Sullivan T Barrett, Marino Nikolas, Reighard Fredrick G, Newton Peter O
University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093, USA.
Rady Children's Hospital, San Diego, 3020 Children's Way, MC 5260, San Diego, CA 92123, USA.
Spine Deform. 2018 Sep-Oct;6(5):529-536. doi: 10.1016/j.jspd.2018.02.002.
Retrospective review; literature comparison.
To review the literature on the relationship between lumbar lordosis (LL) and pelvic incidence (PI) and evaluate this relationship in asymptomatic adolescents while testing the validity of previously reported adult correlation models between LL and PI in an adolescent population.
Accurate understanding of the normal spinopelvic relationship is critical when considering surgical fusion of the lumbar spine. Many studies have reported relationships between pelvic measurements and LL in adult populations, but data in pediatric populations is lacking.
A literature search was performed to identify previously reported relationships between pelvic parameters and LL in adults and pediatric patients. A cohort of 125 asymptomatic adolescent patients evaluated at our institution was evenly split into two cohorts for model development and validation. Linear regression between LL and PI was performed. The resultant regression model was tested in the validation cohort along with previously reported formulae with LL as a function of PI. Mean absolute error (MAE) was calculated and compared between prior models and the newly developed adolescent model using analysis of variance and post-hoc testing.
In our adolescent cohort (mean age: 13 ± 2), there was a strong correlation between PI and LL (r = 0.53). Regression analysis in the development cohort produced the following predictive model: LL = 0.66(PI) + 24.2. Testing in the validation cohort revealed a good correlation between predicted and actual LL (r = 0.51) and an MAE of 8.3. All but three previously reported models functioned with similar accuracy in the adolescent population, with only two methods having an MAE over 10.
The majority of previously published formulae for predicting LL as a function of PI developed in adults can be extrapolated to adolescent populations. These relationships are important in understanding how to surgically restore the sagittal alignment in adolescents with spinal deformity.
Level IV.
回顾性研究；文献比较。
回顾关于腰椎前凸（LL）与骨盆入射角（PI）之间关系的文献，并在无症状青少年中评估这种关系，同时检验先前报道的成人LL与PI相关模型在青少年人群中的有效性。
在考虑腰椎手术融合时，准确理解正常的脊柱骨盆关系至关重要。许多研究报道了成人人群中骨盆测量值与LL之间的关系，但儿科人群的数据尚缺。
进行文献检索，以确定先前报道的成人和儿科患者中骨盆参数与LL之间的关系。在我们机构评估的125例无症状青少年患者队列被平均分为两个队列用于模型开发和验证。对LL和PI进行线性回归。在验证队列中测试所得的回归模型以及先前报道的以PI为函数的LL公式。使用方差分析和事后检验计算并比较先前模型与新开发的青少年模型之间的平均绝对误差（MAE）。
在我们的青少年队列（平均年龄：13±2岁）中，PI与LL之间存在强相关性（r = 0.53）。开发队列中的回归分析产生了以下预测模型：LL = 0.66（PI）+ 24.2。在验证队列中的测试显示预测的LL与实际的LL之间具有良好的相关性（r = 0.51），MAE为8.3。除三个模型外，所有先前报道的模型在青少年人群中的功能具有相似的准确性，只有两种方法的MAE超过10。
大多数先前发表的用于预测以PI为函数的LL的公式可以外推到青少年人群。这些关系对于理解如何通过手术恢复脊柱畸形青少年的矢状位对线很重要。
IV级。
