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 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 The Pelvic Incidence Stratified Sagittal Spinopelvic Alignment in Asymptomatic Chinese Population With Different Age Groups

2021 ◽  
pp. 219256822198964
Author(s):  
Siyu Zhou ◽  
Zhuoran Sun ◽  
Wei Li ◽  
Da Zou ◽  
Weishi Li
Keyword(s):  
Chinese Population ◽  
Pelvic Incidence ◽  
Sagittal Alignment ◽  
Age Groups ◽  
Vertical Axis ◽  
Elderly Subjects ◽  
Sagittal Vertical Axis ◽  
Cross Sectional ◽  
Sagittal Parameters ◽  
Very High

Study Design: Cross-sectional study. Objective: To provide the age- and pelvic incidence-related variations of sagittal alignment in asymptomatic Chinese population. Methods: This study recruited asymptomatic adult subjects. All subjects undertook the standing whole spinal radiograph and the sagittal parameters were measured: sagittal vertical axis (SVA), T1 pelvic angle (TPA), lumbar lordosis (LL), thoracic kyphosis (TK), pelvic incidence (PI) and pelvic tilt (PT). All subjects were divided into young, middle aged and elderly groups, then each age group was further divided into 5 subgroups (very low, low, average, high and very high) based on PI values. The relations between PI, age and other parameters were evaluated. The differences in sagittal parameters of each PI subgroup were compared. Results: 546 subjects were included with an average age of 38.6 years (18 to 81). The number of subjects over 70 years and with very low PI was relatively small. The average of PI, TPA, PT and LL were 45.9° ± 8.4°, 6.4° ± 6.2°, 11.9° ± 6.6° and 49.2° ± 10.1°, respectively. SVA, TPA, TK and PT increased with age ( P < 0.05), while SVA, TPA, PT, PI-LL also increased with PI ( P < 0.05). LL, PT, TPA, PI-LL and LL-TK were different among the 5 PI subgroups ( P < 0.05). However, the values of LL in elderly subjects with high and very high PI were similar. Conclusion: The age- and PI-related variations in sagittal alignment of Chinese population were provided. The sagittal parameters were significantly influenced by age and PI. The individual pelvic morphology should be carefully considered during the assessment and restoration of sagittal balance.

Compensation for standing posture by whole-body sagittal alignment in relation to health-related quality of life

2020 ◽  
Vol 102-B (10) ◽  
pp. 1359-1367
Author(s):  
Kazuhiro Hasegawa ◽  
Masashi Okamoto ◽  
Shun Hatsushikano ◽  
Kei Watanabe ◽  
Masayuki Ohashi ◽  
...  
Keyword(s):  
Knee Flexion ◽  
Sagittal Alignment ◽  
Whole Body ◽  
Health Related Quality ◽  
Threshold Values ◽  
Standing Posture ◽  
Related Quality ◽  
Health Related ◽  
Lumbar Spinal

Aims The aim of this study is to test the hypothesis that three grades of sagittal compensation for standing posture (normal, compensated, and decompensated) correlate with health-related quality of life measurements (HRQOL). Methods A total of 50 healthy volunteers (normal), 100 patients with single-level lumbar degenerative spondylolisthesis (LDS), and 70 patients with adult to elderly spinal deformity (deformity) were enrolled. Following collection of demographic data and HRQOL measured by the Scoliosis Research Society-22r (SRS-22r), radiological measurement by the biplanar slot-scanning full body stereoradiography (EOS) system was performed simultaneously with force-plate measurements to obtain whole body sagittal alignment parameters. These parameters included the offset between the centre of the acoustic meatus and the gravity line (CAM-GL), saggital vertical axis (SVA), T1 pelvic angle (TPA), McGregor slope, C2-7 lordosis, thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), PI-LL, sacral slope (SS), pelvic tilt (PT), and knee flexion. Whole spine MRI examination was also performed. Cluster analysis of the SRS-22r scores in the pooled data was performed to classify the subjects into three groups according to the HRQOL, and alignment parameters were then compared among the three cluster groups. Results On the basis of cluster analysis of the SRS-22r subscores, the pooled subjects were divided into three HRQOL groups as follows: almost normal (mean 4.24 (SD 0.32)), mildly disabled (mean 3.32 (SD 0.24)), and severely disabled (mean 2.31 (SD 0.35)). Except for CAM-GL, all the alignment parameters differed significantly among the cluster groups. The threshold values of key alignment parameters for severe disability were TPA > 30°, C2-7 lordosis > 13°, PI-LL > 30°, PT > 28°, and knee flexion > 8°. Lumbar spinal stenosis was found to be associated with the symptom severity. Conclusion This study provides evidence that the three grades of sagittal compensation in whole body alignment correlate with HRQOL scores. The compensation grades depend on the clinical diagnosis, whole body sagittal alignment, and lumbar spinal stenosis. The threshold values of key alignment parameters may be an indication for treatment. Cite this article: Bone Joint J 2020;102-B(10):1359–1367.

