Pelvic thickness, sex, ethnicity, and age affect pelvic incidence in healthy volunteers of Multi-Ethnic Alignment Normative Study (MEANS) database

Hara, Kazuhiro; Hatsushikano, Shun; Huec, Jean-Charles Le; Sardar, Zeeshan M.; Wong, Hee‐Kit; Hey, Hwee Weng Dennis; Liu, Gabriel; Bourret, Stéphane; Kelly, Michael P.; Riahi, Hend; Chelli-Bouaziz, Mouna; Lenke, Lawrence G.

doi:10.1007/s00586-022-07134-w

Cited by 8 publications

(6 citation statements)

References 19 publications

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“…PTh, a pelvic parameter that approximates the size of the pelvis,9 was also investigated in this study. Previous studies have found PTh to correlate with spinopelvic parameters such as the sacral base19 and PI 20. This study validates the relationship between PTh and PI and found that PTh does not correlate with TK and PI−LL while correlating with other lumbar parameters such as pLL and dLL.…”

Section: Discussionsupporting

confidence: 85%

“…Previous studies have found PTh to correlate with spinopelvic parameters such as the sacral base 19 and PI. 20 This study validates the relationship between PTh and PI and found that PTh does not correlate with TK and PI−LL while correlating with other lumbar parameters such as pLL and dLL. Thus, it seems that PTh represents an important parameter in the lumbopelvic system with a negligible relationship with the thoracic curvature.…”

Section: Discussionsupporting

confidence: 81%

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Variation in Lumbar Shape and Lordosis in a Large Asymptomatic Population

Shen

Sardar

Huec

et al. 2023

Spine

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Study Design. Prospective, cross-sectional cohort study. Objective. To determine the relationship between lumbar shape and sagittal parameters. Summary of Background Data. Understanding the lumbar shape is vital for deformity surgery. Normative sagittal parameters and spine shape remain unstudied in large, multiethnic, asymptomatic cohorts. Materials and Methods. A prospective, cross-sectional cohort of 468 asymptomatic volunteers between 18 and 80 years was enrolled across 5 countries. Demographic data and radiographic parameters such as pelvic incidence (PI) were collected. Pearson correlation test and linear regression were used to find the relationship between lumbar lordosis (LL) and other parameters. One-way analysis of variance and Welch 2-sample t test were performed to compare lumbar shape across such categories as PI and lumbar apex followed by post hoc Bonferroni correction if needed.Results. PI was moderately correlated with proximal lumbar lordosis (pLL) (r = −0.54) and weakly correlated with distal lumbar lordosis (dLL) (r = −0.16). Thoracic kyphosis (T1-T12) was moderately correlated with pLL (r = −0.35) and dLL (r = −0.29). dLL was moderately correlated with LL (r = 0.64). 2.6% (12/468) of subjects had lumbar apex at L2, 40.2% (188/468) at L3, 56.6% at L4 (265/468), and 0.6% (3/468) at other levels. Mean PI was different between volunteers with the apex at L3 and L4. A lower mean PI was associated with the apex at L4 (49.0°), whereas a higher mean PI was associated with the apex at L3 (55.8°). The mean PI−LL mismatch for volunteers was −5.4°with a range from −35°to 39.7°. PI−LL mismatch increased from a mean of −10.1°i n volunteers with low PI to a mean of 2.2°in volunteers with high PI. Age was not correlated with LL (P = 0.84). Conclusions. In asymptomatic adult volunteers, pLL showed a moderate correlation with PI and increased with PI, whereas dLL showed a weak correlation. The lumbar apex migrated proximally with increasing PI. Segmental lordosis and apex position instead of solely global lordosis should be emphasized.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 81%

