scholarly journals Analysis of Measurement Changes in the Pelvic Incidence According to Pelvic Rotation using a 3-dimensional Model

2021 ◽  
Author(s):  
Ki Young Lee ◽  
Jung-Hee Lee ◽  
Sang-Kyu Im ◽  
Won Young Lee
Keyword(s):  
Measurement Errors ◽  
Pelvic Incidence ◽  
Adult Spinal Deformity ◽  
Accurate Method ◽  
X Rays ◽  
Acceptable Error ◽  
Pelvic Rotation ◽  
Lower Lumbar Spine ◽  
Lower Lumbar ◽  
Whole Spine

Abstract Background: Pelvic incidence (PI) is used as a key parameter in surgical correction of adult spinal deformity (ASD) patients. However, there is a limitation to reflecting the exact center or inclination of 3-dimentional anatomical structures in a 2-dimensional (2D) sagittal radiographs, and these can lead to the measurement errors. Therefore, we evaluated whether there is a change in PI measurement according to the actual rotation of the pelvis, and conducted a study on a more accurate method of measuring PI in a 2D sagittal radiograph.Methods: From 2014 to 2015, 30 patients who visited our outpatient clinic were analyzed retrospectively. CT scan images including the lower lumbar spine, pelvis, and both femurs in DICOM format were imported to Mimics Research 17.0 (Materialise NV, Belgium), Solidworks (Dassault systems, France), and AutoCAD 2014 (AUTODESK, US), and the changes in PI according to vertical and horizontal pelvic rotations were evaluated.Results: The average PI according to the horizontal pelvic rotations measured on AutoCAD with 0º, 5º, 10º, 15º, 20º, 25º, 30º, 35º, and 40º was 48.8º, 48.7º, 48.3º, 47.8º, 46.9º, 45.6º, 44.0º, 42.2º, and 39.9º, respectively. The PI of an acceptable error of 6º on radiographs was 35º in the horizontal pelvic rotation. The average PI according to the vertical pelvic rotations measured on AutoCAD with 0º, 5º, 10º, 15º, 20º, 25º, 30º, 35º, and 40º was 48.8º, 49.0º, 49.5º, 50.2º, 51.3º, 52.7º, 54.4º, 56.6º, and 59.4º, respectively. The PI of an acceptable error of 6º on radiographs was 30º in the vertical pelvic rotation. Conclusions: This study revealed that the PI value could differ from the actual anatomical value due to the horizontal and vertical rotation of the pelvis while acquiring the radiograph. In whole-spine lateral radiographs, errors in PI measurement may occur due to rotation of the pelvis or nonvertical projection of X-rays. In the standing pelvic lateral radiographs, placing the overlapping femoral heads at the center and obtaining the straight sacral endplate as much as possible by referring to CT or magnetic resonance imaging would be a more accurate measurement method to define the PI.

Stress Analysis of the Lower Lumbar Spine Three-joint Complex According to Different Pelvic Incidences

2021 ◽  
Author(s):  
Qi Lai ◽  
Jun Yin ◽  
Zi Zhen Zhang ◽  
Jie Yang ◽  
Zongmiao Wan
Keyword(s):  
Finite Element ◽  
Lumbar Spine ◽  
Pelvic Incidence ◽  
Facet Joint ◽  
The Other ◽  
Von Mises Stress ◽  
Facet Joints ◽  
Lower Lumbar Spine ◽  
Flexion Extension ◽  
Lower Lumbar

