Three-dimensional pelvic incidence is much higher in (thoraco)lumbar scoliosis than in controls

Brink, Rob C.; Vavruch, Ludvig; Schlösser, Tom P. C.; Abul-Kasim, Kasim; Ohlin, Acke; Tropp, Hans; Castelein, René M.; Vrtovec, Tomaž

doi:10.1007/s00586-018-5718-6

Cited by 10 publications

(13 citation statements)

References 34 publications

(87 reference statements)

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“…(34) The importance of these backwarldy inclined vertebrae in the development of different curves was demonstrated in a number of studies. (1,(34)(35)(36)(37)44,45,50,(52)(53)(54) Pasha, using a different approach, also showed that the more backwardly inclined vertebrae are most prone to start a decompensation into a scoliotic deformation. She showed that, because of the characteristics of the human spine in the sagittal plane, its mechanical behavior can be compared with that of a prebent S-shaped elastic rod.…”

Section: Discussionmentioning

confidence: 99%

“…( 34 ) The importance of these backwarldy inclined vertebrae in the development of different curves was demonstrated in a number of studies. ( 1,34–37,44,45,50,52–54 )…”

Section: Discussionmentioning

confidence: 99%

“…(50) Brink and colleagues showed that the pelvic incidence, the determinator of sagittal spinal alignment, is significantly higher in lumbar than in thoracic scoliosis and controls. (51,52) Schlösser and colleagues showed that early lumbar scoliosis has a different sagittal profile than does early thoracic scoliosis, (53) and de Reuver and colleagues showed that degenerative de novo scoliosis has similar spino-pelvic configuration as adolescent Lenke 5 scoliosis. (54) This all points to the role of pelvic morphology and the sagittal spinal alignment in the etiology of different types of scoliosis.…”

Section: Consequences Of the Human Fully Upright Sagittal Spinal Profilementioning

confidence: 99%

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Idiopathic Scoliosis as a Rotatory Decompensation of the Spine

Castelein

Pasha

Cheng

et al. 2020

Journal of Bone and Mineral Research

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Many years of dedicated research into the etiology of idiopathic scoliosis have not led to one unified theory. We propose that scoliosis is a mechanical, rotatory decompensation of the human spine that starts in the transverse, or horizontal, plane. The human spine is prone to this type of decompensation because of its unique and individually different, fully upright sagittal shape with some preexistent transverse plane rotation. Spinal stability depends on the integrity of a delicate system of stabilizers, in which intervertebral disc stiffness is crucial. There are two phases in life when important changes occur in the precarious balance between spinal loading and the disc's stabilizing properties: (i) during puberty, when loads and moment arms increase rapidly, while the disc's "anchor," the ring apophysis, matures from purely cartilaginous to mineralized to ultimately fused to the vertebral body, and (ii) in older age, when the torsional stiffness of the spinal segments decreases, due to disc degeneration and subsequent laxity of the fibers of the annulus fibrosus. During these crucial periods, transverse plane vertebral rotation can increase during a relatively brief window in time, either as adolescent idiopathic or degenerative de novo scoliosis. Much more is known of the biomechanical changes that occur during disc aging and degeneration than of the changing properties of the disc during maturation.

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Section: Discussionmentioning

confidence: 99%

“…( 34 ) The importance of these backwarldy inclined vertebrae in the development of different curves was demonstrated in a number of studies. ( 1,34–37,44,45,50,52–54 )…”

Section: Discussionmentioning

confidence: 99%

Section: Consequences Of the Human Fully Upright Sagittal Spinal Profilementioning

confidence: 99%

See 1 more Smart Citation

Idiopathic Scoliosis as a Rotatory Decompensation of the Spine

Castelein

Pasha

Cheng

et al. 2020

Journal of Bone and Mineral Research

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“…Furthermore, as angles in both methods are usually measured from standing lateral radiographs, the angle obtained can be affected by the overlap of anatomic structures, magnification of structures further from the film. In our series, the measurements of PI and SAO were made on CT scan with 3D reconstruction which benefits from the precision associated with the imaging modality chosen [ 19 – 21 ].…”

