Choi Sung Hoon, Son Seung Min, Lee Dong-Ho, Lee Choon Sung, Shin Won Chul, Hong Chul Gie, Lee Jung Sub, Hwang Chang Ju
Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Busan Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul Department of Orthopedic Surgery, Kangwon National University, Chuncheon Department of Orthopedic Surgery, Pusan National University School of Medicine, Busan, Korea.
Medicine (Baltimore). 2018 Jul;97(30):e11668. doi: 10.1097/MD.0000000000011668.
Retrospective study.To investigate the radiologic and geometrical association between L1 incidence (L1I) with pelvic incidence/lumbar lordosis (PI/LL) mismatch and T1 incidence (T1I) with PI/LL/thoracic kyphosis (TK) mismatch.The relationship between PI and LL is not clear, and it might be because of the absence of a direct radiologic parameter to represent PI/LL mismatch. To the best of our knowledge, this is the first report on a direct radiologic parameter for representing PI/LL mismatch.This study is a retrospective review of 146 patients who underwent anteroposterior and lateral standing radiographs of the whole spine. L1I was defined as the angle between the line perpendicular to the L1 upper endplate and the line connecting the midpoint of the sacral endplate to the center of both femoral heads. T1I was defined as the angle between the line perpendicular to the T1 upper endplate and the line connecting the midpoint of the sacral endplate to the center of both femoral heads. Both were validated using the Pearson correlation coefficient and linear regression analysis.Radiologically measured L1I and T1I were coterminous with calculated measurements of ΔPI/LL and ΔPI/LL/TK in terms of means and standard deviations, respectively. Excellent correlations were found between L1I and ΔPI/LL, and T1I and ΔPI/LL/TK (R = 0.997, P < .01; R = 0.981, P < .01, respectively). In linear regression analysis, the slope and intercept of L1I were 0.991 and -0.041, with a predictability of 99.4% (R = 0.994), and those of T1I were 0.990 and -0.026, with a predictability of 99.0% (R = 0.990), respectively.L1I and T1I were strongly correlated with PI/LL mismatch and PI/LL/TK mismatch, respectively. L1I and T1I are direct parameters that represent PI/LL mismatch and PI/LL/TK mismatch. They would be useful in analyzing sagittal balance.
Level 3.
回顾性研究。探讨L1发生率（L1I）与骨盆入射角/腰椎前凸（PI/LL）不匹配以及T1发生率（T1I）与PI/LL/胸椎后凸（TK）不匹配之间的放射学和几何学关联。PI与LL之间的关系尚不清楚，这可能是因为缺乏一个直接的放射学参数来表示PI/LL不匹配。据我们所知，这是关于表示PI/LL不匹配的直接放射学参数的首次报告。本研究是对146例行全脊柱前后位和侧位站立位X线片检查患者的回顾性分析。L1I定义为垂直于L1上终板的线与连接骶骨终板中点至双侧股骨头中心的线之间的夹角。T1I定义为垂直于T1上终板的线与连接骶骨终板中点至双侧股骨头中心的线之间的夹角。两者均采用Pearson相关系数和线性回归分析进行验证。放射学测量的L1I和T1I在均值和标准差方面分别与计算得出的ΔPI/LL和ΔPI/LL/TK测量值一致。L1I与ΔPI/LL以及T1I与ΔPI/LL/TK之间均存在极佳的相关性（分别为R = 0.997，P < 0.01；R = 0.981，P < 0.01）。在线性回归分析中，L1I的斜率和截距分别为0.991和 -0.041，预测能力为99.4%（R = 0.994），T1I的斜率和截距分别为0.990和 -0.026，预测能力为99.0%（R = 0.990）。L1I和T1I分别与PI/LL不匹配和PI/LL/TK不匹配密切相关。L1I和T1I是表示PI/LL不匹配和PI/LL/TK不匹配的直接参数。它们在分析矢状面平衡方面将很有用。
3级。
