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 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 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.

scholarly journals Association of the Anatomical Sacral Slope With Lumbar Lordosis and Pelvic Incidence in Female Patients With Developmental Hip Dysplasia: A Retrospective Cross-sectional Study

2020 ◽  
Author(s):  
Norio Imai ◽  
Hayato Suzuki ◽  
Atsushi Sakagami ◽  
Yuki Hirano ◽  
Naoto Endo
Keyword(s):  
Correlation Coefficient ◽  
Healthy Subjects ◽  
Lumbar Lordosis ◽  
Pelvic Incidence ◽  
Strong Association ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Developmental Dysplasia ◽  
Sacral Slope ◽  
Dysplasia Of The Hip

Abstract Background:The anatomical sacral slope, considered an anatomical pelvic parameter independent of femoral head centers for measurement, was previously described to strongly correlate withpelvic incidenceon two-dimensional examination of normal healthy subjects. However, the associationbetween anatomical sacral slope and pelvic incidence was unclear in patients withdevelopmental dysplasia of the hip. Thecurrent study aimed to examine the association between anatomical sacral slope and other spinopelvic parameters on plain radiographs in female patients with developmental dysplasia of the hip. Methods:Eighty-four women with developmental dysplasia of the hip were examined. Lumbar lordosis, thoracic kyphosis, pelvic incidence, sacral slope, and anatomical sacral slope, which was deemedthe angle formed by the straight line of the S1 superior endplate and a line at a right angle to the anterior pelvic plane, were determined by plain radiographs. The correlations were examined by Pearson correlation coefficients, and intra- and interrater intraclass correlation coefficients were evaluated forreliability.Results:A strong association was observed between pelvic incidence and anatomical sacral slope (r=0.725, p<0.001). In addition, the association between anatomical sacral slope and lumbar lordosis wassimilar to that between pelvic incidence and lumbar lordosis (r=0.661, p<0.001 and r=0.554, p<0.001, respectively). The intraraterintraclass correlation coefficient values were 0.869 for anatomical sacral slope and 0.824 for pelvic incidence. Furthermore, the interraterintraclass correlation coefficient values were 0.83 for anatomical sacral slope and 0.685 for pelvic incidence. Conclusions:We found that the strong association between anatomical sacral slope and pelvic incidence wasequal to that in normal,healthy subjects. The associationbetweenanatomical sacral slope and lumbar lordosis was equal to that between pelvic incidence and lumbar lordosis. Additionally, the intraclass correlation coefficient value foranatomical sacral slope was slightlyhigher than that forpelvic incidence. We thusconclude that anatomical sacral slope can be considered a helpful anatomical pelvic parameter that isasubstitute for pelvic incidence not only in normal subjectsbut also in patients with developmental dysplasia of the hip.

scholarly journals AIR-BT, a new badminton-specific incremental easy-to-use test

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257124
Author(s):  
Javier Abián-Vicén ◽  
Alfredo Bravo-Sánchez ◽  
Pablo Abián
Keyword(s):  
Oxygen Uptake ◽  
Correlation Coefficient ◽  
Pearson Correlation ◽  
Intraclass Correlation ◽  
Regression Equation ◽  
Treadmill Test ◽  
Cross Sectional ◽  
Moment Coefficient ◽  
Significant Difference ◽  
And Performance

Background Badminton is a highly demanding sport characterized by intermittent efforts with energy being provided by both the aerobic and anaerobic systems. To date, no incremental badminton field test has been developed that can be easily used by badminton coaches that requires accessible material for anyone. Objectives The purpose of this study was to develop a practical and reliable easy-to use intermittent endurance badminton test for estimating maximal oxygen uptake (VO2max). Methods Thirty six Spanish badminton players (age: 24.1±10.3 years) performed, on different days of the same week, four incremental protocols to exhaustion in randomized order: a treadmill incremental test, a Yo-Yo intermittent recovery level 1 test (Yo-Yo IR1) and twice the Abian intermittent recovery badminton test (AIR-BT). Oxygen uptake was determined with a breath-by-breath gas analyzer during the incremental treadmill test, and performance in the Yo-yo IR1 and AIR-BT was recorded. Results Significant correlations (p<0.001) for Pearson’s product moment coefficient were found between the performance in the AIR-BT and the two non-specific incremental tests (VO2max in the Treadmill Test: r = 0.87, distance in the Yo-Yo IR1: r = 0.86). The regression equation to calculate the VO2max from the AIR-BT time [VO2max = 0.023*(AIR-BT time in seconds)+31.334] showed an adjusted R2 of 0.76 and a SEE of 3.34 ml·kg-1·min-1. There was no significant difference between VO2max obtained by the incremental treadmill test and VO2max calculated using the regression equation (p = 0.644). A paired t-test reported no significant differences between day 1 and day 2 in the AIR-BT time (p = 0.753), the Pearson correlation coefficient between both days was: r = 0.88 (p<0.001) and the intraclass correlation coefficient was 0.875. Conclusions The AIR-BT is a valid and reliable on-court test for assessing VO2max in badminton players and may be utilized by coaches and physical trainers for cross-sectional comparison of players and for evaluation of longitudinal changes.