scholarly journals Relationship between pelvic morphology and functional parameters in standing position for patient-specific cup planning in THA

10.29007/41f9 ◽  
2018 ◽  
Author(s):  
Maximilian Fischer ◽  
Stephanie Schörner ◽  
Stefan Rohde ◽  
Christian Lüring ◽  
Klaus Radermacher
Keyword(s):  
Pelvic Tilt ◽  
Planning Process ◽  
Pelvic Incidence ◽  
Pubic Symphysis ◽  
Standing Position ◽  
Patient Specific ◽  
Automatic Process ◽  
Sacral Slope ◽  
Functional Parameters ◽  
Eos Imaging

The sagittal orientation of the pelvis commonly called pelvic tilt has an effect on the orientation of the cup in total hip arthroplasty (THA). Pelvic tilt is different between individuals and changes during activities of daily living. In particular, the pelvic tilt in standing position should be considered during the planning of THA to adapt the target angles of the cup patient-specifically to minimize wear and the risk of dislocation. Methods to measure pelvic tilt require an additional step in the planning process, may be time consuming and additional devices or x-ray imaging are necessary.In this study, the relationship between three functional parameters describing the sagittal pelvic orientation in standing position and seven morphological parameters of the pelvis was investigated. Correlations might be used to estimate the pelvic tilt in standing position by the morphology of the pelvis in order to avoid additional measuring techniques of pelvic tilt in the planning process of THA. For 18 subjects a semi-automatic process was established to match a 3D-reconstruction of the pelvis from CT scans to orthogonal EOS imaging in standing position and to calculate the morphological and functional parameters of the pelvis subsequently.The two strongest correlations of the linear correlation analysis were observed between morphological pelvic incidence and functional sacral slope (r = 0.78; p = 0.0001) and between morphological pubic symphysis-posterior superior iliac spines- ratio and functional tilt of anterior pelvic plane (r = -0.59; p = 0.0098). The results of this study suggest that patient-specific adjustments to the orientation of the cup in planning of THA without additional measurement of the sagittal pelvic orientation in standing position should be based on the correlation between morphological pelvic incidence and functional sacral slope.

scholarly journals Correlation of Postural Asymmetries with Gross Motor Functional Classification among Cerebral Palsy Children

2021 ◽  
Keyword(s):  
Cerebral Palsy ◽  
High Frequency ◽  
Sagittal Plane ◽  
Functional Limitation ◽  
Hip Dislocation ◽  
Standing Position ◽  
Spastic Cerebral Palsy ◽  
Special School ◽  
Gross Motor

Background: Motor control and posture disorders are responsible in the development of cerebral palsy (CP). Spastic CP, the most common type of CP is associated with postural asymmetries resulting in functional limitation among children and compromising their quality of life. Therefore, the study aimed to describe the severity of postural asymmetries among special school going children with spastic cerebral palsy in correlation with Gross Motor Function Classification System levels (GMFCS). Methods: Thirty-four subjects from Lahore who were special school going children diagnosed with spastic CP for more than 6 months and less than 1 year were recruited. Children with uncontrolled seizures, hearing and visual impairment, surgery scheduled and other types of cerebral palsy were excluded. The scale used for the assessment of postural asymmetries was Posture and Postural Ability Scale with the reliability of 0.99. ANOVA test was applied with p<0.05 considered as statistically significant. Results: Severe asymmetries were found in standing position with 5.9% (n=2) in frontal and 20.6% (n=7) in sagittal plane. There were mild asymmetries in supine position, 55.9% (n=19) in frontal and 50% (n=17) in sagittal plane. In prone position, reported asymmetries were 55.9% (n=19) in frontal and 44.1% (n=15) in sagittal plane. In sitting position 76.5% (n=26) accounted for both frontal and sagittal plane asymmetries. p<0.05 showed significant distribution of postural asymmetries. Conclusion: Severe postural asymmetries were found in standing position (p<0.05). However, high frequency of pain, scoliosis and hip dislocation were observed at level III of GMFCS among special school going children diagnosed with spastic cerebral palsy. Keywords: Cerebral Palsy; Children; Spastic; Muscle Spasticity.

scholarly journals A Comparison of the Effect of Two Types of Whole Body Vibration Platforms on Fibromyalgia. A Randomized Controlled Trial

2021 ◽  
Vol 18 (6) ◽  
pp. 3007
Author(s):  
José Antonio Mingorance ◽  
Pedro Montoya ◽  
José García Vivas Miranda ◽  
Inmaculada Riquelme
Keyword(s):  
Quality Of Life ◽  
Motor Function ◽  
Whole Body Vibration ◽  
Whole Body ◽  
Control Group ◽  
Body Vibration ◽  
Positive Effects ◽  
Therapy Program

