Scoliosis Research Society-22r score is affected by standing whole body sagittal alignment, age, and sex, but not by standing balance or skeletal muscle mass in healthy volunteers

Hara, Kazuhiro; Hatsushikano, Shun; Watanabe, Kei; Ohashi, Masayuki; Dubousset, Jean

doi:10.1007/s00586-022-07360-2

Cited by 5 publications

(3 citation statements)

References 36 publications

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“…Hasegawa et al used EOS™ slot-scanning 3D X-ray imaging to evaluate standing sagittal alignment of the whole axial skeleton with reference to the gravity line in humans and reported that cervical lordosis, pelvic tilt and incidence, hip extension, knee flexion, and ankle dorsiflexion were all related significantly with age. They also provided evidence that compensation in whole-body alignment, as indicated by several sagittal parameters, correlates with HRQOL scores [ 130 , 131 , 132 ]. We think that all of these parameters are linked in mutual relationships to cervical spine alignment and sagittal deformity following cervical spine surgery.…”

Section: Discussionmentioning

confidence: 99%

Current Concepts of Cervical Spine Alignment, Sagittal Deformity, and Cervical Spine Surgery

Suzuki,

Funaba,

Fujimoto

et al. 2024

JCM

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There are not many reports on cervical spine alignment, and only a few analyze ideal surgical approaches and optimal amounts of correction needed for the various types of deformity. We comprehensively reviewed the present literature on cervical spinal deformities (with or without myelopathy) and their surgical management to provide a framework for surgical planning. A general assessment of the parameters actually in use and correlations between cervical and thoracolumbar spine alignment are provided. We also analyzed posterior, anterior, and combined cervical surgical approaches and indications for the associated techniques of laminoplasty, laminectomy and fusion, and anterior cervical discectomy and fusion. Finally, on the basis of the NDI, SF-36, VAS, and mJOA questionnaires, we fully evaluated the outcomes and measures of postoperative health-related quality of life. We found the need for additional prospective studies to further enhance our understanding of the importance of cervical alignment when assessing and treating cervical deformities with or without myelopathy. Future studies need to focus on correlations between cervical alignment parameters, disability scores, and myelopathy outcomes. Through this comprehensive literature review, we offer guidance on practical and important points of surgical technique, cervical alignment, and goals surgeons can meet to improve symptoms in all patients.

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Section: Discussionmentioning

confidence: 99%

Current Concepts of Cervical Spine Alignment, Sagittal Deformity, and Cervical Spine Surgery

Suzuki,

Funaba,

Fujimoto

et al. 2024

JCM

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“…Reliability in measurement also remains an issue. Finally, height change may be considered a surrogate for improvement in sagittal alignment, which could impact PROMs such as the SRS-22r 29 . However, in our study, both patients with height loss and those with height gain experienced postoperative improvements in sagittal alignment.…”

Section: Discussionmentioning

confidence: 99%

Height Gain Following Correction of Adult Spinal Deformity

Diebo

Tataryn

Alsoof

et al. 2023

Journal of Bone and Joint Surgery

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Background: Height gain following a surgical procedure for patients with adult spinal deformity (ASD) is incompletely understood, and it is unknown if height gain correlates with patient-reported outcome measures (PROMs). Methods: This was a retrospective cohort study of patients undergoing ASD surgery. Patients with baseline, 6-week, and subanalysis of 1-year postoperative full-body radiographic and PROM data were examined. Correlation analysis examined relationships between vertical height differences and PROMs. Regression analysis was utilized to preoperatively estimate T1-S1 and S1-ankle height changes. Results: This study included 198 patients (mean age, 57 years; 69% female); 147 patients (74%) gained height. Patients with height loss, compared with those who gained height, experienced greater increases in thoracolumbar kyphosis (2.81° compared with −7.37°; p < 0.001) and thoracic kyphosis (12.96° compared with 4.42°; p = 0.003). For patients with height gain, sagittal and coronal alignment improved from baseline to postoperatively: 25° to 21° for pelvic tilt (PT), 14° to 3° for pelvic incidence − lumbar lordosis (PI-LL), and 60 mm to 17 mm for sagittal vertical axis (SVA) (all p < 0.001). The full-body mean height gain was 7.6 cm, distributed as follows: sella turcica-C2, 2.9 mm; C2-T1, 2.8 mm; T1-S1 (trunk gain), 3.8 cm; and S1-ankle (lower-extremity gain), 3.3 cm (p < 0.001). T1-S1 height gain correlated with the thoracic Cobb angle correction and the maximum Cobb angle correction (p = 0.002). S1-ankle height gain correlated with the corrections in PT, PI-LL, and SVA (p < 0.001). T1-ankle height gain correlated with the corrections in PT (p < 0.001) and SVA (p = 0.03). Trunk height gain correlated with improved Scoliosis Research Society (SRS-22r) Appearance scores (r = 0.20; p = 0.02). Patient-Reported Outcomes Measurement Information System (PROMIS) Depression scores correlated with S1-ankle height gain (r = −0.19; p = 0.03) and C2-T1 height gain (r = −0.18; p = 0.04). A 1° correction in a thoracic scoliosis Cobb angle corresponded to a 0.2-mm height gain, and a 1° correction in a thoracolumbar scoliosis Cobb angle resulted in a 0.25-mm height gain. A 1° improvement in PI-LL resulted in a 0.2-mm height gain. Conclusions: Most patients undergoing ASD surgery experienced height gain following deformity correction, with a mean full-body height gain of 7.6 cm. Height gain can be estimated preoperatively with predictive ratios, and height gain was correlated with improvements in reported SRS-22r appearance and PROMIS scores. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

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“…We have retrospectively analyzed prospectively collected data from EOS imaging in healthy volunteers, as has been reported previously 27) . In brief, healthy adult volunteers aged ≥20 years without a history of treatment for a spinal disease were enrolled in this study and underwent an EOS system (EOS imaging, Paris, France) from the head to the feet.…”

Section: Study Design and Subjectsmentioning

confidence: 99%

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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Scoliosis Research Society-22r score is affected by standing whole body sagittal alignment, age, and sex, but not by standing balance or skeletal muscle mass in healthy volunteers

Cited by 5 publications

References 36 publications

Current Concepts of Cervical Spine Alignment, Sagittal Deformity, and Cervical Spine Surgery

Current Concepts of Cervical Spine Alignment, Sagittal Deformity, and Cervical Spine Surgery

Height Gain Following Correction of Adult Spinal Deformity

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

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