scholarly journals Correlation of the anatomical sacral slope with pelvic incidence in female patients with developmental hip dysplasia: A retrospective cross-sectional study

2020 ◽  
Author(s):  
Norio Imai ◽  
Hayato Suzuki ◽  
Atsushi Sakagami ◽  
Yuki Hirano ◽  
Naoto Endo
Keyword(s):  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Healthy Subjects ◽  
Lumbar Lordosis ◽  
Pelvic Incidence ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Developmental Dysplasia ◽  
Sacral Slope ◽  
Dysplasia Of The Hip

Abstract Background: The anatomical sacral slope is considered as an anatomical pelvic parameter independent of femoral head centers for measurement of anatomical sacral slope and was previously described to strongly correlate with pelvic incidence on a two-dimensional examination of healthy subjects. However, the correlation between anatomical sacral slope and pelvic incidence was unclear in patients with developmental dysplasia of the hip. This study aimed to examine the correlation between anatomical sacral slope and other spinopelvic parameters by analyzing plain radiographs of female patients with developmental dysplasia of the hip. Methods: Eighty-four women with developmental dysplasia of the hip were examined. Lumbar lordosis, thoracic kyphosis, pelvic incidence, sacral slope, and anatomical sacral slope (the angle formed by the straight line of the S1 superior endplate and a line at a right angle to the anterior pelvic plane), were determined by analyzing plain radiographs. The correlations were examined by Pearson correlation coefficients, and intra- and inter-rater intraclass correlation coefficients were evaluated for reliability. Results: A strong correlation was observed between pelvic incidence and anatomical sacral slope (r=0.725, p<0.001). In addition, the correlation between anatomical sacral slope and lumbar lordosis was similar to that between pelvic incidence and lumbar lordosis (r=0.661, p<0.001 and r=0.554, p<0.001, respectively). The intra-rater intraclass correlation coefficient values were 0.869 and 0.824 for anatomical sacral slope and pelvic incidence, respectively. Furthermore, the inter-rater intraclass correlation coefficient values were 0.83 and 0.685 for anatomical sacral slope and pelvic incidence, respectively. Conclusions: We observed that the strong correlation between anatomical sacral slope and pelvic incidence in patients with developmental dysplasia of the hip was equal to that in normal healthy subjects. The correlation between anatomical sacral slope and lumbar lordosis was equal to that between pelvic incidence and lumbar lordosis. Additionally, the intraclass correlation coefficient values for the anatomical sacral slope were slightly higher than those for pelvic incidence. Thus, we conclude that anatomical sacral slope can be considered as a helpful anatomical pelvic parameter that is a substitute for pelvic incidence not only in normal healthy subjects, but also in patients with developmental dysplasia of the hip.

scholarly journals Correlation of the anatomical sacral slope with pelvic incidence in female patients with developmental hip dysplasia: a retrospective cross-sectional study

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Norio Imai ◽  
Hayato Suzuki ◽  
Atsushi Sakagami ◽  
Yuki Hirano ◽  
Naoto Endo
Keyword(s):  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Healthy Subjects ◽  
Lumbar Lordosis ◽  
Pelvic Incidence ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Developmental Dysplasia ◽  
Sacral Slope ◽  
Dysplasia Of The Hip

