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Three-dimensional pelvic incidence is much higher in (thoraco)lumbar scoliosis than in controls

Brink, Rob C. ; Vavruch, Ludvig ; Schlösser, Tom P.C. ; Abul-Kasim, Kasim LU ; Ohlin, Acke LU ; Tropp, Hans ; Castelein, René M. and Vrtovec, Tomaž (2019) In European Spine Journal 28(3). p.544-550
Abstract

Purpose: The pelvic incidence (PI) is used to describe the sagittal spino-pelvic alignment. In previous studies, radiographs were used, leading to less accuracy in establishing the three-dimensional (3D) spino-pelvic parameters. The purpose of this study is to analyze the differences in the 3D sagittal spino-pelvic alignment in adolescent idiopathic scoliosis (AIS) subjects and non-scoliotic controls. Methods: Thirty-seven female AIS patients that underwent preoperative supine low-dose computed tomography imaging of the spine, hips and pelvis as part of their general workup were included and compared to 44 non-scoliotic age-matched female controls. A previously validated computerized method was used to measure the PI in 3D, as the angle... (More)

Purpose: The pelvic incidence (PI) is used to describe the sagittal spino-pelvic alignment. In previous studies, radiographs were used, leading to less accuracy in establishing the three-dimensional (3D) spino-pelvic parameters. The purpose of this study is to analyze the differences in the 3D sagittal spino-pelvic alignment in adolescent idiopathic scoliosis (AIS) subjects and non-scoliotic controls. Methods: Thirty-seven female AIS patients that underwent preoperative supine low-dose computed tomography imaging of the spine, hips and pelvis as part of their general workup were included and compared to 44 non-scoliotic age-matched female controls. A previously validated computerized method was used to measure the PI in 3D, as the angle between the line orthogonal to the inclination of the sacral endplate and the line connecting the center of the sacral endplate with the hip axis. Results: The PI was on average 46.8° ± 12.4° in AIS patients and 41.3° ± 11.4° in controls (p = 0.025), with a higher PI in Lenke type 5 curves (50.6° ± 16.2°) as compared to controls (p = 0.042), whereas the Lenke type 1 curves (45.9° ± 12.2°) did not differ from controls (p = 0.141). Conclusion: Lenke type 5 curves show a significantly higher PI than controls, whereas the Lenke type 1 curves did not differ from controls. This suggests a role of pelvic morphology and spino-pelvic alignment in the pathogenesis of idiopathic scoliosis. Further longitudinal studies should explore the exact role of the PI in the initiation and progression of different AIS types. Graphical abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.]

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Computed tomography, Idiopathic scoliosis, Pelvic incidence, Sagittal alignment, Three-dimensional analysis
in
European Spine Journal
volume
28
issue
3
pages
544 - 550
publisher
Springer
external identifiers
  • scopus:85051834138
  • pmid:30128762
ISSN
0940-6719
DOI
10.1007/s00586-018-5718-6
language
English
LU publication?
yes
id
129fcc6d-1768-43e6-aae1-a141046374b3
date added to LUP
2018-09-12 13:23:57
date last changed
2024-04-15 11:24:48
@article{129fcc6d-1768-43e6-aae1-a141046374b3,
  abstract     = {{<p>Purpose: The pelvic incidence (PI) is used to describe the sagittal spino-pelvic alignment. In previous studies, radiographs were used, leading to less accuracy in establishing the three-dimensional (3D) spino-pelvic parameters. The purpose of this study is to analyze the differences in the 3D sagittal spino-pelvic alignment in adolescent idiopathic scoliosis (AIS) subjects and non-scoliotic controls. Methods: Thirty-seven female AIS patients that underwent preoperative supine low-dose computed tomography imaging of the spine, hips and pelvis as part of their general workup were included and compared to 44 non-scoliotic age-matched female controls. A previously validated computerized method was used to measure the PI in 3D, as the angle between the line orthogonal to the inclination of the sacral endplate and the line connecting the center of the sacral endplate with the hip axis. Results: The PI was on average 46.8° ± 12.4° in AIS patients and 41.3° ± 11.4° in controls (p = 0.025), with a higher PI in Lenke type 5 curves (50.6° ± 16.2°) as compared to controls (p = 0.042), whereas the Lenke type 1 curves (45.9° ± 12.2°) did not differ from controls (p = 0.141). Conclusion: Lenke type 5 curves show a significantly higher PI than controls, whereas the Lenke type 1 curves did not differ from controls. This suggests a role of pelvic morphology and spino-pelvic alignment in the pathogenesis of idiopathic scoliosis. Further longitudinal studies should explore the exact role of the PI in the initiation and progression of different AIS types. Graphical abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.]</p>}},
  author       = {{Brink, Rob C. and Vavruch, Ludvig and Schlösser, Tom P.C. and Abul-Kasim, Kasim and Ohlin, Acke and Tropp, Hans and Castelein, René M. and Vrtovec, Tomaž}},
  issn         = {{0940-6719}},
  keywords     = {{Computed tomography; Idiopathic scoliosis; Pelvic incidence; Sagittal alignment; Three-dimensional analysis}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{544--550}},
  publisher    = {{Springer}},
  series       = {{European Spine Journal}},
  title        = {{Three-dimensional pelvic incidence is much higher in (thoraco)lumbar scoliosis than in controls}},
  url          = {{http://dx.doi.org/10.1007/s00586-018-5718-6}},
  doi          = {{10.1007/s00586-018-5718-6}},
  volume       = {{28}},
  year         = {{2019}},
}