Sacrum morphometry and spinopelvic parameters among the Indonesian population using computed tomography scans

Abstract

This is a cross-sectional study. This study aims to describe the characteristics of sacrum vertebrae and spinopelvic parameters among the Indonesian population and compare them with studies from other populations. This study also intends to determine the sexual dimorphism of sacrum vertebrae and find the correlations between spinopelvic parameters.Morphometry of the sacrum is necessary for designing sacral prosthesis and instrumentations. Knowledge of spinopelvic parameters further supports the prosthesis installation procedure to restore the physiological spinal alignment of the patients. However, previous studies showed varied results among different populations. This is the first study to be conducted among the Indonesian population.Morphometric dimensions of sacrum vertebrae and the spinopelvic parameters (pelvic incidence, pelvic tilt, sacral slope, lumbar lordosis) were analyzed using thin-cut (1 mm) computed tomography images in 150 males and 150 females, aged 25 to 50 years without any spinal pathology.Generally, the size of the sacrum vertebrae was greater in males (P < .05). The sacral index, curvature index, and corporo-basal index were statistically different between genders (P < .001). Lumbar lordosis was the only spinopelvic parameter found significantly greater in females (P < .001). Significant positive correlations between all spinopelvic parameters, except for lumbar lordosis and pelvic tilt, were found in the present study (P < .001).The study serves as the first large series database of sacrum morphometric characteristics and spinopelvic parameters of the Indonesian population. There was significant gender-associated differences in various dimensions of sacrum vertebrae. The sacral index was found to be the most useful parameter for sex determination. There were strong significant positive correlations between various spinopelvic parameters. A comparison of populations revealed morphometric characteristic differences, which is proved to be critical in surgical implications.

Morphometric study of sexual dimorphism in sacrum- A review paper

“…This study also led to the development and launching of sacral prosthesis based on the sacral body curved length and total curved length based on sacral amputation. 20 Studies by (Kothapalli et al, 2012) suggest that the length of the auricular surface and ala of the sacrum are higher in females. Generally, the studies of sacra are performed by manual measurements, and intact parts of undamaged or non-fractured, normal bones are usually chosen for effective results.…”

“…The study of the spinopelvic parameters (pelvic incidence (PI), pelvic tilt (PT), Sacral slope (SS), and Lumbar lordosis (LL) Computed tomographic images, showed that lumbar lordosis was found to be significantly greater in females. 20,21 A strong positive correlation between LL and SS provides the idea of analyzing LL and SS together in sexual dimorphism. This study also led to the development and launching of sacral prosthesis based on the sacral body curved length and total curved length based on sacral amputation.…”

Design of a Transforaminal Lumbar Interbody Fusion (TLIF) Spine Cage

“…therefore, we designed the spine cages based on Indonesian Lumbar Morphometry. The morphometry was suggested by Triwidodo et al (2021), which was observed and adapted in current study. The image was then analyzed further using Phyton software to find the specific geometrical parameters (Genisa et al, 2020).…”

“…There are some parameters from Triwidodo studies that could be considered as important features of the spine cage (Triwidodo et al, 2021). Python image processing is used to sketch the lumbar image, as shown in Figure 1.…”

“…For the contact area, the profile of the jaws was made to increase friction and limit the micromotion of the spine cage. Increasing the surface roughness of the spine cage is suitable for fixating the implant to the bone (Triwidodo et al, 2021). Therefore, we designed the surface area equipped with a pyramid jaws profile to gain a better osteogenic process.…”