Pelvic Incidence Is Associated With Sacral Curvature, Sacroiliac Joint Angulation, and Sacral Ala Width

Abola, Matthew V.; Teplensky, Jason; Cooperman, Daniel R.; Bauer, Jennifer M.; Liu, Raymond W.

doi:10.1097/brs.0000000000002679

Cited by 14 publications

(17 citation statements)

References 21 publications

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“…In addition to the “line method” and the “angle summation method” we used in this study, several other methods are available to measure sacral curvature, as reviewed by Abola, Teplensky, Cooperman, Bauer, and Liu (2018). These include the S1–S4 sagittal Cobb angle, the angle formed by a bisecting line of S1 and a line from the inferior borders of S2 and S4, and the sacral table angle.…”

Section: Discussionmentioning

confidence: 99%

“…These include the S1–S4 sagittal Cobb angle, the angle formed by a bisecting line of S1 and a line from the inferior borders of S2 and S4, and the sacral table angle. On dry sacrums, Abola et al (2018) evaluated curvature by measuring the difference between the direct distance (using calipers) and the curved bony distance (using a tape measure laid flush with the ventral sacrum) from the sacral promontory to the inferior aspect of S4. Using the “line method,” Abitbol (1989) observed in 113 adult dry sacrums that 8.8% were angular, with S1‐S3 segments forming a right angle with S4–S5; 9.7% were flat with only part of S5 making an abrupt ventral angle; and the other 81.4% displayed a 29°–107° (mean of 65°) sacral curvature.…”

Section: Discussionmentioning

confidence: 99%

“…They found this curvature was slightly greater, but statistically insignificant, in males and in nulliparous rather than multiparous females, and there were no age‐related changes in sacral curvature. The limitations of these ex vivo studies is that dry sacra lack ligamentous or soft tissue attachments, and therefore these specimens may not faithfully represent true in vivo sacral curvature (Abola et al, 2018). Conversely, using a three‐dimensional (3D) statistical model derived from clinical computed tomographic imaging data of 92 intact pelvises, Wagner et al (2017) derived the “angle summation method” and found a mean sacral curvature of 41.5°, also slightly greater in males.…”

Section: Discussionmentioning

confidence: 99%

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Imaging anatomy of the vertebral canal for trans‐sacral hiatus puncture of the lumbar cistern

2020

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A standard lumbar puncture may be impossible for many anatomic or technical reasons. Previous accounts of caudal epidural anesthesia and other procedures via the sacral hiatus prompted us to test if image‐guided percutaneous trans‐sacral hiatus access to the lumbosacral subarachnoid cistern would be anatomically feasible. To study vertebral canal morphometry and curvature, we analyzed midsagittal computed tomography‐myelogram images of 40 normal subjects and digitally measured sacral curvatures between S1 to S5 and S2 to S4 using two methods whereby a lower angle signifies a straighter sacrum. We measured midsagittal vertebral canal area, hiatus width, dural sac termination levels, and distance from sacral hiatus to the dural sac tip (needle distance). Subjects were F:M = 25:15, with a mean age of 44.9 years. The two S1–S5 full sacral curvature mean angles were 57.3° and 60.4°. Almost all sacral hiatuses were at S4, and dural sac terminations were at S1–S2. The mean S2–S4 sacral curvature was 25.1°, and the mean needle distance was 57.7 mm. Using two‐way analysis of variance, there were significant sex differences for needle distances (p = .001), and full and limited sacral curvatures (p = .02, and p = .046, respectively). There were no significant linear regression correlations between age and sacral curvature, needle distance, canal area, or hiatus width. Therefore, despite a frequently prominent full sacral curvature, the combination of S1–S2 dural sac termination plus a relatively straight trajectory of the lower vertebral canal between S2 and S4 support the theoretical feasibility of percutaneous trans‐sacral hiatus and vertebral canal access to the lumbosacral cistern using a standard spinal needle.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Imaging anatomy of the vertebral canal for trans‐sacral hiatus puncture of the lumbar cistern

2020

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“…As a parameter of the sagittal spine pro le, pelvic incidence describes the angulation of the sacrum in the pelvis in relation to the hip joints, and in uences force transmission thus has been associated with spondylolisthesis. Abola et al 10 measured 120 cadaveric samples and found that a more curved sacrum, decreased sacral-ala width, and a more linear SI joint were related to an increased pelvic incidence.…”

Section: Discussionmentioning

confidence: 99%

Correlation of sagittal configuration of the sacrum and pelvic incidence evaluated by computed tomography measurements

