Abstract
BackgroundScoliosis is a complex three-dimensional deformity. While the frontal profile is well understood, increasing attention has turned to balance in the sagittal plane. The present study evaluated changes in sagittal spino-pelvic parameters in a large Hungarian population with adolescent idiopathic scoliosis.MethodsEOS 2D/3D images of 458 scoliotic and 69 control cases were analyzed. After performing 3D reconstructions, the sagittal parameters were assessed as a whole and by curve type using independent sample t test and linear regression analysis.ResultsPatients with scoliosis had significantly decreased thoracic kyphosis (p < 0.001) with values T1–T12, 34.1 ± 17.1o vs. 43.4 ± 12.7o in control; T4–T12, 27.1 ± 18.8o vs. 37.7 ± 15.1o in control; and T5–T12, 24.9 ± 15.8o vs. 32.9 ± 15.0o in control. Changes in thoracic kyphosis correlated with magnitude of the Cobb angle (p < 0.001). No significant change was found in lumbar lordosis and the pelvic parameters. After substratification according to the Lenke classification and individually evaluating subgroups, results were similar with a significant decrease in only the thoracic kyphosis. A strong correlation was seen between sacral slope, pelvic incidence, and lumbar lordosis, and between pelvic version and thoracic kyphosis in control and scoliotic groups, whereas pelvic incidence was also seen to be correlated with thoracic kyphosis in scoliosis patients.ConclusionAdolescent idiopathic scoliosis patients showed a significant decrease in thoracic kyphosis, and the magnitude of the decrease was directly related to the Cobb angle. Changes in pelvic incidence were minimal but were also significantly correlated with thoracic changes. Changes were similar though not identical to those seen in other Caucasian studies and differed from those in other ethnicities. Scoliotic curves and their effect on pelvic balance must still be regarded as individual to each patient, necessitating individual assessment, although changes perhaps can be predicted by patient ethnicity.
Highlights
Intra-observer reliabilities for Three dimensional (3D) reconstructions were all greater than 0.9, regarded as “excellent.” The results of sagittal spine and pelvis evaluations are presented in Table 2, which shows the differences between the scoliosis cohort as a whole and the control group
We aimed to evaluate the changes of the sagittal spino-pelvic parameters in adolescent idiopathic scoliosis, in a large population of 458 Central European (Hungarian) Caucasian adolescent and young adult patients using low-distortion EOS Two dimensional (2D)/3D reconstructions
This study presents the sagittal profile of 458 children with Adolescent idiopathic scoliosis (AIS), from a Central European Caucasian population, as assessed by full-body biplanar X-ray scanner
Summary
The sagittal spino-pelvic parameters have been assessed in numerous publications with normal, disease-free populations [4,5,6,7,8] and in spine deformities, including scoliosis [9,10,11]. While many of these studies found alterations in sagittal alignment in scoliotic patients [9, 10, 12], a notable number reported no significant difference [13]. Changes are seen during growth, too, with all parameters evolving and developing throughout childhood and puberty until their attainment of mature adult values [16,17,18]
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