Abstract Background: Pelvic incidence is closely related to degeneration of the facet joint and intervertebral disc and is related to the orientation of the facet joints. Currently, very few studies have been conducted on the force analysis of the three-joint complex in patients with different pelvic incidence measurements under different sports postures. We designed this study to better assess the influence of pelvic incidence on the stress of the lumbar three-joint complex. Finite element analysis can provide a biomechanical basis for the relationship between different pelvic incidences and degenerative diseases of the lower lumbar spine.Methods: We developed three nonlinear finite element models of the lumbar spine (L1-S1) with different pelvic incidences (27.44°, 47.05°, and 62.28°) and validated them to study the biomechanical response of facet joints and intervertebral discs with a follower preload of 400 N, under different torques (5 Nm, 10 Nm, and 15 Nm), and compared the stress of the three-joint complex of the lower lumbar spine (L3-S1) in different positions (flexion-extension, left-right bending, and left-right torsion).Results: In the flexion position, the stress of the disc in the low pelvic incidence model was the largest among the three models; the stress of the facet joint in the high pelvic incidence model was the largest among the three groups during the extension position. During torsion, the intradiscal pressure of the high pelvic incidence model was higher than that of the other two models in the L3/4 segment, and the maximum von Mises stress of the annulus fibrosus in the L5/S1 segment with a large pelvic incidence was greater than that of the other two models.Conclusions: Pelvic incidence is related to the occurrence and development of degenerative lumbar diseases. The stress of the lower lumbar facet joints and fibrous annulus of individuals with a high pelvic incidence is greater than that of individuals with a low pelvic incidence or a normal pelvic incidence. Although this condition only occurs in individual segments, to a certain extent, it can also reflect the influence of pelvic incidence on the force of the three-joint complex of the lower lumbar spine.

scholarly journals Increased pelvic incidence may lead to arthritis and sagittal orientation of the facet joints at the lower lumbar spine

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Thorsten Jentzsch ◽  
James Geiger ◽  
Samy Bouaicha ◽  
Ksenija Slankamenac ◽  
Thi Dan Linh Nguyen-Kim ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Pelvic Incidence ◽  
Facet Joints ◽  
Lower Lumbar Spine ◽  
Lower Lumbar ◽  
Sagittal Orientation

228. Does interbody fusion protect against rod failure in the lower lumbar spine after long fusions to the sacrum: a comparative analysis of adult spinal deformity patients

2019 ◽  
Vol 19 (9) ◽  
pp. S112
Author(s):  
Mostafa H. El Dafrawy ◽  
Keith H. Bridwell ◽  
Owoicho Adogwa ◽  
Maksim A. Shlykov ◽  
Thamrong Lertudomphonwanit ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Lumbar Spine ◽  
Spinal Deformity ◽  
Interbody Fusion ◽  
Adult Spinal Deformity ◽  
Lower Lumbar Spine ◽  
Lower Lumbar

scholarly journals Bamboo spine – X-ray findings of ankylosing spondylitis revisited

2012 ◽  
Vol 16 (3) ◽  
pp. 111-113
Author(s):  
Antoinette Reinders ◽  
Matthys J Van Wyk
Keyword(s):  
Ankylosing Spondylitis ◽  
X Rays ◽  
Age Group ◽  
Radiographic Findings ◽  
X Ray ◽  
Prompt Treatment ◽  
Lower Lumbar Spine ◽  
Patients At Risk ◽  
Lower Lumbar ◽  
Seronegative Spondylarthropathies

Ankylosing spondylitis is a debilitating disease that is one of the seronegative spondylarthropathies, affecting more males than females in the proportion of about 6:1 in the age group 15 - 35 years of age. Early radiographic findings include bilateral sacro-iliitis and early axial (lower lumbar spine) ankylosis. Typical X-ray findings are florid spondylitis (Romanus lesions), florid diskitis (Andersson lesions), early axial ankylosis, enthesitis, syndesmophytes and insufficiency fractures. Typical radiological abnormalities are pointed out on conventional X-rays and reviewed for early diagnosis and prompt treatment of patients at risk.

