Abstract
Study designA retrospective study.BackgroundTo determine whether radiological parameters such as maximal lumbar lordosis-maximal thoracic kyphosis (maxLL-maxTK), sacral slope-pelvic tilt(SS-PT) and sacral slope/pelvic tilt (SS/PT) could be used as indicators for the diagnosis of degenerative disc disease (DDD) in compensatory sagittal balanced patients.MethodsMedical records of sagittal balanced DDD patients and asymptomatic adults within our hospital registry from July 2019 to November 2019 were reviewed. General characteristics and radiological parameters were evaluated between the two groups. Analysis of covariance with age as a covariate was conducted, followed by receiver operating characteristic (ROC) analysis and areas under the curve (AUC) calculation. The max Youden index was calculated to identify the optimal sensitivity specificity pairs.ResultsA total of 42 DDD patients and 199 asymptomatic adults were included. For those parameters that showed significant differences between the two groups, AUC for SS/PT and SS-PT were the largest, reaching 0.919 and 0.936, respectively. The sensitivity was 0.749, the specificity was 0.952 and the max Youden index was 0.701 when SS/PT = 1.635 was used as threshold. The max Youden index was found for a threshold of SS-PT =8.500, for which the sensitivity increased to 0.854, while the specificity decreased to 0.857.ConclusionsBoth SS/PT and SS-PT were significantly different between sagittal balanced DDD patients and asymptomatic adults. SS/PT < 1.6 and SS-PT < 8.5 could be used as indicators for the diagnosis of DDD patients with compensatory sagittal balance.
Highlights
To determine whether radiological parameters such as maximal lumbar lordosis-maximal thoracic kyphosis, sacral slope-pelvic tilt(SS-PT) and sacral slope/pelvic tilt (SS/PT) could be used as indicators for the diagnosis of degenerative disc disease (DDD) in compensatory sagittal balanced patients
Both sacrum slope (SS)/PT and SS-PT were significantly different between sagittal balanced DDD patients and asymptomatic adults
There were no significant differences in pelvic incidence (PI) and the general characteristics with the exception of age between two groups, while age and other residual parameters were significantly different between two groups (Table 1)
Summary
To determine whether radiological parameters such as maximal lumbar lordosis-maximal thoracic kyphosis (maxLL-maxTK), sacral slope-pelvic tilt(SS-PT) and sacral slope/pelvic tilt (SS/PT) could be used as indicators for the diagnosis of degenerative disc disease (DDD) in compensatory sagittal balanced patients. Intervertebral discs degeneration is a normal process of aging that can be accelerated by different environmental and biological factors It associated with pain, referred to as degenerative disc diseases (DDD) [1]. Increasing PT during standing posture was reported to reflect patients need to compensate for their proximal spinal deformity [10], and degenerative loss of lordosis moves the spine forward, as a result, compensatory mechanisms such as pelvic retroversion and knee flexion lead to posterior pelvic shift [11]. The backward rotation of the pelvis can continue to a certain extent, the femoral head is forward result from the increasing tilt of the pelvis, the sacrum and the spine are backward This causes the C7(seventh cervical vertebrae) plumb line to stay behind the perpendicular line passing through the middle of the femoral head, and the gravity line to fall between the feet (Fig. 1). The full body is in an uneconomic compensatory balance because the maintenance of this balance increases the tension of the posterior spinal muscle causing energy-consuming and low back pain
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