Abstract Background The anatomical sacral slope is considered as an anatomical pelvic parameter independent of femoral head centers for measurement of anatomical sacral slope and was previously described to strongly correlate with pelvic incidence on a two-dimensional examination of healthy subjects. However, the correlation between anatomical sacral slope and pelvic incidence was unclear in patients with developmental dysplasia of the hip. This study aimed to examine the correlation between anatomical sacral slope and other spinopelvic parameters by analyzing plain radiographs of female patients with developmental dysplasia of the hip. Methods Eighty-four women with developmental dysplasia of the hip were examined. Lumbar lordosis, thoracic kyphosis, pelvic incidence, sacral slope, and anatomical sacral slope (the angle formed by the straight line of the S1 superior endplate and a line at a right angle to the anterior pelvic plane) were determined by analyzing plain radiographs. The correlations were examined by Pearson’s correlation coefficients, and intra- and inter-rater intraclass correlation coefficients were evaluated for reliability. Results A strong correlation was observed between pelvic incidence and anatomical sacral slope (r = 0.725, p < 0.001). In addition, the correlation between anatomical sacral slope and lumbar lordosis was similar to that between pelvic incidence and lumbar lordosis (r = 0.661, p < 0.001, and r = 0.554, p < 0.001, respectively). The intra-rater intraclass correlation coefficient values were 0.869 and 0.824 for anatomical sacral slope and pelvic incidence, respectively. Furthermore, the inter-rater intraclass correlation coefficient values were 0.83 and 0.685 for anatomical sacral slope and pelvic incidence, respectively. Conclusions We observed that the strong correlation between anatomical sacral slope and pelvic incidence in patients with developmental dysplasia of the hip was equal to that in normal healthy subjects. The correlation between anatomical sacral slope and lumbar lordosis was equal to that between pelvic incidence and lumbar lordosis. Additionally, the intraclass correlation coefficient values for the anatomical sacral slope were slightly higher than those for pelvic incidence. Thus, we conclude that anatomical sacral slope can be considered as a helpful anatomical pelvic parameter that is a substitute for pelvic incidence not only in normal healthy subjects, but also in patients with developmental dysplasia of the hip.

scholarly journals The Validity and Reliability of Kinovea Software in Measuring Thoracic Kyphosis and Lumbar Lordosis

2021 ◽  
Vol 19 (2) ◽  
pp. 129-136
Author(s):  
Ali Sharifnezhad ◽  
◽  
Gholam Reza Raissi ◽  
Bijan Forogh ◽  
Hosniyeh Soleymanzadeh ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Lumbar Lordosis ◽  
Thoracic Kyphosis ◽  
Pearson Correlation ◽  
Intraclass Correlation ◽  
Standing Position ◽  
Cross Sectional Study ◽  
Validity And Reliability ◽  
Cross Sectional ◽  
Cobb Method

Objectives: The present study evaluated the inter-rater and intra-rater validity and reliability of posturography by Kinovea software to measure the thoracic kyphosis and lumbar lordosis. Methods: Eighteen subjects (10 females & 8 males) referring for radiographic imaging were included in this cross-sectional study. For evaluating the validity, the thoracic kyphosis and lumbar lordosis were measured according to the Cobb method and Kinovea in standing position. The inter-rater and intra-rater reliability of Kinovea were tested by 3 evaluators and one expert evaluator, respectively. Results: Pearson correlation coefficient data suggested that the validity of measuring the thoracic kyphosis depends on the evaluator’s expertise. Besides, the correlation was not significant in measuring the lumbar lordosis angle (P>0.05). The inter-rater and intra-rater repeatability revealed that the correlation was significant in all angles by the intraclass correlation coefficient (P<0.001). Discussion: Posturography by Kinovea, as a noninvasive method presents an excellent inter-rater and intra-rater repeatability for measuring thoracic kyphosis and lumbar lordosis. This reliable method is simple, efficient, and inexpensive.

scholarly journals REPRODUCIBILITY AND EQUIVALENCE OF COBBMETER APPLICATION IN THE SAGITTAL EVALUATION OF THE SPINE

2016 ◽  
Vol 15 (4) ◽  
pp. 279-282 ◽  
Author(s):  
Luis Marchi ◽  
Fernanda Fortti ◽  
Rodrigo Amaral ◽  
Leonardo Oliveira ◽  
Joes Nogueira-Neto ◽  
...  
Keyword(s):  
Lumbar Lordosis ◽  
Pelvic Tilt ◽  
Pelvic Incidence ◽  
Intraclass Correlation ◽  
Smartphone Application ◽  
Standing Position ◽  
Lateral View ◽  
Cross Sectional ◽  
K Value ◽  
Sagittal Spinal Alignment

