Abstract

ObjectivesTo introduce a new method of pelvic incidence (PI) measurement based on three-dimensional (3D) pelvic models reconstructed from CT images and to report the normal distribution of PI in normal pelvic anatomy.MethodsCT images of 320 subjects with normal pelvic anatomy who visited the Radiology Department between 2006 and 2017 were retrospectively selected and saved in Digital Imaging and Communications in Medicine (DICOM) format. A computerized method was employed to determine the bony landmarks required for the measurement of PI. To quantify the method’s accuracy and reliability, the intraclass correlation coefficient (ICC) was calculated. A subgroup of 30 DICOM files was randomly selected to perform a validation study. Three independent testers performed all procedures. All measurements were performed twice independently by the three testers on all 10 subjects with an interval of 2 weeks. Independent samples t tests were used to identify statistically significant differences in the PI value between sexes. Pearson correlation coefficient was employed to determine the relationship between PI and age.ResultsPI measurement using the new method resulted in an excellent intraobserver reliability (0.9612, range 0.8917–0.9893; p < 0.001) and interobserver reliability (0.9867, range 0.9611–0.9964; p < 0.001). PI was significantly different between sexes, with larger PI in women (p = 0.019). PI was significantly larger in the 40–80-year age group (45.94 ± 9.08°) than the < 40-year age group (43.50 ± 7.39°). We did not find any linear correlation between PI and age in the male (r = 0.140, p = 0.105) or female subgroup (r = 0.119, p = 0.107). A weak correlation between PI and age overall was observed (r = 0.142, p = 0.011).ConclusionAccurate PI measurement could be achieved by a CT data-based 3D pelvic model.

Highlights

  • Pelvic incidence (PI), a spinal sagittal parameter, is vital in assessing spinal balance and in the guiding operative principle [1]

  • Our study aimed (1) to introduce a new method of PI measurement based on 3D pelvic models reconstructed from Computed tomography (CT) images, whose accuracy and reliability are quantified statistically, and (2) to report the normal distribution of PI in 320 Chinese subjects with normal pelvic anatomy, including the correlation between PI and age, and differences between the sexes

  • We found PI was significantly larger in the 40–80-year age group (45.94 ± 9.08°) than < 40-year age group (43.50 ± 7.39°)

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Summary

Introduction

Pelvic incidence (PI), a spinal sagittal parameter, is vital in assessing spinal balance and in the guiding operative principle [1]. PI is a constant value when one reaches bone maturity and is not affected by the spatial orientation of the pelvis, which is PI is typically measured using plain radiological images, which are obtained with patients in a standing position, with superimposition of both femoral heads and the anterior superior iliac spines (ASISs). Chen et al Journal of Orthopaedic Surgery and Research (2019) 14:13 with the projective nature of X-ray, anatomical structures could not be well observed in the standardized standing lateral X-ray of the spine and pelvis; superimposition of both femoral heads and a perfect mid-sagittal view of the pelvis could not be achieved, thereby resulting in a large intra- and interobserver variation. Our study aimed (1) to introduce a new method of PI measurement based on 3D pelvic models reconstructed from CT images, whose accuracy and reliability are quantified statistically, and (2) to report the normal distribution of PI in 320 Chinese subjects with normal pelvic anatomy, including the correlation between PI and age, and differences between the sexes

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