Observations on Sagittal Alignment of Lumbo-Sacral Spine in Asymptomatic Adults in Kashmir

Introduction: Sacropelvic parameters in various spine and hipdisorders have been published in various studies. We aimed tostudy the normal sacropelvic parameters and curvatures of thespine and their correlation in asymptomatic Indian adults inrelation to variations in sex and age.Material and Methods: 200 Volunteers were taken fromgeneral population with age ranging from 18-50. Patientwas made to stand and left lateral radiograph exposing C7 toS1 and both the hips with a long 30x90 cm cassette placedat 230 cm from the X-ray tube was performed by a singleradiographer to avoid bias.Results: The average LL, SS, PI, PT, and SVA values wereaverage 55.61±10.68, 38.38±8.33,47.94±10.24,10.16±6.23 and 17.27±9.72 respectively. No statistically significantdifference was observed in statistical values with regardsto sex. Our study showed that PI has significant positivecorrelations with SS, LL and PT, and also affects LL. SS hassignificant positive correlation with LL.Conclusion: The current results could contribute to not onlythe understanding of normal sagittal spinal alignment, but alsoserve as a basis for realignment strategies in young Kashmiriadults.

Spinopelvic Orientation on Radiographs in Various Body Postures: Upright Standing, Chair Sitting, Japanese Style Kneel Sitting, and Korean Style Cross-Legged Sitting

BACKGROUND: Several previous studies reported on the impact of upright standing and chair sitting on the sagittal spinopelvic alignment. However, there are no studies on the impact of the two Asian (Korean and Japanese) style floor-sitting positions on the sagittal spinopelvic alignment. The purpose of this study was to evaluate the impact of four different body postures (standing, chair sitting, kneel sitting, and cross-legged sitting) on the sagittal spinopelvic alignment. METHODS: Sixteen selected healthy volunteers (10 males and six females) were subjects of this pilot study. In all subjects, radiographs were taken in comfortable standing and sitting positions. All spinal curvatures including lumbar lordotic angle (LLA), sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI) were measured on the radiographs. RESULTS: In standing position, the average LLA, SS, PT, and PI were 37.1°, 35.3°, 15.7°, and 51.0°, respectively. In chair sitting, the average LLA, SS, PT, and PI were 17.9°, 20.3°, 28.2°, and 49.5°, respectively. In kneel sitting (Japanese style), the average LLA, SS, PT, and PI were 31.8°, 38.3°, 14.2°, and 52.5°, respectively. In cross-legged sitting (Korean style), the average LLA, SS, PT, and PI were 9.8°, 13.4°, 38.3°, and 51.7°, respectively. LLA in standing (37.1°) and kneel sitting (31.8°) were very similar. Remarkable reduction in LLA was observed in Korean-style cross-legged sitting (9.8°), and LLA in chair sitting (17.9°) was about half of that in standing. SS was similar in standing (35.3°) and kneel sitting (38.3°), and it was reduced remarkably in cross-legged sitting (13.4°). PT was largest in cross-legged sitting (38.3°), and it was similar between standing (15.7°) and kneel sitting (14.2°). PIs were similar in all positions. CONCLUSIONS: The kneel sitting position did not show significant differences with the standing position when assessed using four parameters related to the sagittal spinopelvic alignment, whereas chair sitting and cross-legged sitting positions significantly altered the spinopelvic alignment compared to the standing position.

Effects of different pelvic incidence minus lumbar lordosis mismatch after long posterior instrumentation and fusion for adult degenerative scoliosis / 中华外科杂志

