The role of sagittal pelvic morphology in the development of adult degenerative scoliosis

被引:11
|
作者
de Reuver, Steven [1 ]
van der Linden, Philip P. [1 ]
Kruyt, Moyo C. [1 ]
Schlosser, Tom P. C. [1 ]
Castelein, Rene M. [1 ]
机构
[1] Univ Med Ctr Utrecht, Dept Orthopaed Surg, G05-228,POB 85500, NL-3508 GA Utrecht, Netherlands
关键词
Adult degenerative scoliosis; Sagittal pelvic morphology; Spino-pelvic alignment; Pelvic incidence; Sex-age matched controls; SHEAR LOADS; ALIGNMENT; SPINE; GROWTH; PATHOGENESIS; DORSAL;
D O I
10.1007/s00586-021-06924-y
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Purpose Pelvic morphology dictates the alignment and biomechanics of the spine. Recent observations in different types of adolescent idiopathic scoliosis indicate that individual pelvic morphology is related to the spinal levels in which scoliosis develops: primary lumbar adolescent scoliosis is associated with a higher pelvic incidence (PI) than thoracic scoliosis and non-scoliotic controls. We hypothesize that adult degenerative scoliosis (ADS) of the lumbar spine follows the same mechanical principles and is associated with a high PI. Methods This study used an existing CT-scan database, 101 ADS patients were sex and age matched to 101 controls. The PI was measured by two observers with multi-planar reconstruction, perpendicular to the hip-axis according to a previously validated technique. Results The PI was 54.1 degrees +/- 10.8 degrees in ADS patients and 47.7 degrees +/- 10.8 degrees in non-scoliotic controls (p < 0.001). The median ADS curve apex was the disc L2-3 and median curve length was 4 vertebral levels. The mean supine Cobb angle was 21 degrees +/- 8 degrees (ranged 10 degrees-47 degrees). There was no significant correlation between PI and the apex level (p = 0.883), the curve length (p = 0.418) or the Cobb angle (p = 0.518). Conclusions ADS normally develops de novo in the lumbar spine of patients with a higher PI than controls, similar to primary lumbar adolescent idiopathic scoliosis. This suggests a shared mechanical basis of both deformities. Pelvic morphology dictates spinal sagittal alignment, which determines the segments of the spine that are prone to develop scoliosis.
引用
收藏
页码:2467 / 2472
页数:6
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