Yamauchi Hideya, Endo Kenji, Sawaji Yasunobu, Nishimura Hirosuke, Yamamoto Kengo
Orthopedic Surgery, Tokyo Medical University, Tokyo, JPN.
Cureus. 2025 May 6;17(5):e83612. doi: 10.7759/cureus.83612. eCollection 2025 May.
In spine surgery, understanding the balance between sagittal and coronal planes, taking both spinal alignment and pelvic orientation into account, is crucial. The purpose of this study was to clarify the influence of pelvic incidence (PI) on spinopelvic parameters in patients with degenerative lumbar scoliosis (DLS) by comparing them to those without DLS.
The subjects were 259 patients (146 men and 113 women, mean age 69.4 years) who underwent surgery in our department between January 2010 and August 2018. The nonscoliosis group (N group, Cobb angle: 0°-9°; n = 161) and the scoliosis group (S group, Cobb angle: 10°-29°; n = 98) were used to compare their spinal alignments.
Regarding the parameters of sagittal spinal alignment, lumbar lordosis (LL) (N group 35.3 ± 12.5°; S group 31.6 ± 14.9°) was significantly smaller (p < 0.05) and PI (N group 46.6 ± 11.6°; S group 52.3 ± 12.1°) and PI-LL (N group 11.8 ± 14.3°; S group 21.0 ± 17.5°) were significantly larger (p < 0.001) in the S group than in the N group. Positive correlations were observed between Cobb angle and sagittal vertical axis (SVA), pelvic tilt (PT), PI, and PI-LL, and a negative correlation was observed between Cobb angle and LL.
The incidence of DLS in middle-aged and older patients is related to PI, and the coronal Cobb angle is positively correlated with PI and PI-LL and is negatively correlated with LL. Coronal deformity could be affected by both pelvic orientation and sagittal spine alignment.
在脊柱手术中，兼顾脊柱矢状面和冠状面平衡并同时考虑脊柱排列和骨盆方向至关重要。本研究的目的是通过将退行性腰椎侧弯（DLS）患者与非DLS患者进行比较，阐明骨盆入射角（PI）对DLS患者脊柱骨盆参数的影响。
研究对象为2010年1月至2018年8月在我科接受手术的259例患者（男性146例，女性113例，平均年龄69.4岁）。将非脊柱侧弯组（N组，Cobb角：0°-9°；n = 161）和脊柱侧弯组（S组，Cobb角：10°-29°；n = 98）用于比较脊柱排列情况。
关于脊柱矢状面排列参数，腰椎前凸（LL）（N组35.3±12.5°；S组31.6±14.9°）在S组中显著更小（p < 0.05），而PI（N组46.6±11.6°；S组52.3±12.1°）和PI-LL（N组11.8±14.3°；S组21.0±17.5°）在S组中显著更大（p < 0.001）。观察到Cobb角与矢状垂直轴（SVA）、骨盆倾斜（PT）、PI和PI-LL之间呈正相关，且Cobb角与LL之间呈负相关。
中老年患者DLS的发生率与PI有关，冠状面Cobb角与PI和PI-LL呈正相关，与LL呈负相关。冠状面畸形可能受骨盆方向和脊柱矢状面排列两者的影响。