Objective@#To evaluate the influence of PI-LL (pelvic incidence minus lumbar lordosis mismatch) on scoliosis correction, living quality and internal fixation related complications for adult degenerative scoliosis (ASD) after long posterior instrumentation and fusion.@*Methods@#A total of 79 patients with ADS underwent long posterior instrumentation and fusion in the Department of Orthopedics at Beijing Chao Yang Hospital from January 2010 to January 2014 were retrospectively reviewed.There were 21 males and 58 females aging from 55 to 72 years with the mean age (63.4±4.8)years. The patients were divided into three groups according to immediately postoperative PI-LL: PI-LL<10°, 10°≤PI-LL≤20°, PI-LL>20°.Compare the Cobb′s angles, PI-LL, Japanese Orthopaedic Association (JOA) score, Oswestry Disability Index (ODI), Visual Analog Scale (VAS) and Lumbar Stiffness Disability Index (LSDI). Measurement data were compared via t test and ANOVA, enumeration data were compared via Kruskal-Wallis test, noncontiguous data was performed by χ2 test. Univariate linear regression equation was performed to investigate the relative influences of postoperative PI-LL on postoperative radiographic parameters and clinical outcome.@*Results@#All the operations were successful without intraoperative complications. The operation time was 145-310 minutes (235.3±42.0) minutes, the intraoperative blood loss was 300-5 300 ml (1 021±787) ml, the duration of hospital was 12-18 d (14.5±1.3) d. A total of 4 to 10 (7.0±1.1) vertebra levels were fused. Compared to preoperative, the Cobb′s angle of scoliosis ((4.2±1.8)° vs. (20.1±2.7)°), PI-LL ((16.1±8.6)° vs. (36.0±4.3)°), JOA (3.0±1.3 vs. 5.5±1.2), ODI (24.4±8.1 vs. 62.9±2.7), VAS (3.0±1.0 vs. 6.8±1.3) were significantly decreased postoperative (t=18.539~53.826, P<0.01). Compared to preoperative, postoperative Cobb′s angle of scoliosis ((4.1±2.7)° vs. (19.5±2.7)°, (4.0±1.4)° vs. (20.2±2.4)°, (4.7±0.9)° vs. (20.6±3.0)°) (t=21.148-45.355, P<0.01) and PI-LL ((5.2±2.8)° vs. (35.8±4.9)°, (17.9±2.9)° vs. (37.2±3.9)°, (25.8±2.7)° vs. (34.5±4.0)°) (t=7.227-38.250, P<0.01) were significantly reduced postoperative in PI-LL<10° group, 10°≤PI-LL≤20° group and PI-LL>20° group. Compared to preoperative, ODI (27.7±4.9 vs. 63.3±2.6, 17.7±5.9 vs. 63.1±2.8, 30.6±6.5 vs. 62.3±2.5) (t=21.218~50.858, P<0.01), JOA (2.8±1.2 vs. 5.2±1.2, 3.3±1.1 vs. 5.7±1.1, 2.8±1.7 vs. 5.7±1.2) (t=9.042-16.025, P<0.01) and VAS (2.9±1.2 vs.7.0±1.3, 3.3±0.9 vs.7.0±1.4, 2.9±0.8 vs. 6.3±1.2) (t=16.073-22.214, P<0.01) were all significantly reduced at last follow-up. There were statistic differences in ODI and LSDI (F=38.477, P<0.01; F=37.063, P<0.01) at the last follow-up among the three groups. There was a negative correlation in PI-LL and LSDI according to linear regression (B=-5.838, P<0.01) in the last follow-up. All the patients were followed up, the follow-up duration were 2 to 5 years with the mean (3.1±0.7) years. The internal fixation failure related complications in 3 years included proximal junctional kyphosis (PJK) in 19 cases, internal fixation loosening in 6 cases. Eight patients received reoperation for severe local pain and low extremity symptoms. PJK occurrences were significantly different among PI-LL<10° group, 10°≤PI-LL≤20° group and PI-LL>20° group.@*Conclusions@#The PI-LL between 10° and 20° may be the best choice in ADS patients after long posterior instrumentation and fusion for its better clinical outcome and less proximal junctional kyphosis (PJK). The overcorrection of LL may lead to more serious postoperative lumbar stiffness.

Pelvic Incidence Can Be Changed not only by Age and Sex, but also by Posture Used during Imaging

OBJECTIVE: Computed tomography (CT), rather than conventional 2-dimensional radiography, was used to scan and measure pelvic parameters. The results were compared with measurements using X-ray. METHODS: Pelvic parameters were measured using both CT and X-ray in 254 patients who underwent both abdomino-pelvic CT and X-ray at the pelvic site. We assessed the similarity of the pelvic parameters between the 2 exams, as well as the correlations of pelvic parameters with sex and age. RESULTS: The mean values of the subjects’ pelvic parameters measured on X-ray were: sacral slope (SS), 31.6°; pelvic tilt (PT), 18.6°; and pelvic incidence (PI), 50.2°. The mean values measured on CT were: SS, 35.1°; PT, 11.9°; and PI, 47.0°. PT was found to be 4.07° higher on X-ray and 2.98° higher on CT in women, with these differences being statistically significant (p < 0.001, p < 0.001). PI was 4.10° higher on X-ray and 2.78° higher on CT in women, with these differences also being statistically significant (p < 0.001, p=0.009). We also observed a correlation between age and PI. For men, this correlation coefficient was 0.199 measured using X-ray and 0.184 measured using CT. For women, this correlation coefficient was 0.423 measured using X-ray and 0.372 measured using CT. CONCLUSION: When measured using CT compared to X-ray, SS increased by 3.5°, PT decreased by 6.7°, and PI decreased by 3.2°. There were also statistically significant differences in PT and PI between male and female subjects, while PI was found to increase with age.

