Durbas Atahan, Subramanian Tejas, Simon Chad, Allen Myles R J, Samuel Justin, Colón Luis Felipe, Mazzucco Michael R, Pagan Cale, Karasavvidis Theofilos, Vigdorchik Jonathan, Cunningham Matthew E, Kim Han Jo, Lovecchio Francis C
Department of Spine Surgery, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021, USA.
Weill Cornell Medical College, 1300 York Ave, New York, NY 10021, USA.
J Clin Med. 2025 Apr 24;14(9):2952. doi: 10.3390/jcm14092952.
: Sagittal spinal alignment goals for adult spinal deformity (ASD) surgery are predominantly derived from standing radiographs, despite the biomechanical relevance of sitting posture. Existing studies on sitting alignment involve young, healthy cohorts, which poorly represent ASD patients. This study assessed posture-dependent changes in spinopelvic parameters, including pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and lumbar lordosis (LL), and examined how age, BMI, and gender influence these changes. In this retrospective cohort study, sitting and standing lateral radiographs of 1447 patients were evaluated. Spinopelvic parameters were measured, and changes (ΔPI, ΔPT, ΔSS, and ΔLL) were calculated. Multiple regression analysis was used to determine associations between these changes and age, BMI, and gender. : All parameters differed significantly between positions ( < 0.001); PT and PI increased in sitting (ΔPT = -19.20°; ΔPI = -4.52°), while SS and LL increased in standing (ΔSS = 14.67°; ΔLL = 18.44°). Older age correlated with increased ΔPT ( < 0.001) and ΔPI ( = 0.049) but reduced ΔLL and ΔSS ( < 0.001). Higher BMI was associated with decreased ΔPI, ΔPT, and ΔLL ( < 0.001, 0.003, and 0.025). Females showed greater ΔPT ( = 0.013) but smaller ΔPI, ΔSS, and ΔLL ( = 0.043, <0.001, and 0.001). : Spinopelvic parameters vary significantly between sitting and standing positions, affected by age, BMI, and gender. The observed PI change suggests SIJ involvement, highlighting the need for posture-specific and demographic-adjusted alignment goals in ASD surgery to optimize outcomes.
成人脊柱畸形（ASD）手术的矢状面脊柱对线目标主要源自站立位X线片，尽管坐姿具有生物力学相关性。现有的关于坐姿对线的研究涉及年轻、健康的队列，不能很好地代表ASD患者。本研究评估了包括骨盆入射角（PI）、骨盆倾斜角（PT）、骶骨倾斜角（SS）和腰椎前凸（LL）在内的脊柱骨盆参数随姿势的变化，并研究了年龄、体重指数（BMI）和性别如何影响这些变化。在这项回顾性队列研究中，对1447例患者的坐姿和站立位侧位X线片进行了评估。测量了脊柱骨盆参数，并计算了变化量（ΔPI、ΔPT、ΔSS和ΔLL）。采用多元回归分析来确定这些变化与年龄、BMI和性别的关联。所有参数在不同体位间均有显著差异（<0.001）；坐姿时PT和PI增加（ΔPT = -19.20°；ΔPI = -4.52°），而站立时SS和LL增加（ΔSS = 14.67°；ΔLL = 18.44°）。年龄较大与ΔPT增加（<0.001）和ΔPI增加（= 0.049）相关，但与ΔLL和ΔSS减少（<0.001）相关。较高的BMI与ΔPI、ΔPT和ΔLL降低相关（<0.001、0.003和0.025）。女性的ΔPT更大（= 0.013），但ΔPI、ΔSS和ΔLL更小（= 0.043、<0.001和0.001）。脊柱骨盆参数在坐姿和站立位之间有显著差异，受年龄、BMI和性别的影响。观察到的PI变化提示骶髂关节受累，强调在ASD手术中需要针对特定姿势和根据人口统计学调整的对线目标以优化手术效果。
