Tanaka Nobuki, Ohba Tetsuro, Oda Kotaro, Takei Hayato, Mizukami Kai, Go Goto, Haro Hirotaka
Department of Orthopaedics Surgery, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3898, Japan.
Eur Spine J. 2025 Mar 11. doi: 10.1007/s00586-025-08769-1.
The present study aimed to analyze the preoperative degeneration of the sacroiliac joint (SIJ) and its involvement in postoperative pelvic incidence (PI) change.
Data from consecutive patients who underwent corrective surgery for adult spinal deformity (ASD) were included in this study. Pre- and early postoperative full-standing radiographs and preoperative pelvic computed tomography (CT) images were examined. Spinopelvic parameters were measured from full-standing radiographs, whereas SIJ degeneration was evaluated from pelvic CT images. We then compared preoperative and postoperative spinopelvic parameters, focusing on PI change, and investigated whether spinopelvic parameters and SIJ degeneration affected PI change.
Data from 122 patients (mean age, 71.8 years) were analyzed, with the mean number of fixed vertebrae being 10.2. Postoperative PI decreased significantly by 3.2° (from 50.8° to 47.6°; P < 0.0001). After confirming the presence of SIJ degeneration based on preoperative CT, we found that 39, 38, 49, 98, and 54 patients had osteophytes, sclerosis, bridging bone, articular gas, and SIJ subluxation, respectively. No significant association was observed between sclerosis, osteophyte formation, bony bridging, or articular gas and postoperative PI change, although a significantly greater decrease in postoperative PI was observed among those with SIJ subluxation (P = 0.0035). PI change only correlated with preoperative PI (P < 0.001, R = - 0.56).
PI decreased significantly after ASD surgery. We found that several patients showed SIJ subluxation before ASD surgery. PI change after ASD surgery was significantly associated with preoperative PI value and SIJ subluxation.
本研究旨在分析骶髂关节（SIJ）的术前退变情况及其对术后骨盆倾斜角（PI）变化的影响。
本研究纳入了连续接受成人脊柱畸形（ASD）矫正手术患者的数据。检查了术前和术后早期的全站立位X线片以及术前骨盆计算机断层扫描（CT）图像。从全站立位X线片测量脊柱骨盆参数，而从骨盆CT图像评估SIJ退变情况。然后我们比较术前和术后的脊柱骨盆参数，重点关注PI变化，并研究脊柱骨盆参数和SIJ退变是否影响PI变化。
分析了122例患者（平均年龄71.8岁）的数据，平均固定椎体数为10.2个。术后PI显著降低了3.2°（从50.8°降至47.6°；P < 0.0001）。在根据术前CT确认存在SIJ退变后，我们发现分别有39、38、49、98和54例患者存在骨赘、硬化、骨桥形成、关节积气和SIJ半脱位。虽然在SIJ半脱位患者中观察到术后PI的下降幅度明显更大（P = 0.0035），但未观察到硬化、骨赘形成、骨桥或关节积气与术后PI变化之间存在显著关联。PI变化仅与术前PI相关（P < 0.001，R = -0.56）。
ASD手术后PI显著降低。我们发现部分患者在ASD手术前存在SIJ半脱位。ASD手术后的PI变化与术前PI值和SIJ半脱位显著相关。
