to pubis (SIP). The correlation coefficient of each parameter, regression equation of PI using SIP, and regression equation of lumbar lordosis (LL) using PI or SIP were obtained. The intraclass correlation coefficient (ICC) was calculated as an evaluation of the measurement reliability.Results: Reliability analysis showed high intra- and inter-rater agreements in all the spinopelvic parameters, with ICCs > 0.9. The SIP and pelvic inclination angle (PIA) demonstrated strong correlation with PI (R = 0.96) and pelvic tilt (PT) (R = 0.92). PI could be predicted according to the regression equation: PI = –9.92 + 0.905 * SIP (R = 0.9596, p < 0.0001). The ideal LL could be predicted using the following equation using PI and age: ideal LL = 32.33 + 0.623 * PI – 0.280 * age (R = 0.6033, p < 0.001) and using SIP and age: ideal LL = 24.29 + 0.609 * SIP – 0.309 * age (R = 0.6177, p < 0.001).Conclusion: Both SIP and PIA were reliable parameters for determining the morphology and orientation of the pelvis, respectively. Ideal LL was accurately predicted using the SIP with equal accuracy as the PI. Our findings will assist clinicians in the assessment of spinopelvic sagittal alignment.

scholarly journals Influence of postoperative sagittal balance and spinopelvic parameters on the outcome of patients surgically treated for degenerative lumbar spondylolisthesis

2017 ◽  
Vol 26 (4) ◽  
pp. 448-453 ◽  
Author(s):  
Ingrid Radovanovic ◽  
Jennifer C. Urquhart ◽  
Venkat Ganapathy ◽  
Fawaz Siddiqi ◽  
Kevin R. Gurr ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Sagittal Balance ◽  
Sagittal Alignment ◽  
Degenerative Spondylolisthesis ◽  
Consecutive Series ◽  
Spinopelvic Parameters ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Global Sagittal Alignment ◽  
Lumbar Degenerative Spondylolisthesis ◽  
Multiple Levels

OBJECTIVE The object of this study was to determine the association between postoperative sagittal spinopelvic alignment and patient-rated outcome measures following decompression and fusion for lumbar degenerative spondylolisthesis. METHODS The authors identified a consecutive series of patients who had undergone surgery for lumbar degenerative spondylolisthesis between 2008 and 2012, with an average follow-up of 3 years (range 1–6 years). Surgery was performed to address the clinical symptoms of spinal stenosis, not global sagittal alignment. Sagittal alignment was only assessed postoperatively. Patients were divided into 2 groups based on a postoperative sagittal vertical axis (SVA) < 50 mm (well aligned) or ≥ 50 mm (poorly aligned). Baseline demographic, procedure, and outcome measures were compared between the groups. Postoperative outcome measures and postoperative spinopelvic parameters were compared between groups using analysis of covariance. RESULTS Of the 84 patients included in this study, 46.4% had an SVA < 50 mm. Multiple levels of spondylolisthesis (p = 0.044), spondylolisthesis at the L3–4 level (p = 0.046), and multiple levels treated with fusion (p = 0.028) were more common among patients in the group with an SVA ≥ 50 mm. Patients with an SVA ≥ 50 mm had a worse SF-36 physical component summary (PCS) score (p = 0.018), a worse Oswestry Disability Index (ODI; p = 0.043), and more back pain (p = 0.039) than those with an SVA < 50 mm after controlling for multiple levels of spondylolisthesis and multilevel fusion. The spinopelvic parameters differing between the < 50-mm and ≥ 50-mm groups included lumbar lordosis (LL; 56.4° ± 4.7° vs 49.8° ± 4.3°, respectively, p = 0.040) and LL < pelvic incidence ± 9° (51% vs 23.1%, respectively, p = 0.013) after controlling for type of surgical procedure. CONCLUSIONS Data in this study revealed that patient-rated outcome is influenced by the overall postoperative sagittal balance as defined by the SVA.

scholarly journals Sacral incidence to pubis: a novel and alternative morphologic radiological parameter to pelvic incidence in assessing spinopelvic sagittal alignment

2020 ◽  
Author(s):  
Yasuhito Takahashi ◽  
Kei Watanabe ◽  
Masashi Okamoto ◽  
Shun Hatsushikano ◽  
Kazuhiro Hasegawa ◽  
...  
Keyword(s):  
Pelvic Incidence ◽  
Sagittal Alignment ◽  
Hip Dislocation ◽  
Pubic Symphysis ◽  
Standing Position ◽  
Whole Body ◽  
Spinopelvic Parameters ◽  
Pelvic Inclination ◽  
Sagittal Parameters

Abstract Background: Although pelvic incidence (PI) is a key morphologic parameter in assessing spinopelvic sagittal alignment, accurate measurements of PI become difficult in patients with severe hip dislocation or femoral head deformities. This study aimed to investigate the reliability of our novel morphologic parameters and the correlations with established sagittal spinopelvic parameters.Methods: One hundred healthy volunteers (25 male and 75 female), with an average age of 38.9 years, were analysed. Whole-body alignment in the standing position was measured using a slot-scanning X-ray imager. We measured the established spinopelvic sagittal parameters and two original parameters: 1) the sacral incidence to pubis (SIP), which is the value of the angle between the line perpendicular to the superior plate of the first sacral vertebra at its anterior edge and the line connecting this point to the upper edge of the pubic symphysis, and 2) the pelvic inclination angle (PIA).Results: Reliability analysis showed high intra- and inter-rater agreements in all the spinopelvic parameters, with ICCs > 0.9. The SIP and PIA demonstrated strong correlation with PI (R = 0.96) and pelvic tilt (PT) (R = 0.92), respectively. PI could be predicted according to the regression equation: PI = –9.92 + 0.905 * SIP (R = 0.9596, p < 0.0001). The ideal lumbar lordosis (LL) could be predicted using the following equation using PI and age: ideal LL = 32.33 + 0.623 * PI – 0.280 * age (R = 0.6033, p < 0.001) and using SIP and age: ideal LL = 24.29 + 0.609 * SIP – 0.309 * age (R = 0.6177, p < 0.001).Conclusion: Both SIP and PIA were reliable parameters for determining the morphology and orientation of the pelvis, respectively. Ideal LL was accurately predicted using the SIP with equal accuracy as the PI. Our findings will assist clinicians in the assessment of spinopelvic sagittal alignment, decision-making, and ultimately help improve patient quality of life.

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