Legaye Jean
Orthopaedic Surgery Department, University Hospital Mont-Godinne, 5530 , Yvoir, Belgium.
Eur Spine J. 2007 Feb;16(2):219-25. doi: 10.1007/s00586-006-0090-3. Epub 2006 Mar 17.
The sagittal pelvic morphology modulates the individual alignment of the spine. Anatomical angular parameters were described as follows: the "Pelvic Incidence" (PI) and the Jackson's angle "Pelvic Lordosis" (PR-S1). Significant chains of relationships were expressed connecting these angles with pelvic and spinal positional parameters. This allows an individual assessment of the harmony of the sagittal spinal balance. But in case of spondylolysis with high-grade listhesis, the upper plate of the sacrum shows a dome-shaped deformity. The previous anatomical parameters are therefore imprecise. Indeed, the anterior part of the sacrum being inaccurate, an exact assessment of these angles becomes impossible. Therefore, we propose a new angular parameter named "Femoro-Sacral Posterior Angle" (FSPA): the angle between the posterior wall of the first sacral vertebra, always well definite, and the line connecting the posterior part of the sacral plate to the femoral axis. The validation of this parameter was performed and compared with the classical published parameters. It showed good inter-observer reliability, even with dome-shaped sacral plate. In spite of lower correlation with the positional parameters than those observed with PI or PR-S1, the FSPA appeared to be reliable and precise for an exact evaluation of the sagittal spino-pelvic balance is case of spondylo-listhesis with dome-shaped sacral endplate.
骨盆矢状面形态调节脊柱的个体排列。解剖学角度参数描述如下：“骨盆倾斜度”（PI）和杰克逊角“骨盆前凸”（PR-S1）。这些角度与骨盆和脊柱位置参数之间存在显著的关系链。这使得能够对矢状面脊柱平衡的协调性进行个体评估。但在伴有高度滑脱的椎弓根峡部裂病例中，骶骨上终板呈圆顶状畸形。因此，先前的解剖学参数并不精确。实际上，由于骶骨前部不准确，无法对这些角度进行精确评估。因此，我们提出了一个新的角度参数，称为“股骨-骶骨后角”（FSPA）：第一骶椎后壁（总是明确的）与连接骶骨终板后部与股骨干轴线的直线之间的夹角。对该参数进行了验证，并与已发表的经典参数进行了比较。结果显示，即使在骶骨终板呈圆顶状的情况下，观察者间的可靠性也很好。尽管与位置参数的相关性低于PI或PR-S1，但FSPA在伴有圆顶状骶骨终板的腰椎滑脱病例中，对于精确评估矢状面脊柱-骨盆平衡似乎是可靠且精确的。
