Department of Orthopedic Surgery, Hanyang University College of Medicine, Seoul, Republic of Korea.
Department of Orthopaedic Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University, Yangsan Hospital, Yangsan, Republic of Korea.
World Neurosurg. 2021 Nov;155:e621-e629. doi: 10.1016/j.wneu.2021.08.119. Epub 2021 Sep 2.
We investigated the pelvic morphologic factors that determine the degree of pelvic incidence (PI)-lumbar lordosis (LL) mismatch.
Overall, 306 patients were included. The regional and global sagittal parameters were measured. Linear regression analyses were performed for 4 pelvic parameters and PI-LL mismatch. E1 and E2 were defined as linear regression equations between pelvic tilt (PT) and PI-LL mismatch and PI and PI-LL mismatch, respectively. The patients were categorized by cluster analysis using the hierarchal method for the 4 pelvic parameters.
E1 and E2 showed statistical significance; however, the coefficient of determination of E1 was higher than that of E2 (R = 0.675 vs. 0.238; P < 0.01). Sex, LL, E1, and E2 showed significant differences in the regional parameters. The T1 pelvic angle (TPA), spinosacral angle (SSA), and incidence angle of inflection points (IAIPs) showed significant differences in global parameters (P < 0.01). The IAIPs and TPA were low in the anteverted pelvis group and high in the retroverted pelvis group (P < 0.001). The SSA was low in the small pelvis group and high in the large pelvis group (P < 0.001). The proportion of women in the large pelvis group (93%) was significantly higher than that in the other groups (P < 0.01).
The individual differences between the PI and LL values can be more accurately determined using the individual PT, and the optimal PT amount will differ depending on the pelvis shape. The increase in the TPA and IAIPs corresponded to the PT, and the SSA increased in accordance with the pelvic size.
研究决定骨盆入射角（PI）-腰椎前凸（LL）不匹配程度的骨盆形态学因素。
共纳入 306 例患者。测量局部和整体矢状参数。对 4 项骨盆参数和 PI-LL 不匹配进行线性回归分析。E1 和 E2 分别为骨盆倾斜（PT）与 PI-LL 不匹配和 PI 与 PI-LL 不匹配之间的线性回归方程。使用层次聚类分析方法对 4 项骨盆参数对患者进行分类。
E1 和 E2 具有统计学意义；然而，E1 的决定系数高于 E2（R=0.675 比 0.238；P<0.01）。性别、LL、E1 和 E2 在局部参数中存在显著差异。在全局参数中，T1 骨盆角（TPA）、骶骨角（SSA）和拐点入射角（IAIPs）存在显著差异（P<0.01）。IAIPs 和 TPA 在前倾骨盆组中较低，在后倾骨盆组中较高（P<0.001）。SSA 在小骨盆组中较低，在大骨盆组中较高（P<0.001）。大骨盆组中女性的比例（93%）明显高于其他组（P<0.01）。
使用个体 PT 可以更准确地确定 PI 和 LL 值之间的个体差异，并且最佳 PT 量将根据骨盆形状而有所不同。TPA 和 IAIPs 的增加与 PT 相对应，而 SSA 则随着骨盆大小的增加而增加。