Basic Pelvic Parameters Associated with Lumbar Degenerative Disease: Review Article

STUDY DESIGN: Literature review. OBJECTIVES: The aim of this study was to present updated information on the basic pelvic parameters associated with lumbar degenerative disease. SUMMARY OF LITERATURE REVIEW: Sagittal imbalance has been known to be related to a poor prognosis in almost all adult spine problems, including lumbar degenerative disease. MATERIALS AND METHODS: Review of the relevant literature. RESULTS: Pelvic incidence is a morphologic parameter of the pelvis. It influences lumbar lordosis and thoracic kyphosis, and determines the limitations of pelvic retroversion in sagittal imbalance. Pelvic tilt is a positional parameter of the pelvis, indicating the degree of compensation for sagittal imbalance. A C7-sagittal vertical axis >5 cm, pelvic tilt >20°, and pelvic incidence-lumbar lordosis mismatch are known to be independent factors predictive of poor outcomes. CONCLUSIONS: The C7-sagittal vertical axis, pelvic tilt, and pelvic incidence-lumbar lordosis mismatch should be considered when surgery is planned for a patient with degenerative lumbar disease.

Clinical Implications of Spino-pelvic Parameters for the Outcome of Spinal Surgery for Lumbar Degenerative Diseases

STUDY DESIGN: A review of the literature. OBJECTIVES: To discuss how to evaluate, interpret, and utilize measurements of spino-pelvic alignment before and after spinal surgery in patients with lumbar degenerative disease. SUMMARY OF LITERATURE REVIEW: Various spino-pelvic parameters are currently utilized in the evaluation of spinal patients; however, interpretation of these parameters is not easy. MATERIALS AND METHODS: Each spino-pelvic parameter and factors affecting its value, and how to interpret and utilize the spino-pelvic parameters before and after spinal surgery were discussed for patients with lumbar degenerative disease with and without sagittal spinal deformity. RESULTS: Sagittal modifiers in the SRS-Schwab classification including pelvic incidence minus lumbar lordosis (PI-LL), sagittal vertical axis (SVA), and pelvic tilt (PT) are widely accepted in the evaluation of lumbar degenerative disease with sagittal deformity. Surgery for sagittal realignment is meant to restore both the SVA and PT by restoring the LL in reference to the PI. However, patients with an extremely high SVA and PT or those with a high SVA and low PT can end up with postoperative residual malalignment. In patients without deformity, PI-LL mismatch (> 10°) should be highlighted and should be actively corrected by restoring the lordosis of the pathologic segment. CONCLUSIONS: Sagittal modifiers are beneficial for their simplicity and comprehensibility; however, they are insufficient for evaluating sub-regional spinal deformity. Spino-pelvic parameters can be useful for evaluating spinal patients in a clinical setting, but the measurements are greatly affected by confounding factors such as poor patient posture, unqualified testers, and manual measurement techniques.

Restoration of Lumbar Lordosis in Flat Back Deformity: Optimal Degree of Correction

STUDY DESIGN: A retrospective comparative study. PURPOSE: To provide an ideal correction angle of lumbar lordosis (LL) in degenerative flat back deformity. OVERVIEW OF LITERATURE: The degree of correction in degenerative flat back in relation to pelvic incidence (PI) remains controversial. METHODS: Forty-nine patients with flat back deformity who underwent corrective surgery were enrolled. Posterior-anterior-posterior sequential operation was performed. Mean age and mean follow-up period was 65.6 years and 24.2 months, respectively. We divided the patients into two groups based on immediate postoperative radiographs-optimal correction (OC) group (PI-9degrees or =55degrees). Radiological and clinical results were analyzed. RESULTS: Patients in OC group had significantly less correction loss and maintained normal sagittal alignment (sagittal vertical axis<5 cm), as compared to patients in UC group (p<0.05). LL of low PI group significantly maintained within 9degrees better than high PI group (p<0.05). Oswestry disability index (ODI) significantly decreased at last follow-up, as compared to preoperative state. However, there was no significant difference in last follow-up ODI between the groups. CONCLUSIONS: In flat back deformity, correction of LL to within 9degrees of PI will result in better sagittal balance. Thus, we recommend sufficient LL to prevent correction loss, especially in patients with high PI.

