Abstract

Purpose

To elucidate whether specific spinopelvic morphologies affect the subsequent spinal sagittal alignments and determine the alignment patterns.

Methods

Whole-spine standing radiographs of 244 patients were analyzed. Sagittal alignment parameters were compared according to the three types of pelvic version: anteverted pelvis (AP), neutral pelvis, and retroverted pelvis (RP), grouped per the amount of pelvic tilt (PT) and the ratio of sacral slope to pelvic incidence (PI). Incidence angles of inflection points (IAIPs) were defined as the angle between a line from the center of the femoral heads through the midpoint of the sacral superior endplate and a line perpendicular to each L1, T1 superior endplate, C2 inferior endplate, and the C1 ring, respectively.

Results

C1 incidence equaled to the geometrical sum from the pelvis to the C1 vertebra; it also equaled the sum of the C1 slope and PT (p < 0.001). Moving from the AP group to the RP group, there were progressive increases in PT, PI, and IAIPs and decreases in LL, and SS/PI (p < 0.001). Negative correlation was observed between the pelvic anteversion and the IAIPs, and a significant positive correlation was observed between the pelvic retroversion and the IAIPs.

Conclusion

IAIPs are novel PI-relevant radiographic parameters reflecting the relationship between the pelvis and the spinal alignment. An anteverted pelvis requires more lumbar lordosis than pelvic incidence and aligns with low IAIPs, and a retroverted pelvis requires less lumbar lordosis than pelvic incidence and aligns with high IAIPs.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.

中文翻译：

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脊柱骨盆形态对矢状脊柱排列的影响：拐点入射角的分析

摘要

目的

为了阐明特定的脊柱骨盆腔形态是否会影响随后的脊柱矢状位并确定其排列方式。

方法

分析了244例患者的全脊柱站立X线照片。根据三种类型的骨盆版本比较矢状面对齐参数：反骨盆（AP），中性骨盆和逆行骨盆（RP），按骨盆倾斜量（PT）和骨斜率与骨盆发生率的比率分组（ PI）。拐点的入射角定义为从股骨头中心到from上终板中点的直线与垂直于每个L1，T1上终板，C2下终板和C1的直线之间的夹角分别响。

结果

C1入射等于从骨盆到C1椎骨的几何和；它也等于C1斜率与PT之和（p  <0.001）。从AP组转移到RP组，PT，PI和IAIP逐渐增加，而LL和SS / PI降低（p  <0.001）。骨盆前倾与IAIP之间存在负相关，而骨盆逆行与IAIP之间存在显着的正相关。

结论

IAIPs是新颖的PI相关的放射学参数，反映了骨盆和脊柱排列之间的关系。骨盆翻倒需要比骨盆的发病率高的腰椎前凸，并与低IAIP对齐；而骨盆逆行比骨盆的发病率需要的腰椎前凸少，并与高IAIP对齐。

图形摘要

这些幻灯片可以在电子补充材料下找到。