ABSTRACT Objective: This study aims to evaluate the reliability and equivalency of using the Cobbmeter application for iPhone compared to the manual measurement method in the analysis of the sagittal spinal alignment. Methods: Cross-sectional, prospective, single-center study that had 20 panoramic radiographs of the spine in lateral view, in a neutral standing position, analyzed blindly and randomly by three independent examiners in three different times. The parameters were pelvic incidence (PI), pelvic tilt (PT) and lumbar lordosis (LL). The statistical analysis was performed to measure the intraclass correlation coefficient (ICC) between the two measurement methods, in addition to measuring the intra and inter-evaluators reliability. Results: For reproducibility analysis, the intra-evaluators ICC using the application resulted in a Kappa (K) of 0.975 for the evaluation of pelvic incidence (PI) evaluation. For pelvic tilt (PT), the K value obtained was 0.981 and the K measured for lumbar lordosis (LL) analysis was 0.987. The inter-evaluators evaluation of reproducibility using the application resulted in a K value of 0.917 for PI, 0.930 for PT and 0.951 for LL. For the assessment of equivalency of methods, comparing the application to the standard method, with a goniometer and dermographic pencil, the K value found for PI was 0.873, for PV was 0.939 and for LL was 0.914. All values were significant (p<0.001) against the null hypothesis. Conclusion: This smartphone application is a valid and reliable instrument for measuring the angle involved in the sagittal balance of the spine. Furthermore, the results show that its applicability is not inferior to the manual method with goniometer and dermographic pencil.

scholarly journals A Preliminary Algorithm Using Spine Measurement Software to Predict Sagittal Alignment Following Pedicle Subtraction Osteotomy

2017 ◽  
Vol 7 (6) ◽  
pp. 543-551
Author(s):  
Robert K. Merrill ◽  
Jun S. Kim ◽  
Dante M. Leven ◽  
Joshua J. Meaike ◽  
Joung Heon Kim ◽  
...  
Keyword(s):  
Lumbar Lordosis ◽  
Sagittal Alignment ◽  
Adult Spinal Deformity ◽  
Case Series ◽  
Pedicle Subtraction Osteotomy ◽  
Regression Equation ◽  
Sacral Slope ◽  
Pelvic Inclination ◽  
Manual Rotation ◽  
Measurement Software

Study Design: Retrospective case series. Objective: To evaluate if spine measurement software can simulate sagittal alignment following pedicle subtraction osteotomy (PSO). Methods: We retrospectively reviewed consecutive adult spinal deformity patients who underwent lumbar PSO. Sagittal measurements were performed on preoperative lateral, standing radiographs. Sagittal measurements after simulated PSO were compared to actual postoperative measurements. A regression equation was developed using cases 1-7 to determine the amount of manual rotation required of each film to match the simulated sagittal vertical axis (SVA) to the actual postoperative SVA. The equation was then applied to cases 8-13. Results: For all 13 cases, the spine software accurately simulated lumbar lordosis, pelvic incidence lumbar lordosis mismatch, and T1 pelvic angle, with no significant differences between actual and simulated measurements. The pelvic tilt (PT), sacral slope (SS), thoracolumbar alignment (TL), thoracic kyphosis (TK), T9 spino-pelvic inclination (T9SPi), T1 spino-pelvic inclination (T1SPi), and SVA were inaccurately simulated. The PT, SS, T9SPi, T1SPi, and SVA all change with manual rotation of the film, and by using the regression equation developed with cases 1-7, we were able to improve the accuracy and decrease the variability of the simulated PT, SS, T9SPi, T1SPi, and SVA for cases 8-13. Conclusions: Dedicated spine measurement software can accurately simulate certain sagittal measurements, such as LL, PI-LL, and TPA, following PSO. A number of measurements, including PT, SS, TL, TK, T9SPi, T1SPi, and SVA were inaccurately simulated. Our preliminary algorithm improved the accuracy and decreased the variability of certain measurements, but requires future prospective studies for further validation.

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