Comparison of Sagittal Spinopelvic Alignment between Lumbar Degenerative Spondylolisthesis and Degenerative Spinal Stenosis

OBJECTIVE: The purpose of this study was to evaluate the differences in sagittal spinopelvic alignment between lumbar degenerative spondylolisthesis (DSPL) and degenerative spinal stenosis (DSS). METHODS: Seventy patients with DSPL and 72 patients with DSS who were treated with lumbar interbody fusion surgery were included in this study. The following spinopelvic parameters were measured on whole spine lateral radiographs in a standing position : pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis angle (LL), L4-S1 segmental lumbar angle (SLL), thoracic kyphosis (TK), and sagittal vertical axis from the C7 plumb line (SVA). Two groups were subdivided by SVA value, respectively. Normal SVA subgroup and positive SVA subgroup were divided as SVA value ( or =50 mm). Spinopelvic parameters/PI ratios were assessed and compared between the groups. RESULTS: The PI of DSPL was significantly greater than that of DSS (p=0.000). The SVA of DSPL was significantly greater than that of DSS (p=0.001). In sub-group analysis between the positive (34.3%) and normal SVA (65.7%), there were significant differences in LL/PI and SLL/PI (p<0.05) in the DSPL group. In sub-group analysis between the positive (12.5%) and normal SVA (87.5%), there were significant differences in PT/PI, SS/PI, LL/PI and SLL/PI ratios (p<0.05) in the DSS group. CONCLUSION: Patients with lumbar degenerative spondylolisthesis have the propensity for sagittal imbalance and higher pelvic incidence compared with those with degenerative spinal stenosis. Sagittal imbalance in patients with DSPL is significantly correlated with the loss of lumbar lordosis, especially loss of segmental lumbar lordosis.

Difference of Sagittal Spinopelvic Alignments between Degenerative Spondylolisthesis and Isthmic Spondylolisthesis

OBJECTIVE: The purpose of this study was to analyze the differences of spinopelvic parameters between degenerative spondylolisthesis (DSPL) and isthmic spondylolisthesis (ISPL) patients. METHODS: Thirty-four patients with DSPL and 19 patients with ISPL were included in this study. Spinopelvic parameters were evaluated on whole spine X-rays in a standing position. The following spinopelvic parameters were measured : pelvic incidence (PI), sacral slope, pelvic tilt (PT), lumbar lordosis (LL), and sagittal vertical axis from C7 plumb line (SVA). The population of patients was compared with a control population of 30 normal and asymptomatic adults. RESULTS: There were statistically significant differences in LL (p=0.004) and SVA (p=0.005) between the DSPL and ISPL group. The LL of DSPL (42+/-13degrees) was significantly lower than that of the control group (48+/-11degrees; p=0.029), but that of ISPL (55+/-6degrees) was significantly greater than a control group (p=0.004). The SVA of DSPL (55+/-49 mm) was greater than that of a control group (<40 mm), but that of ISPL (21+/-22 mm) was within 40 mm as that of a control group. The PT of DSPL (24+/-7degrees) and ISPL (21+/-7degrees) was significantly greater than that of a control group (11+/-6degrees; p=0.000). CONCLUSION: Both symptomatic DSPL and ISPL patients had a greater PI than that of the asymptomatic control group. In conclusion, DSPL populations are likely to have global sagittal imbalance (high SVA) compared with ISPL populations because of the difference of lumbar lordosis between two groups.

The Association of Lumbosacral Sagittal Alignments and the Patterns of Lumbar Disc Degeneration

STUDY DESIGN: Retrospective review and radiological analysis. OBJECTIVES: We investigated whether the lumbosacral sagittal curvature have any relation to the patterns of lumbar disc degeneration. SUMMARY OF THE LITERATURE REVIEW: Recently, there have been many studies on the correlations between the changes of lumbar disc degeneration and associated factors, such as age, gender, weight, occupation, cigarette smoking, and genetics; but, it is hard to find research into lumbosacral sagittal alignments. MATERIALS AND METHODS: This study enrolled 117 young adult patients limited by age (18-35 years), BMD (<30kg/m2), no smoking, occupation except heavy worker, no prior lumbar surgery and no combined spinal deformity. By measuring the pelvic incidence, sacral slope, lumbar tilt angle, lumbar lordosis and lumbar axis indicating the parameters of sagittal alignments, we investigated the correlation between the number and severity of lumbar disc degeneration and the number of herniated intervertebral discs. RESULTS: This study found a moderate correlation between pelvic incidence, sacral slope, lumbar lordosis, and the number of lumbardegenerative disc (r=-0.451, p<0.001; r=-0.433, p<0.001; r=-0.425, p<0.001). We calculated the most proper cut-off value of pelvic incidence associated with more than three segments of multiple lumbar disc degeneration, using a minimum p-value approach. CONCLUSIONS: As pelvic incidence, sacral slope, and lumbar lordosis indicating the parameters of lumbosacral sagittal alignments get smaller, the numbers of lumbar disc degenerations and herniated intervertebral discs increase. When pelvic incidence is below 45.6 degrees, it is more likely for degenerative changes of lumbar disc to affect more than three segments.

