230. Racial and ethnic variation in sagittal spinopelvic parameters in an urban setting

Abstract

BACKGROUND CONTEXT Normal spinopelvic alignment is influenced by a variety of factors, including, gender, age, and ethnicity. Recent literature has reported on the influence of ethnicity on pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS), among other measures, in a number of isolated Asian and African populations. Assessment of spinopelvic parameters is instrumental to appropriate the evaluation of symptomatic patients. Here we present a retrospective chart review of spinopelvic parameters among an ethnically diverse urban population with no radiographic evidence of thoracolumbar pathology. PURPOSE The purpose of this study is to determine whether spinopelvic parameters differ significantly among those belonging to different ethnic groups in a heterogeneous urban population. STUDY DESIGN/SETTING Retrospective cohort study. PATIENT SAMPLE A total of 110 consecutive patients (mean age 56.08 ± 14.84 years) from an academic center in United States with no evidence of thoracolumbar pathology and no history of low back pain or previous spinal surgery. OUTCOME MEASURES PI, PT, SS, T1-Pelvic angle (TPA), Sagittal balance (SB), coronal balance (CB), lumbar lordosis (LL), and PI/LL offset. METHODS A total of 110 consecutive patients (mean age 56.08 ± 14.84 years) with no evidence of thoracolumbar pathology and no history of low back pain or previous spinal surgery were included in this study. Patient ethnicity was obtained in accordance with IRB recommendations. Among included patients, the following measurements were obtained from standing PA and Lateral films: PI, PT, SS, TPA, SB, CB, LL, and PI/LL offset. One-way ANOVA was used to test for significance. RESULTS A total of 110 patients were included in this study, grouped into the following categories: African american (31/110), Hispanic (54/110), and Caucasian (25/110). For Black patients, mean PI, PT, SS, and TPA were 64.45. ± 10.07°, 16.29± 11.51°, 48.16 ± 10.87°, and 16.46 ± 8.60° respectively. For Hispanic patients, mean PI, PT, SS and TPA were 60.20± 14.34°, 11.14 ± 9.93°, 49.05 ± 12.80° and 15.05 ± 9.07° respectively. For Caucasian patients, mean PI, PT, and SS were 57.86±14.84°, 14.10 ± 14.79°, 43.76 ±14.51° and 16.47± 14.6° respectively. There was no significant difference between the three groups in PI (p=0.185), PT (p=0.126), SS (p=0.222), TPA (p=0.779), SB (p=0.470), CB (p=0.36), LL (p=0.32), and PI/LL offset (p= 0.606). Offset mean for African American was 7.45± 18.7, for Hispanic was 1.41 ± 16.3, and for Caucasian was 4.66 ± 22.38. CONCLUSIONS SP measurements taken among a diverse urban population cannot readily be distinguished on the basis of ethnicity alone. This study demonstrates that there are no difference in SP measurements among African American, Hispanic and Caucasian population in a heterogeneous urban setting FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs. Normal spinopelvic alignment is influenced by a variety of factors, including, gender, age, and ethnicity. Recent literature has reported on the influence of ethnicity on pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS), among other measures, in a number of isolated Asian and African populations. Assessment of spinopelvic parameters is instrumental to appropriate the evaluation of symptomatic patients. Here we present a retrospective chart review of spinopelvic parameters among an ethnically diverse urban population with no radiographic evidence of thoracolumbar pathology. The purpose of this study is to determine whether spinopelvic parameters differ significantly among those belonging to different ethnic groups in a heterogeneous urban population. Retrospective cohort study. A total of 110 consecutive patients (mean age 56.08 ± 14.84 years) from an academic center in United States with no evidence of thoracolumbar pathology and no history of low back pain or previous spinal surgery. PI, PT, SS, T1-Pelvic angle (TPA), Sagittal balance (SB), coronal balance (CB), lumbar lordosis (LL), and PI/LL offset. A total of 110 consecutive patients (mean age 56.08 ± 14.84 years) with no evidence of thoracolumbar pathology and no history of low back pain or previous spinal surgery were included in this study. Patient ethnicity was obtained in accordance with IRB recommendations. Among included patients, the following measurements were obtained from standing PA and Lateral films: PI, PT, SS, TPA, SB, CB, LL, and PI/LL offset. One-way ANOVA was used to test for significance. A total of 110 patients were included in this study, grouped into the following categories: African american (31/110), Hispanic (54/110), and Caucasian (25/110). For Black patients, mean PI, PT, SS, and TPA were 64.45. ± 10.07°, 16.29± 11.51°, 48.16 ± 10.87°, and 16.46 ± 8.60° respectively. For Hispanic patients, mean PI, PT, SS and TPA were 60.20± 14.34°, 11.14 ± 9.93°, 49.05 ± 12.80° and 15.05 ± 9.07° respectively. For Caucasian patients, mean PI, PT, and SS were 57.86±14.84°, 14.10 ± 14.79°, 43.76 ±14.51° and 16.47± 14.6° respectively. There was no significant difference between the three groups in PI (p=0.185), PT (p=0.126), SS (p=0.222), TPA (p=0.779), SB (p=0.470), CB (p=0.36), LL (p=0.32), and PI/LL offset (p= 0.606). Offset mean for African American was 7.45± 18.7, for Hispanic was 1.41 ± 16.3, and for Caucasian was 4.66 ± 22.38. SP measurements taken among a diverse urban population cannot readily be distinguished on the basis of ethnicity alone. This study demonstrates that there are no difference in SP measurements among African American, Hispanic and Caucasian population in a heterogeneous urban setting