Increased Pelvic Incidence is Associated With a More Coronal Facet Orientation in the Lower Lumbar Spine

Spine ◽  
2016 ◽  
Vol 41 (19) ◽  
pp. E1138-E1145 ◽  
Author(s):  
Douglas S. Weinberg ◽  
Katherine K. Xie ◽  
Raymond W. Liu ◽  
Jeremy J. Gebhart ◽  
Zachary L. Gordon
Keyword(s):  
Lumbar Spine ◽  
Pelvic Incidence ◽  
Lower Lumbar Spine ◽  
Facet Orientation ◽  
Lower Lumbar

scholarly journals Pelvic Girdle Reconstruction Based on Spinal Fusion and Ischial Screw Fixation in a Case of Aneurysmal Bone Cyst

Sarcoma ◽  
2003 ◽  
Vol 7 (3-4) ◽  
pp. 177-182 ◽  
Author(s):  
Matthias Honl ◽  
Florian Westphal ◽  
Volker Carrero ◽  
Michael Morlock ◽  
Karsten Schwieger ◽  
...  
Keyword(s):  
Aneurysmal Bone Cyst ◽  
Iliac Crest ◽  
Screw Fixation ◽  
Pelvic Ring ◽  
Bone Cyst ◽  
Pedicle Screws ◽  
Lytic Lesion ◽  
Titanium Plate ◽  
Lower Lumbar Spine ◽  
Lower Lumbar

A case of lytic lesion of the pelvis in a 23-year-old woman is presented. A biopsy led to the diagnosis aneurysmal bone cyst (ABC). Due to the histologically very aggressive growth of the tumor, a low malignant osteosarcoma could not be excluded. In an initial operation the tumour, affecting the sacrum, the iliac crest and the lower lumbar spine was resected. Temporary restabilisation of the pelvic ring was achieved by a titanium plate. The histological examination of the entire tumour confirmed the diagnosis ABC. After 6 months, the MRI showed no recurrence. The observed tilt of the spine to the operated side on the sacral base prompted a second surgical procedure: a transpedicular fixation of L5 and L4 was connected via bent titanium stems to the ischium, where the fixation was achieved by two screws. This construction allowed the correction of the base angle and yielded a stable closure of the pelvic ring. The patient has now been followed for 6 years: the bone grafts have been incorporated and, in spite of radiological signs of screw loosening in the ischium, the patient is fully rehabilitated and free of symptoms. Pedicle screws in the lower spine can be recommended for fixation of a pelvic ring discontinuity.

Accuracy of 11 formulae to guide umbilical arterial catheter tip placement in newborn infants

2017 ◽  
Vol 103 (4) ◽  
pp. F364-F369 ◽  
Author(s):  
Wei Ling Lean ◽  
Jennifer A Dawson ◽  
Peter G Davis ◽  
Christiane Theda ◽  
Marta Thio
Keyword(s):  
Gold Standard ◽  
Newborn Infants ◽  
Body Part ◽  
Accurate Method ◽  
Arterial Catheter ◽  
X Rays ◽  
Success Rates ◽  
Common Procedure ◽  
Optimal Position ◽  
Umbilical Arterial Catheter

BackgroundUmbilical arterial catheter (UAC) insertion is a common procedure in the neonatal intensive care unit (NICU). Correct placement of the tip of the UAC at first attempt minimises handling of the infant and reduces the risk of infection and complications. We aimed to determine the accuracy of 11 published formulae to guide UAC placement.MethodsThis was a one-year prospective observational study in a tertiary NICU. Clinicians used their preferred formula for UAC insertion, with X-rays performed immediately post-procedure to check the tip position. Birth weight and measurements included in the 11 formulae were recorded within 48 hours. The gold standard insertion distance was defined as the distance from the abdominal wall to the mid-descending aorta, at T8 level on X-ray (range T6–T10). Insertion length using the 11 formulae was calculated and compared with this gold standard distance.ResultsOne hundred and three infants were included, with median (IQR) gestational age and weight of 28 (26–33.5) weeks and 980 (780–2045) g, respectively. The predicted value of the 11 formulae to place the UAC in correct position ranged from 51.0% to 73.8%. Formulae that involved direct body part measurements showed the highest predicted success rates, smallest mean difference from T8 and narrowest limits of agreement using the Bland-Altman method.ConclusionSuccess rates for accurate UAC placement are highest when formulae that involve body measurements are used. However, even the most accurate method would result in more than 25% of UACs needing manipulation to achieve an optimal position.

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