A Surgical Option for Multilevel Anterior Lumbar Interbody Fusion with Ponte Osteotomy to Achieve Optimal Lumbar Lordosis and Sagittal Balance

OBJECTIVE: To document lumbar lordosis (LL) of the spine and its change during surgeries with the different height but the same angle setting of the anterior cage. Additionally, we attempted to determine if sufficient LL is achieved at different cage heights and to quantify the change in LL during multi-level anterior lumbar interbody fusion (ALIF). METHODS: The medical records and radiographs of 42 patients who underwent more than 2 level ALIFs between 2008 and 2009 were retrospectively reviewed. We evaluated 3 parameters seen on lateral whole spine radiographs : LL, pelvic incidence (PI), and sagittal vertical axis (SVA). The mean follow-up time was 28.1 months and the final follow-up radiographs of all patients were reviewed at least 2 years after surgery. Statistical analysis was performed using the paired t-tests. RESULTS: Lumbar lordosis had changed up to 30 degrees immediately and 2 years after surgery (preoperative mean LL, SVA : 22.45 degrees, 112.31 mm; immediate postoperative mean LL, SVA : 54.45 degrees, 37.36 mm; final follow-up mean LL, SVA : 49.56 degrees, 26.95 mm). Our goal of LL is to obtain as much PI as possible, preoperative mean PI value was 55.38+/-3.35. The pre-operative and two year post-surgery follow-up mean of the Japanese Orthopedic Association score were 9.2+/-0.6 and 13.2+/-0.6 (favorable outcome rate : 95%), respectively. In addition, we were able to obtain good clinical outcomes and sagittal balance with a subsidence rate of 22.7%. CONCLUSION: We were able to achieve sufficient LL, such that it was similar to the PI, utilizing multi-level ALIF with the use of a tall cage with the same angle setting of the cage. We have found out that achieving sufficient lumbar lordosis and sagittal balance require an anterior lumbar cage with high angle and height.

Correlation of Pelvic Parameters with Isthmic Spondylolisthesis

STUDY DESIGN: A retrospective radiological evaluation. PURPOSE: To verify that PI is related with progression of IS as well as development of IS and to assess the differences of pelvic parameters between the L4 & L5 IS, as well as between single & two level IS. OVERVIEW OF LITERATURE: High pelvic incidence (PI) has been known to be related with development of IS. However, the previous studies were limited to just L5 spondylolisthesis or there was no differentiation between L4 & L5 spondylolisthesis METHODS: Sixty five IS patients and 30 persons as a control group participated the study. Among the 65 patients, 30 had L4 IS, 30 had L5 IS and 5 had bi-level IS. We used the whole spine lateral radiographs to measure the slip percentage, the pelvic tilt (PT) and the pelvic incidence (PI), and we compared them between the normal control group and the IS patients, as well as between single-level and bi-level spondylolisthesis, and we investigated the correlation between the degree of slip of spondylolisthesis and the pelvic parameters. RESULTS: The averages of the PT, PI and lumbar lordosis (LL) in the control group and the IS group were 11.0degrees vs 21.4degrees (p0.05). On comparison between the single-level IS group and the bilevel IS group, there was a significant difference of the PT and PI (p<0.05), and the slip percentage had a correlation with only the PI among all the pelvic parameters (Spearman's r=0.293, p=0.023). There was a significant correlation of the degree of slip with the PI for the L5 single level IS, but not with the L4 single level IS (r=0.362, p=0.05). CONCLUSIONS: The high pelvic incidence can be a factor of L4 & L5 spondylolysis and it may have an influence on the slip progression in patients with L5 isthmic spondylolisthesis, but not on the slip progression in patients with L4 IS. Yet other factors seem to have an influence on the slip progression in patients with L4 isthmic spondylolisthesis.

