Impact of pelvic obliquity on coronal alignment in patients with adolescent idiopathic scoliosis

Banno, Tomohiro; Yamato, Yu; Hasegawa, Tomohiko; Yoshida, Go; Kobayashi, Sho; Yasuda, Tatsuya; Arima, Hideyuki; Oe, Shin; Ushirozako, Hiroki; Yamada, Tomohiro; Ide, Koichiro; Watanabe, Yasuhide; Matsuyama, Yukihiro

doi:10.1007/s43390-020-00145-x

Cited by 15 publications

(26 citation statements)

References 29 publications

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“…Banno et al considered PO ≥ 3° Fig. 5 The non-normal distribution of pelvic obliquity angle, median, and 95% percentile as a definition of PO in patients with scoliosis, but they had no anatomical references for the considered range [2].…”

Section: Discussionmentioning

confidence: 99%

Slight pelvic obliquity is normal in a healthy population: a cross‐sectional study

et al. 2023

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Purpose Pelvic obliquity (PO) has not been extensively investigated, and there is no gold standard for measurement. The PO is essential for surgeons in planning hip arthroplasty, which includes the restoration of leg length discrepancy (LLD). We aimed to establish a normative range of PO angles by measuring healthy individuals without musculoskeletal disorders. Methods Our study included 134 consecutive cases (70 females) referred to our institution between April 2020 and September 2021 for non-orthopedic problems. Patients were screened for normal gait and posture using the visual observation method (VOM) and the Modified Gait Abnormality Rating Scale (GARS-M). In standing standard radiographs, the PO angle was measured as the angle between the horizontal plane and the inter-teardrop line. Results Patients' mean age and Body Mass Index (BMI) were 39.7 ± 16.8 and 22.3 ± 3.1, respectively. PO angles did not follow a normal distribution, with a median (IQR) of 2.0° (0.9°—3.1°). According to the Wilcoxon one-sample test, the median PO angle differed significantly from zero (P < 0.001). The PO angle did not differ significantly between males and females (2° vs. 2°, P = 0.46), nor did it correlate significantly with age (P = 0.24). Considering the 95% percentile of PO angles was 5.6°, this range (0°—5.6°) was regarded as a normative value. Conclusion Normative values for PO in the normal healthy population range from 0° to 5.6°, with a median value of 2.0°. The PO angle was independent of age and sex and differed significantly from 0°. Slight pelvic obliquity may be normal, and physicians should not always assume that it is caused by pain, scoliosis, or weakness of the abductors. Level of evidence III.

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Section: Discussionmentioning

confidence: 99%

Slight pelvic obliquity is normal in a healthy population: a cross‐sectional study

et al. 2023

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“…There is an abundance of literature that discusses the biomechanical impact of scoliosis on the hip (Gum et al, 2007;Kotwicki et al, 2008;Radcliff et al, 2013;Buckland et al, 2015;Esposito et al, 2016;Márkus et al, 2018Márkus et al, , 2018Nielsen and Goldstein, 2018;Banno et al, 2020;Si et al, 2020;Zhang et al, 2020;Smith et al, 2021;Bortz et al, 2022), yet only one study that discusses the orthopedic extremity disease burden from scoliosis (Smith et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

“…The complex biomechanical relationship between the hip and spine is well observed (Offierski and MacNab, 1983;Radcliff et al, 2013;Buckland et al, 2015;Esposito et al, 2016;Eguchi et al, 2018;Nielsen and Goldstein, 2018;Rivière et al, 2018;Burkus et al, 2019;Morimoto et al, 2019;Prather and van Dillen, 2019;Banno et al, 2020;Si et al, 2020;Smith et al, 2021;Bortz et al, 2022).…”

Section: Review Of the Literaturementioning

confidence: 99%

Physical Therapy Management of Hip Pain in Adults with Scoliosis: A Case Series

Roberts¹

2023

FMCR

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Background and Purpose: Adult scoliosis (AS) is a structural deformity of the spine in a skeletally mature patient and can cause asymmetrical loading on both the spine and the extremities. The purpose of this case series is to highlight physical therapy management of 3 adults with AS and hip pain by incorporating scoliosis specific exercise (PSSE) into their course of treatment. Case Description: The three patients in this study all had structural scoliosis of the spine found on radiograph, complained of hip pain that limited their quality of life, and varied in ages: 31, 48 and 68 years. All three patients had prior treatment to address their hip conditions with only temporary relief. The patients were treated with a combination of PSSE to address their scoliosis and posture in addition to more traditional physical therapy modalities to manage their pain and tissue healing. Outcomes: At the completion of physical therapy, all three patients reported a decrease in pain on VAS, improved scores on LEFS and reported meeting functional mobility goals in ADLS with self-management of symptoms. Discussion: Scoliosis is an asymmetrical deformity in multiple planes of motion and therefore causes asymmetrical forces to the pelvis and hip leading to stress, soft tissue and intraarticular breakdown to the hips across an age span. Non-operative treatment of orthopedic sequelae in this population should include assessment and management of the spine and, if managed earlier in a lifespan, may help minimize permanent damage to the joint.

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“…It is clinically relevant to note that the error in the radiographic PI measurement increases in a patient with a large distance between the centers of the femoral heads in the lateral radiograph. For example, in patients with abduction contracture, leg-length discrepancy, scoliosis, or hemiplegia, the pelvis tilts laterally [34][35][36] and requires careful attention.…”

Section: Discussionmentioning

confidence: 99%

Errors in the radiographic measurement of pelvic incidence

Iwasa

Hamada

Uemura

et al. 2022

Journal Orthopaedic Research

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Pelvic incidence (PI) is often quantified in patients undergoing total hip arthroplasty. Errors in radiographic PI measurements can affect clinical outcomes. The purposes of this study were (1) to evaluate the error in radiographic PI measurement in patients with hip osteoarthritis (OA) and (2) to analyze the factors related to the error. Radiographs and computer tomography (CT) images of 100 patients (24 men and 76 women; mean age 63.7 years) with unilateral OA were reviewed. The error in radiographic PI measurement was defined as the difference between the radiographic measurement of the PI (rPI) and the accurate value of PI measured using CT images (cPI). Factors related to the error in the rPI were analyzed, including the coronal and axial rotation of the pelvis on lateral radiographs. The degree of coronal and axial rotation was expressed as the angle of rotation around the anteroposterior and craniocaudal axes. The mean rPI was significantly larger than the cPI (57.8° and 54.1°, p < 0.01). The error in the rPI was 3.6° on average and 15.8° at maximum. The mean coronal and axial rotation of the pelvis was 9.6° and 4.4°, respectively. The error in the rPI positively correlated with coronal pelvic rotation and rPI, and negatively correlated with axial pelvic rotation (p < 0.01, r = 0.35, 0.43, and −0.45, respectively). The rPI was 3.6° larger on average than the cPI in patients with hip OA. Coronal and axial rotation of the pelvis and a large PI were related to the error in the rPI.

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Impact of pelvic obliquity on coronal alignment in patients with adolescent idiopathic scoliosis

Cited by 15 publications

References 29 publications

Slight pelvic obliquity is normal in a healthy population: a cross‐sectional study

Slight pelvic obliquity is normal in a healthy population: a cross‐sectional study

Physical Therapy Management of Hip Pain in Adults with Scoliosis: A Case Series

Errors in the radiographic measurement of pelvic incidence

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