Chen

Tian

Zhou

et al. 2020

Preprint

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Objective To measure the sagittal configurations of the sacrum using computed tomography (CT), and to investigate the correlation between the sagittal configuration of the sacrum and pelvic incidence. Methods The computed topographies of complete pelvic imaging between 2006 and 2018 was retrospectively studied. Measurements of pelvic and sacral morphological parameters were performed on the midsagittal plane of the 2D reconstruction images of computed tomography. Pelvic incidence (PI) (STA) were measured as previously described, and sacral table angle, sacral incidence (SI), sacral segmental vertebral angle (SSVA), sacral segmental kyphosis (SSK), central angle (SCA), arc length (SAL) as well as arc radius (SAR) were introduced to describe the segmental morphology of sacrum. Pearson Correlation Coefficient and Stepwise Regression Analysis were used to determine the relationship between PI and sacral morphological parameters. Results A total of 304 subjects were finally included in this study. The average age of the patients were 46.22 ± 15.92 years, and the average PI was 45.24±8.68°. Most of the sacral morphological parameters were not different as affected by gender or age. The morphological parameters of S1: S1I, SSVA1 and STA were finally confirmed to be closely correlated with PI, while no significant correlation between sacral curvature (SCA) and PI was identified, and morphological parameters of other sacral segments were not correlated to PI either. Conclusion The morphological parameters of S1 are more closely correlated with PI, and the sacral incidence of S1 might serve as a useful tool for the calculation of PI.

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“…05). This may be related to the difference in the pelvic bone structure between sexes (Schlösser et al, 2014;Giacomini et al, 2015;Bao et al, 2018), a larger anteroposterior diameter of pelvic inlet and wider pubic arch in female, and a higher degree of sacral anteversion in male (Abola et al, 2018).…”

Section: Comparison Of Spinal-pelvic Parameters and Pelvic Anatomicalmentioning

confidence: 99%

A Comparative Study of Sagittal Spinal-Pelvic Parameters Between Patients with Adolescent Idiopathic Scoliosis and Healthy Controls

Zhang

Wang

et al. 2020

Int. J. Morphol.

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This study aimed to investigate the sagittal spinal-pelvic morphological changes, as well as the relationship between pelvic anatomical changes and the spinal-pelvic plane in patients with adolescent idiopathic scoliosis (AIS), in order to provide guidelines for orthopedic surgery in AIS. X-ray data were collected for retrospective analysis from 30 patients diagnosed as AIS in the Departments of Radiology at the Second Affiliated Hospital of Inner Mongolia Medical University and the Inner Mongolia International Mongolian Medical Hospital from April 2014 to November 2018, along with 30 normal adolescents as control. Pelvic parameters, including pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS), a spinal parameter, lumbar lordosis (LL), and anatomical parameters, including sacral width (SW) and femoral head-sacrum distance (FH-S), were measured. The spinal-pelvic parameters were compared between AIS patients and normal controls and also between male and female AIS patients. Pearson correlation was performed to analyze correlation between spinal-pelvic parameters and between spinal-pelvic parameters and anatomical parameters in both AIS patients and normal controls. PT was significantly lower in AIS patients than in normal controls (P < 0.05), whereas no significant difference was found in the other spinal-pelvic parameters, i. e. , LL, PI, and SS. There was a significant difference in PT between sexes in AIS patients. SS was significantly correlated with LL in EIA patients (P < 0.05, r > 0.5). SS was significantly correlated with LL and PI, and PT with LL, PI, and SS in normal controls (all P < 0.05), and there was no significant correlation between the other sagittal spinal-pelvic parameters (P > 0.05). FH-S was significantly correlated with LL, PI, SS, and PT in AIS patients (all P < 0.05). AIS affects some of the sagittal spinalpelvic parameters and anatomical parameters. In AIS, there is a significant correlation between the spinal-pelvic parameters, and the anatomical parameter is significantly correlated with multiple spinal-pelvic parameters.

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Pelvic Incidence Is Associated With Sacral Curvature, Sacroiliac Joint Angulation, and Sacral Ala Width

Abstract: N/A.

Cited by 14 publications

References 21 publications

Imaging anatomy of the vertebral canal for trans‐sacral hiatus puncture of the lumbar cistern

Imaging anatomy of the vertebral canal for trans‐sacral hiatus puncture of the lumbar cistern

Correlation of sagittal configuration of the sacrum and pelvic incidence evaluated by computed tomography measurements

A Comparative Study of Sagittal Spinal-Pelvic Parameters Between Patients with Adolescent Idiopathic Scoliosis and Healthy Controls

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