Whole body vibration has been proven to improve the health status of patients with fibromyalgia, providing an activation of the neuromuscular spindles, which are responsible for muscle contraction. The present study aimed to compare the effectiveness of two types of whole body vibrating platforms (vertical and rotational) during a 12-week training program. Sixty fibromyalgia patients (90% were women) were randomly assigned to one of the following groups: group A (n = 20), who performed the vibration training with a vertical platform; group B (n = 20), who did rotational platform training; or a control group C (n = 20), who did not do any training. Sensitivity measures (pressure pain and vibration thresholds), quality of life (Quality of Life Index), motor function tasks (Berg Scale, six-minute walking test, isometric back muscle strength), and static and dynamic balance (Romberg test and gait analysis) were assessed before, immediately after, and three months after the therapy program. Although both types of vibration appeared to have beneficial effects with respect to the control group, the training was more effective with the rotational than with vertical platform in some parameters, such as vibration thresholds (p < 0.001), motor function tasks (p < 0.001), mediolateral sway (p < 0.001), and gait speed (p < 0.05). Nevertheless, improvements disappeared in the follow-up in both types of vibration. Our study points out greater benefits with the use of rotational rather than vertical whole body vibration. The use of the rotational modality is recommended in the standard therapy program for patients with fibromyalgia. Due to the fact that the positive effects of both types of vibration disappeared during the follow-up, continuous or intermittent use is recommended.

scholarly journals The Interplay between Mitochondrial Morphology and Myomitokines in Aging Sarcopenia

2020 ◽  
Vol 22 (1) ◽  
pp. 91
Author(s):  
Vanina Romanello
Keyword(s):  
Mitochondrial Dysfunction ◽  
Poor Quality ◽  
Whole Body ◽  
Fibroblast Growth Factor 21 ◽  
Mitochondrial Morphology ◽  
Mass Force ◽  
Major Mechanism ◽  
Muscle Aging ◽  
And Function

Sarcopenia is a chronic disease characterized by the progressive loss of skeletal muscle mass, force, and function during aging. It is an emerging public problem associated with poor quality of life, disability, frailty, and high mortality. A decline in mitochondria quality control pathways constitutes a major mechanism driving aging sarcopenia, causing abnormal organelle accumulation over a lifetime. The resulting mitochondrial dysfunction in sarcopenic muscles feedbacks systemically by releasing the myomitokines fibroblast growth factor 21 (FGF21) and growth and differentiation factor 15 (GDF15), influencing the whole-body homeostasis and dictating healthy or unhealthy aging. This review describes the principal pathways controlling mitochondrial quality, many of which are potential therapeutic targets against muscle aging, and the connection between mitochondrial dysfunction and the myomitokines FGF21 and GDF15 in the pathogenesis of aging sarcopenia.

scholarly journals Lowest Instrumented Vertebra Selection to S1 or Ilium Versus L4 or L5 in Adult Spinal Deformity: Factors for Consideration in 349 Patients With a Mean 46-Month Follow-Up

2021 ◽  
pp. 219256822110091
Author(s):  
Yu-Cheng Yao ◽  
Han Jo Kim ◽  
Mathieu Bannwarth ◽  
Justin Smith ◽  
Shay Bess ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Sagittal Alignment ◽  
Adult Spinal Deformity ◽  
Operating Time ◽  
Patient Demographics ◽  
Lowest Instrumented Vertebra ◽  
Related Quality ◽  
Health Related

Study Design: Retrospective cohort study. Objective: To compare the outcomes of patients with adult spinal deformity (ASD) following spinal fusion with the lowest instrumented vertebra (LIV) at L4/L5 versus S1/ilium. Methods: A multicenter ASD database was evaluated. Patients were categorized into 2 groups based on LIV levels—groups L (fusion to L4/L5) and S (fusion to S1/ilium). Both groups were propensity matched by age and preoperative radiographic alignments. Patient demographics, operative details, radiographic parameters, revision rates, and health-related quality of life (HRQOL) scores were compared. Results: Overall, 349 patients had complete data, with a mean follow-up of 46 months. Patients in group S (n = 311) were older and had larger sagittal and coronal plane deformities than those in group L (n = 38). After matching, 28 patients were allocated to each group with similar demographic, radiographic, and clinical parameters. Sagittal alignment restoration at postoperative week 6 was significantly better in group S than in group L, but it was similar in both groups at the 2-year follow-up. Fusion to S1/ilium involved a longer operating time, higher PJK rates, and greater PJK angles than that to L4/L5. There were no significant differences in the complication and revision rates between the groups. Both groups showed significant improvements in HRQOL scores. Conclusions: Fusion to S1/ilium had better sagittal alignment restoration at postoperative week 6 and involved higher PJK rates and greater PJK angles than that to L4/L5. The clinical outcomes and rates of revision surgery and complications were similar between the groups.

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