Abstract

Purpose

To evaluate the 3D deformity of the acetabula and lower limbs in subjects with adolescent idiopathic scoliosis (AIS) and their relationship with spino-pelvic alignment.

Methods

Two hundred and seventy-four subjects with AIS (frontal Cobb: 33.5° ± 18° [10°–110°]) and 84 controls were enrolled. All subjects underwent full-body biplanar X-rays with subsequent 3D reconstructions. Classic spino-pelvic and lower limb parameters were collected as well as acetabular parameters: acetabular orientation in the 3 planes (tilt, anteversion and abduction), center–edge angle (CEA) and anterior and posterior sector angles. Subjects with AIS were represented by both lower limb sides and classified by elevated (ES) or lowered (LS), depending on the frontal pelvic obliquity. Parameters were then compared between groups. Determinants of acetabular and lower limb alterations were investigated among spino-pelvic parameters.

Results

Acetabular abduction was higher on the ES in AIS (59.2° ± 6°) when compared to both LS (55.6° ± 6°) and controls (57.5° ± 3.9°, p < 0.001). CEA and acetabular anteversion were higher on the LS in AIS (32° ± 6.1°, 20.5° ± 5.7°) when compared to both ES (28.7° ± 5.1°, 19.8° ± 5.1°) and controls (29.8° ± 4.8°, 19.1° ± 4°, respectively, p < 0.001). Anterior sector angle was lower on both ES and LS in AIS when compared to controls. CEA, acetabular abduction and acetabular anteversion were found to be mostly determined (adjusted R²: 0.08–0.32) by pelvic tilt and less by frontal pelvic obliquity, frontal Cobb and T1T12.

Conclusions

Subjects with AIS had a more abducted acetabulum at the lowered side, more anteverted acetabulum and a lack of anterior coverage of both acetabula. These alterations were strongly related to pelvic tilt.

中文翻译：

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青少年特发性脊柱侧弯 3D 髋臼和下肢参数的改变。

摘要

目的

评估青少年特发性脊柱侧凸 (AIS) 受试者的髋臼和下肢 3D 畸形及其与脊柱-骨盆排列的关系。

方法

纳入了 274 名 AIS 受试者（额叶 Cobb：33.5° ± 18° [10°–110°]）和 84 名对照者。所有受试者均接受全身双平面 X 射线检查，并随后进行 3D 重建。收集经典的脊柱骨盆和下肢参数以及髋臼参数：3 个平面的髋臼方向（倾斜、前倾和外展）、中心边缘角 (CEA) 以及前扇区和后扇区角。患有 AIS 的受试者以双下肢为代表，并根据骨盆前倾角分为升高 (ES) 或降低 (LS)。然后比较各组之间的参数。在脊柱骨盆参数中研究了髋臼和下肢改变的决定因素。

结果

与 LS (55.6° ± 6°) 和对照组 (57.5° ± 3.9°, p  < 0.001)相比，AIS 中 ES 的髋臼外展较高 (59.2° ± 6°)。与 ES（28.7°±5.1°、19.8°±5.1°）和对照（29.8°±4.8°）相比，AIS 中 LS 的 CEA 和髋臼前倾角较高（32°±6.1°、20.5°±5.7°） ，分别为 19.1° ± 4°，p  < 0.001）。与对照组相比，AIS 中 ES 和 LS 的前房角均较低。研究发现，CEA、髋臼外展和髋臼前倾角主要由骨盆倾斜度决定（调整后的R ^{2 ：0.08-0.32），较少由额骨盆倾斜度、额骨 Cobb 和 T1T12 决定。}

结论

患有 AIS 的受试者在较低的一侧有更多的外展髋臼，更多的前倾髋臼并且缺乏两个髋臼的前部覆盖。这些变化与骨盆倾斜密切相关。