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. 2018 Jun 14:13:10.
doi: 10.1186/s13013-018-0156-0. eCollection 2018.

Sagittal plane assessment of spino-pelvic complex in a Central European population with adolescent idiopathic scoliosis: a case control study

Máté Burkus  1   2 , Ádám Tibor Schlégl  1 , Ian O'Sullivan  1 , István Márkus  1 , Csaba Vermes  1 , Miklós Tunyogi-Csapó  1
Affiliations

Sagittal plane assessment of spino-pelvic complex in a Central European population with adolescent idiopathic scoliosis: a case control study

Máté Burkus et al. Scoliosis Spinal Disord. .

Abstract

Background: Scoliosis is a complex three-dimensional deformity. While the frontal profile is well understood, increasing attention has turned to balance in the sagittal plane. The present study evaluated changes in sagittal spino-pelvic parameters in a large Hungarian population with adolescent idiopathic scoliosis.

Methods: EOS 2D/3D images of 458 scoliotic and 69 control cases were analyzed. After performing 3D reconstructions, the sagittal parameters were assessed as a whole and by curve type using independent sample t test and linear regression analysis.

Results: Patients with scoliosis had significantly decreased thoracic kyphosis (p < 0.001) with values T1-T12, 34.1 ± 17.1o vs. 43.4 ± 12.7o in control; T4-T12, 27.1 ± 18.8o vs. 37.7 ± 15.1o in control; and T5-T12, 24.9 ± 15.8o vs. 32.9 ± 15.0o in control. Changes in thoracic kyphosis correlated with magnitude of the Cobb angle (p < 0.001). No significant change was found in lumbar lordosis and the pelvic parameters. After substratification according to the Lenke classification and individually evaluating subgroups, results were similar with a significant decrease in only the thoracic kyphosis. A strong correlation was seen between sacral slope, pelvic incidence, and lumbar lordosis, and between pelvic version and thoracic kyphosis in control and scoliotic groups, whereas pelvic incidence was also seen to be correlated with thoracic kyphosis in scoliosis patients.

Conclusion: Adolescent idiopathic scoliosis patients showed a significant decrease in thoracic kyphosis, and the magnitude of the decrease was directly related to the Cobb angle. Changes in pelvic incidence were minimal but were also significantly correlated with thoracic changes. Changes were similar though not identical to those seen in other Caucasian studies and differed from those in other ethnicities. Scoliotic curves and their effect on pelvic balance must still be regarded as individual to each patient, necessitating individual assessment, although changes perhaps can be predicted by patient ethnicity.

Keywords: Adolescent idiopathic scoliosis; EOS 2D/3D; Sagittal alignment; Spino-pelvic parameters.

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Conflict of interest statement

Our work on human beings complies with the principles laid down in the Declaration of Helsinki. In the case of retrospective analysis of de-identified patient records, further ethical approval was not necessary according to Article 1997. CLIV. 157. § of the Hungarian Government and the 23/2002 (V.9.) regulation of the Hungarian Ministry of Health.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
EOS 3D reconstruction. EOS scan and 3D reconstruction of a 16-year-old female patient with AIS. Cobb angle 67°; Lenke classification, 1AN
Fig. 2
Fig. 2
Measured spine parameters. The left picture shows the line of the superior endplate of the upper vertebra of the scoliotic curve and the line of the inferior end plate of the lower vertebra of the curve; the complementary angle of these lines is the Cobb angle The right picture shows the sagittal parameters. The kyphosis and lordosis parameters are defined as the angle between the superior endplate of the upper vertebra and inferior endplate surface of the lower vertebra
Fig. 3
Fig. 3
Measured pelvic parameters. From left to right: pelvic tilt, sacral slope, and pelvic incidence
See this image and copyright information in PMC

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