Significance of Pelvic Incidence in the Development of Abnormal Sagittal Alignment / 대한정형외과학회잡지

PURPOSE: Under the assumption that the pelvic incidence influences the development of an abnormal curvature, this study examined the relationship between the pelvic incidence and the development of an abnormal curvature. MATERIALS AND METHODS: Twenty-two adults with a normal curvature and seventy-nine adults with an abnormal curvature were enrolled in this study. All subjects were older than fifty years of age at the time of the study. The patients were classified based on the alignment of the spine and the strategic vertebrae as follows: extension of the lordosis of the lumbar spine to the upper part of the thoracolumbar transitional portion (Group 1), kyphosis on the lower lumbar area but an extension of the lordosis from the upper lumbar area to the upper part of the thoracolumbar transitional portion (Group 2), extension of the kyphosis from the thoracic spine to the lower lumbar area (Group 3), the presence of lordosis on the lower lumbar portion but an extension of the kyphosis from the upper lumbar portion to the upper portion of the thoracolumbar area (Group 4). In each group, the interrelationship between the sagittal alignment, pelvic tilt, sacral slope and pelvic incidence were evaluated, and the changes in the numerical figures were compared and analyzed. RESULTS: In the normal group the average pelvic incidence was 52.5 degrees. The average pelvic incidence was higher in groups 1 and 2 (61.6 and 58.5 degrees, respectively) than in groups 3 and 4 (44.5 and 47.2 degrees, respectively) (p<0.001). The average sacral slope was 31.5 in the normal group, 34.5 in group 1, 25.1 in group 4, 20.1 in group 2, and 9.2 in group 3. In groups 1 and 2, group 2 showed a lower sacral slope compared with group 1 (p<0.001). In groups 3 and 4, group 4 had a larger sacral slope than group 3 (p<0.001). The average pelvic tilt was 21 in the normal group. Groups 2 and 3 showed a larger pelvic tilt (38.4 and 35.3, respectively) than that of groups 1 and 4 (27.1 and 22.1, respectively). CONCLUSION: In the elderly with an abnormal lordotic curve, the sagittal alignment of the spine is associated with the pelvic tilt, sacral slope and pelvic incidence, in a similar manner to that in normal adults with a normal lordotic curve. Therefore, measuring these figureswould help in making an estimate of the perspective changes in the sagittal alignment of spine.

Analysis of sagittal parameters in L_5～S_1 insthmic spondylolisthesis / 中国矫形外科杂志

[Objective]To investigate the correlation of sagittal parameters in L5~S1 isthmic spondylolisthesis and its clinical manifestation.[Method]Seventy-six patients with L5~S1 isthmic spondylolisthesis were treated between January 2000 and December 2005,there were 32 males and 44 females with the age between 12 and 68 years.The lateral standing radiographs of the spine and pelvis were analyzed retrospectively.Radiographic parameters measured including pelvic incidence(PI),sacral slope(SS),lumbar lordosis(LL),lumbosacral angle(LSA)and grade of spondylolisthesis.All measurements were done by the same individual and compared to those of a cohort of 30 normal subjects.Students test was used to compare the parameters between the curve types and Pearsons correlation coefficients were used to investigate the association between all parameters(P

Radiologic Measurement of Pelvic Sagittal Incidence and Lordosis in Young Korean Women / 대한정형외과학회잡지

PURPOSE: To determine the normative data for the pelvic morphology parameters in the young Korean female population. MATERIALS AND METHODS: Young Korean female patients in 20s and 30s who had visited the outpatient clinic for a first attack acute sprain underwent a telephone interview at a minimum of 1 year after their last hospital visit. Those who had recovered completely and had no back-related complaints were selected for the pelvic lordosis angle (PRS1)and pelvic angle of incidence (AOI)measurements (n=40 each age group). RESULTS: There was no age difference in both parameters. The PRS1 in the young female population was 38.7+/-8.3 degrees (range: 13.6-52.9 degrees and the AOI was 48.5 +/-9.4 degrees(range: 30.5-74.7 degrees, which shows a close correlation between the two parameters (correlation coefficient, r=-0.965). The linear regression equation obtained is as follow; Equation I: PRS1=79.909-0.850 x AOI, Equation II: AOI=90.902-1.096xPRS1 (linear regression analysis, p=0.000, R2 =0.931). CONCLUSION: The data obtained from the study may be used for future studies related to the sagittal spinopelvic balance.