Section: Discussionmentioning

confidence: 99%

Sacral Anatomical Orientation in the Lebanese Population

Maalouly

Jabbour

Saidy

et al. 2020

Advances in Orthopedics

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Introduction. PI is currently used as the gold standard measurement in spinopelvic anatomy. There is a need for a reliable method to calculate sacral anatomic orientation (SAO) independent of posture and to establish its association with PI, which was previously established in a single study (Peleg et al., 2007). Therefore, the aim of our study is the application and verification of this association on a Lebanese sample. Methods. Methods for measuring SAO and PI on living individuals are described. The study was carried out on 200 adult individuals using CT 3D images (volume-rendering method). Reliability (intratester and intertester) was evaluated using the intraclass correlation test. A regression analysis was carried out to evaluate the association between the two measurements. Results. There were 103 females (51%) and 97 males (49%) with a mean age of 58.68 ± 19.6 years (min = 20; max = 93). The mean SAO and PI in our population were found to be 52.65° (SD = 8.16°) and 59.08° (SD = 12.53°), respectively. SAO and PI measurements were highly correlated (Pearson correlation test; r = −0.296, P<0.0001 for our general population). PI can be predicted via SAO, i.e., SAO = (−0.193 × PI) + 64.057. Conclusions. SAO may be an important tool, alongside PI, in defining the sagittal shape of the spine and useful for understanding its association with spinal diseases as they are not affected by postural changes.

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“…Earlier studies observed a higher PI in primary lumbar adolescent idiopathic scoliosis patients compared to primary thoracic curve types and to non-scoliotic controls [7,[12][13][14]. In adolescents, pelvic morphology dictates the spinal alignment, where a higher PI corresponds with a more pronounced curvature of the spinal profile in the sagittal plane, including a steeper dorsally inclined segment of the thoracolumbar spine [15].…”

Section: Introductionmentioning

confidence: 95%

The role of sagittal pelvic morphology in the development of adult degenerative scoliosis

et al. 2021

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Purpose Pelvic morphology dictates the alignment and biomechanics of the spine. Recent observations in different types of adolescent idiopathic scoliosis indicate that individual pelvic morphology is related to the spinal levels in which scoliosis develops: primary lumbar adolescent scoliosis is associated with a higher pelvic incidence (PI) than thoracic scoliosis and non-scoliotic controls. We hypothesize that adult degenerative scoliosis (ADS) of the lumbar spine follows the same mechanical principles and is associated with a high PI. Methods This study used an existing CT-scan database, 101 ADS patients were sex and age matched to 101 controls. The PI was measured by two observers with multi-planar reconstruction, perpendicular to the hip-axis according to a previously validated technique. Results The PI was 54.1° ± 10.8° in ADS patients and 47.7° ± 10.8° in non-scoliotic controls (p < 0.001). The median ADS curve apex was the disc L2-3 and median curve length was 4 vertebral levels. The mean supine Cobb angle was 21° ± 8° (ranged 10°–47°). There was no significant correlation between PI and the apex level (p = 0.883), the curve length (p = 0.418) or the Cobb angle (p = 0.518). Conclusions ADS normally develops de novo in the lumbar spine of patients with a higher PI than controls, similar to primary lumbar adolescent idiopathic scoliosis. This suggests a shared mechanical basis of both deformities. Pelvic morphology dictates spinal sagittal alignment, which determines the segments of the spine that are prone to develop scoliosis.

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Three-dimensional pelvic incidence is much higher in (thoraco)lumbar scoliosis than in controls

Cited by 10 publications

References 34 publications

Idiopathic Scoliosis as a Rotatory Decompensation of the Spine

Idiopathic Scoliosis as a Rotatory Decompensation of the Spine

Sacral Anatomical Orientation in the Lebanese Population

The role of sagittal pelvic morphology in the development of adult degenerative scoliosis

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