Format

Send to

Choose Destination

See 1 citation found by title matching your search:

Spine (Phila Pa 1976). 2018 May 15;43(10):681-687. doi: 10.1097/BRS.0000000000002346.

The Lumbar Pelvic Angle, the Lumbar Component of the T1 Pelvic Angle, Correlates With HRQOL, PI-LL Mismatch, and it Predicts Global Alignment.

Author information

1
Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, NY.
2
Deparment of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY.
3
Department of Neurosurgery, University of Virginia Medical Center, Charlottesville, VA.
4
The San Diego Center for Spinal Disorders, San Diego, CA.
5
Department of Neurosurgery, University of California San Francisco Medical Center, San Francisco, CA.
6
Department of Orthopaedic Surgery, University of Kansas Medical Center, Kansas City, KS.
7
Rocky Mountain Scoliosis & Spine, Denver, CO.
8
Department of Orthopaedic Surgery, University of California Davis Medical Center, Davis, CA.
9
Department of Orthopaedic Surgery, Oregon Health and Science University, Portland, OR.

Abstract

STUDY DESIGN:

Prospective multicenter analysis of adult spinal deformity (ASD) patients.

OBJECTIVE:

The aim of this study was to introduce the lumbar pelvic angle (LPA), a novel parameter of spinopelvic alignment.

SUMMARY OF BACKGROUND DATA:

The T1 pelvic angle (TPA), a measure of global spinopelvic alignment, correlates with health-related quality of life (HRQOL), but it may not be measureable on all intraoperative x-rays. In patients with previous interbody fusion at L5-S1, the plane of the S1 endplate can be blurred, creating error in pelvic incidence and lumbar lordosis (PI-LL) measure. The LPA is more readily measured on intraoperative imaging than the TPA.

METHODS:

ASD patients were included with either coronal Cobb angle >20°, sagittal vertical axis (SVA) >5 cm, thoracic kyphosis >60°, or pelvic tilt (PT) >25°. Measures of disability included Oswestry Disability Index (ODI), Scoliosis Research Society (SRS), and Short Form (SF)-36. Baseline and 2-year follow-up radiographic and HRQOL outcomes were evaluated. Linear regressions compared LPA with radiographic parameters and HRQOL.

RESULTS:

A total of 852 ASD patients (407 operative) were enrolled (mean age 53.7). Baseline LPA correlated with PI-LL (r = 0.79), PT (r = 0.78), TPA (r = 0.82), and SVA (r = 0.61) (all P < 0.001). PI-LL, LPA, and TPA correlated with ODI (r = 0.42/0.29/0.45), SF-36 physical component score (-0.43/-0.28/-0.45) SRS (-0.354/-0.23/-0.37) with all P < 0.001. At 2 years' follow-up, LPA correlated with PI-LL (r = 0.77), PT (r = 0.78), TPA (r = 0.83), and SVA (r = 0.57) (all P < 0.001). Categorizing patients by increasing LPA (<7°; 7°-15°; >15°) revealed progressive increases in all HRQOL, PI-LL (-3.2°/12.7°/32.4°), and TPA (9.7°/20.1°/34.6°) with all P < 0.001. Moderate disability (ODI = 40) corresponded to LPA 10.1°, PI-LL 12.6°, and TPA 20.6°. Mild disability (ODI = 20) corresponded to LPA 7.2°, PI-LL 4.2°, and TPA 14.7°.

CONCLUSION:

LPA correlates with TPA, PI-LL, and HRQOL in ASD patients. LPA can be used as an intraoperative tool to gauge correction with a target LPA of <7.2°. LPA predicts global alignment, as it correlates with baseline and 2-year TPA and SVA. Along with the cervical-thoracic pelvic angle and TPA, LPA completes the fan of spinopelvic alignment.

LEVEL OF EVIDENCE:

3.

PMID:
28742755
DOI:
10.1097/BRS.0000000000002346
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wolters Kluwer
Loading ...
Support Center