Variation in Lumbar Shape and Lordosis in a Large Asymptomatic Population

Shen

Sardar

Huec

et al. 2023

Spine

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“…The complex anatomy of the sacroiliac (SI) joint with a strong network of ligaments restricts the movement of the SI joint 32,33) ; therefore, the PI has been assumed to be constant in each individual. However, previous studies have demonstrated a positive correlation between PI and age in both healthy adults and patients with scoliosis 7,13,18,19) . Additionally, Hasegawa et al investigated the factors affecting PI, including pelvic thickness (PTh), which is the distance between the hip axis and the center of the sacral endplate 18) , a representative parameter for pelvic size, and demonstrated a positive correlation between PI and age, a negative correlation between PTh and age, and the highest contribution of PTh to the PI value among the affecting factors.…”

Section: Discussionmentioning

confidence: 86%

“…However, previous studies have demonstrated a positive correlation between PI and age in both healthy adults and patients with scoliosis 7,13,18,19) . Additionally, Hasegawa et al investigated the factors affecting PI, including pelvic thickness (PTh), which is the distance between the hip axis and the center of the sacral endplate 18) , a representative parameter for pelvic size, and demonstrated a positive correlation between PI and age, a negative correlation between PTh and age, and the highest contribution of PTh to the PI value among the affecting factors. Based on these results, they hypothesized that aging or SI joint osteoarthrosis with concomitant hypermobility may result in a posteroinferior shift of the sacral endplate, leading to an increase in PI 18) .…”

Section: Discussionmentioning

confidence: 86%

“…Moreover, predicting natural SS and PT would help estimate the natural sagittal profile represented by the Roussouly classification 9,10) , making the surgical goal more appropriate. Although PI has been the most commonly used anatomical parameter for those prediction processes 11,12) , the PI can change with age 13) , positioning 14,15) , and corrective spinal surgery 16,17) , even in healthy adults 7,18,19) . Pelvic retroversion generally increases acetabular anteversion and inclination 20) , decreasing anterior coverage of the femoral head by the acetabulum and leading to hip osteoarthritis 21,22) .…”

Section: Introductionmentioning

confidence: 99%

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Anatomical Pelvic Parameters Using the Anterior Pelvic Plane: Normative Values and Estimation of the Standing Sagittal Alignment in Healthy Volunteers

Ohashi,

Hasegawa,

Hatsushikano

et al. 2024

Spine Surg Relat Res

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Objectives: In this study, we aim to estimate the natural standing sagittal alignment in patients with adult spinal deformity (ASD), firstly by investigating the normative values of anatomical pelvic parameters based on the anterior pelvic plane (APP) in a healthy population, and to clarify the relationships between the anatomical and positional pelvic parameters in standing position. Methods: The images of biplanar slot-scanning full-body stereoradiography in 140 healthy Japanese volunteers (mean age, 39.5 years; 59.3% female) were examined. In addition to three-dimensional measurements including pelvic incidence (PI), sacral slope (SS), and pelvic tilt (PT), the APP angle (APPA; anterior tilting = positive) was measured as the angle between the APP and the vertical line using the two-dimensional lateral image. Anatomical SS and PT (aSS and aPT) were calculated as the angles of SS and PT in reference to APP. Results:The mean (range) values of APPA, aSS, and aPT were determined to be 0.7° (−16.8°/15.5°), 36.8° (18.3°/64.9°), and 13.2° (−0.6°/28.7°), respectively. Moreover, SS was found to be significantly correlated with PI and aSS, while PT was significantly correlated with PI, aSS, aPT, and body weight. Also, PT was significantly larger in females than in males. Multiple linear regression analysis deduced the following equations: SS = 0.404 × aSS + 0.203 × PI + 12.463, PT = −0.391 × aSS + 0.774 × PI + 1.950 × sex (male = 0, female = 1) − 12.971, wherein aSS had the greatest effect for predicting SS among the included factors and PI had the greatest effect for predicting PT. In addition, no significant differences were noted between PT/PI and aPT/PI. Conclusions: As per the results of this study, significant correlations were noted among parameters and predicting models for positional parameters (SS and PT) using anatomical parameters (aSS and aPT) in a healthy population. This novel measurement concept based on the APP has been considered to be useful in estimating natural SS and PT in standing position using the anatomical pelvic parameters in patients with ASD.

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