Chen Feng, Shen Jian-xiong, Qiu Gui-xing
Department of Orthopedic Surgery, Peking Union Medical College Hospital, Beijing 100730, China.
Zhonghua Yi Xue Za Zhi. 2013 Feb 19;93(7):487-90.
To explore the features of pelvic parameters in patients with adolescent idiopathic scoliosis (AIS) and the relationships with spinal sagittal parameters and evaluate their roles in sagittal balance.
A total of 112 AIS patients from March 2007 to February 2011 were recruited. Six parameters were evaluated from lateral standing radiographs:pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL), thoracic kyphosis (TK) and sagittal vertical axis (SVA). Pearson's correlation was used to determine the relationship between the above parameters and t-test applied to compare the differences between the subgroups: (1) by the major curve types in coronal plane (primary thoracic curve vs. primary lumbar curve); (2) by the value of SVA (positive vs. negative).
The values of PI and SS in our cohort were 47.2° and 39.4° and they were lower than those in Caucasians as previously reported. PI was correlated with SS, PT and LL (r = 0.562, 0.773 and 0.278 respectively); TK not correlated with pelvic parameters (PI, PT and SS). SVA correlated with both spinal (TK, LL) and pelvic parameters (PI, PT). In the subgroup analyses, the values of PI and SS were significantly higher in the primary thoracic curve subgroup than those in the primary lumbar curve subgroup (49.4° vs 45.1°, 41.0° vs 38.0°). The values of PI and PT were distinctively higher in the positive SVA subgroup than those in the negative SVA subgroup (54.6° vs 45.6°, 14.3° vs 6.2°).
Ethnic differences exist in the main pelvic parameters and their values are lower in Chinese than in Caucasians. There are also differences among different types of AIS. The values of main pelvic parameters are higher in AIS patients with a primary thoracic curve than in those with a primary lumbar curve. Pelvic parameters play an important role in maintaining a sagittal balance. The main pelvic parameters have influences on sagittal lumbar configuration but little on thoracic segment. A high PI value leads to a forward lean in torso with an increased PT as a result of compensation and vice versa. The alteration of PT is a major compensatory pattern of pelvis. The features of pelvic parameters should be considered during surgical planning.
探讨青少年特发性脊柱侧凸（AIS）患者骨盆参数的特征及其与脊柱矢状面参数的关系，并评估其在矢状面平衡中的作用。
招募了2007年3月至2011年2月期间的112例AIS患者。从站立位全脊柱侧位X线片上评估6项参数：骨盆入射角（PI）、骶骨倾斜角（SS）、骨盆倾斜角（PT）、腰椎前凸角（LL）、胸椎后凸角（TK）和矢状垂直轴（SVA）。采用Pearson相关性分析确定上述参数之间的关系，并采用t检验比较亚组间差异：（1）根据冠状面主要弯曲类型（胸主弯与腰主弯）；（2）根据SVA值（正值与负值）。
本队列中PI和SS值分别为47.2°和39.4°，低于先前报道的白种人。PI与SS、PT和LL相关（r分别为0.562、0.773和0.278）；TK与骨盆参数（PI、PT和SS）无关。SVA与脊柱参数（TK、LL）和骨盆参数（PI、PT）均相关。在亚组分析中，胸主弯亚组的PI和SS值显著高于腰主弯亚组（49.4°对45.1°，41.0°对38.0°）。SVA正值亚组的PI和PT值明显高于SVA负值亚组（54.6°对45.6°，14.3°对6.2°）。
骨盆主要参数存在种族差异，中国人的这些参数值低于白种人。不同类型的AIS之间也存在差异。胸主弯AIS患者的主要骨盆参数值高于腰主弯患者。骨盆参数在维持矢状面平衡中起重要作用。主要骨盆参数对腰椎矢状面形态有影响，但对胸椎节段影响较小。高PI值导致躯干前倾，PT代偿性增加，反之亦然。PT的改变是骨盆的主要代偿模式。手术规划时应考虑骨盆参数的特征。
