Abstract
PurposePelvic morphology dictates the alignment and biomechanics of the spine. Recent observations in different types of adolescent idiopathic scoliosis indicate that individual pelvic morphology is related to the spinal levels in which scoliosis develops: primary lumbar adolescent scoliosis is associated with a higher pelvic incidence (PI) than thoracic scoliosis and non-scoliotic controls. We hypothesize that adult degenerative scoliosis (ADS) of the lumbar spine follows the same mechanical principles and is associated with a high PI.MethodsThis study used an existing CT-scan database, 101 ADS patients were sex and age matched to 101 controls. The PI was measured by two observers with multi-planar reconstruction, perpendicular to the hip-axis according to a previously validated technique.ResultsThe PI was 54.1° ± 10.8° in ADS patients and 47.7° ± 10.8° in non-scoliotic controls (p < 0.001). The median ADS curve apex was the disc L2-3 and median curve length was 4 vertebral levels. The mean supine Cobb angle was 21° ± 8° (ranged 10°–47°). There was no significant correlation between PI and the apex level (p = 0.883), the curve length (p = 0.418) or the Cobb angle (p = 0.518).ConclusionsADS normally develops de novo in the lumbar spine of patients with a higher PI than controls, similar to primary lumbar adolescent idiopathic scoliosis. This suggests a shared mechanical basis of both deformities. Pelvic morphology dictates spinal sagittal alignment, which determines the segments of the spine that are prone to develop scoliosis.
Highlights
The unique upright sagittal profile of the human spine and its consequences for human spinal biomechanics provide an important mechanical basis for the development of spinal deformities [1,2,3,4,5]
Demographics and results: A total of 101 adult degenerative scoliosis (ADS) patients were compared to 101 sex and age matched control patients
A higher pelvic incidence (PI) has been shown to be related to primary lumbar adolescent idiopathic scoliosis, whereas a lower PI was associated with primary thoracic curves and non-scoliotic controls [7, 12,13,14]
Summary
The unique upright sagittal profile of the human spine and its consequences for human spinal biomechanics provide an important mechanical basis for the development of spinal deformities [1,2,3,4,5]. Spinal alignment and consequent biomechanics are to a large extent determined by the pelvic incidence (PI), first described by Duval-Beaupère et al [6]. The PI describes position-independent sagittal pelvic morphology and is strongly related to the sagittal spinal configuration, making it ideal for studying and comparing spino-pelvic alignment [7]. Pelvic morphology dictates the spinal alignment, where a higher PI corresponds with a more. European Spine Journal (2021) 30:2467–2472 pronounced curvature of the spinal profile in the sagittal plane, including a steeper dorsally inclined segment of the thoracolumbar spine [15]. This dorsally inclined segment appears to be of causal importance. A recently published study demonstrated that the inclination and magnitude of this dorsally inclined area in the years before the onset of scoliosis, differs between those that will and will not develop scoliosis [16]
Sign-in/Register to view highlights & summary 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.
