The cohort study for the determination of reference values for spinopelvic parameters (T1 pelvic angle and global tilt) in elderly volunteers
Tóm tắt
T1 pelvic angle (TPA) and global tilt (GT) are spinopelvic parameters that account for trunk anteversion and pelvic retroversion. To investigate spinopelvic parameters, especially TPA and GT, in Japanese adults and determine norms for each parameter related to health-related quality of life (HRQOL). Six hundred and fifty-six volunteers (262 men and 394 women) aged 50–92 years (mean, 72.8 years) were enrolled in this study. The incidence of vertebral fracture, spondylolisthesis and coronal malalignment were measured. Five spinopelvic parameters (TPA, GT, sagittal vertical axis [SVA], pelvic tilt [PT], and pelvic incidence-lumbar lordosis [PI-LL]) were measured using whole spine standing radiographs. The mean values for each parameter were estimated by sex and decade of life. HRQOL measures, including the Oswestry Disability Index (ODI) and EuroQuol-5D (EQ-5D), were also obtained. Pearson’s correlation coefficients were determined between each parameter and HRQOL measure. Moreover, the factors contributing to the QOL score were calculated using logistic regression with age, sex, the existence of vertebral fracture and spondylolisthesis, coronal malalignment (coronal curve >30°) and sagittal malalignment (SVA >95 mm) as explanatory variables and the presence of disability (ODI >40) as a free variable. The mean values for the spinopelvic parameters were as follows: TPA, 17.9°; GT, 23.2°; SVA, 50.2 mm; PT, 18.6°; and PI-LL, 7.5°. TPA and GT strongly correlated with each other (r = 0.990) and with the other spinopelvic parameters. TPA and GT correlated with ODI (r = 0.339, r = 0.348, respectively) and EQ-5D (r = −0.285, r = −0.288, respectively), similar to those for SVA. TPA, GT, PT, and PI-LL were significantly higher in women than in men. PT and PI-LL gradually increased with age, while TPA, GT, and SVA tended to deteriorate after the 7th decade. Based on a logistic regression analysis, the deterioration of ODI was mostly affected by the sagittal malalignment. The TPA and GT cut-off values for severe disability (ODI >40) based on linear regression modeling were 26.0° and 33.7°, respectively. We determined reference values for spinopelvic parameters in elderly volunteers. Similar to SVA, TPA and GT correlated with HRQOL. TPA, GT, PT, and PI-LL were worse in women and progressed with age.
Tài liệu tham khảo
citation_journal_title=Spine (Phila Pa 1976); citation_title=An analysis of sagittal spinal alignment in 100 asymptomatic middle and older aged volunteers; citation_author=DE Gelb, LG Lenke, KH Bridwell, K Blanke, KW McEnery; citation_volume=20; citation_publication_date=1995; citation_pages=1351-1358; citation_doi=10.1097/00007632-199520120-00005; citation_id=CR1
citation_journal_title=Euro Spine J; citation_title=Age- and sex-related variations in sagittal sacropelvic morphology and balance in asymptomatic adults; citation_author=JM Mac-Thiong, P Roussouly, E Berthonnaud, P Guigui; citation_volume=20; citation_publication_date=2011; citation_pages=572-577; citation_doi=10.1007/s00586-011-1923-2; citation_id=CR2
citation_journal_title=J Bone Joint Surg Am; citation_title=Radiographic analysis of the sagittal alignment and balance of the spine in asymptomatic subjects; citation_author=R Vialle, N Levassor, L Rillardon, A Templier, W Skalli, P Guigui; citation_volume=87; citation_publication_date=2005; citation_pages=260-267; citation_doi=10.2106/JBJS.D.02043; citation_id=CR3
citation_journal_title=Spine (Phila Pa 1976); citation_title=Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position; citation_author=P Roussouly, S Gollogly, E Berthonnaud, J Dimnet; citation_volume=30; citation_publication_date=2005; citation_pages=346-353; citation_doi=10.1097/01.brs.0000152379.54463.65; citation_id=CR4
citation_journal_title=Spine; citation_title=Standing balance and sagittal plane spinal deformity: analysis of spinopelvic and gravity line parameters; citation_author=V Lafage, F Schwab, W Skalli, N Hawkinson, PM Gagey, S Ondra, JP Farcy; citation_volume=33; citation_publication_date=2008; citation_pages=1572-1578; citation_doi=10.1097/BRS.0b013e31817886a2; citation_id=CR5
citation_journal_title=Spine; citation_title=Normal patterns of sagittal alignment of the spine in young adults radiological analysis in a Korean population; citation_author=CS Lee, SS Chung, KC Kang, SJ Park, SK Shin; citation_volume=36; citation_publication_date=2011; citation_pages=E1648-E1654; citation_doi=10.1097/BRS.0b013e318216b0fd; citation_id=CR6
citation_journal_title=Spine (Phila Pa 1976); citation_title=Sagittal alignment of spine and pelvis in asymptomatic adults: norms in Chinese populations; citation_author=Z Zhu, L Xu, F Zhu, L Jiang, Z Wang, Z Liu, BP Qian, Y Qiu; citation_volume=39; citation_publication_date=2014; citation_pages=E1-E6; citation_doi=10.1097/BRS.0000000000000022; citation_id=CR7
citation_journal_title=Spine; citation_title=Variations in pelvic and other sagittal spinal parameters as a function of race in adolescent idiopathic scoliosis; citation_author=BS Lonner, JD Auerbach, P Sponseller, AD Rajadhyaksha, PO Newton; citation_volume=35; citation_publication_date=2010; citation_pages=E374-E377; citation_doi=10.1097/BRS.0b013e3181bb4f96; citation_id=CR8
citation_journal_title=J Bone Joint Surg Am; citation_title=TheT1 pelvic angle, a novel radiographic measure of global sagittal deformity, accounts for both spinal inclination and pelvic tilt and correlates with health-related quality of life; citation_author=T Protopsaltis, F Schwab, N Bronsard, JS Smith, E Klineberg, G Mundis, DJ Ryan, R Hostin, R Hart, D Burton, C Ames, C Shaffrey, S Bess, T Errico, V Lafage; citation_volume=96; citation_publication_date=2014; citation_pages=1631-1640; citation_doi=10.2106/JBJS.M.01459; citation_id=CR9
citation_journal_title=Spine; citation_title=T1 pelvic angle (TPA) effectively evaluates sagittal deformity and assesses radiographical surgical outcomes longitudinally; citation_author=; citation_volume=39; citation_publication_date=2014; citation_pages=1203-1210; citation_doi=10.1097/BRS.0000000000000382; citation_id=CR10
citation_journal_title=Eur Spine J; citation_title=Global tilt: a single parameter incorporating the spinal and pelvic sagittal parameters and least affected by patient positioning; citation_author=L Boissiere, I Obeid, JM Vital, F Kleinstück, F Pellise, FJS Perez-Grueso, A Alanay, E Acaroglu; citation_volume=23; citation_issue=Suppl 5; citation_publication_date=2014; citation_pages=469-496; citation_id=CR11
citation_journal_title=J Bone Miner Res; citation_title=Vertebral fracture assessment using a semiquantitative technique; citation_author=HK Genant, CY Wu, C Kuijk, MC Nevitt; citation_volume=8; citation_publication_date=1993; citation_pages=1137-1148; citation_doi=10.1002/jbmr.5650080915; citation_id=CR12
citation_journal_title=Spine; citation_title=Scoliosis Research Society-Schwab adult spinal deformity classification: a validation study; citation_author=F Schwab, B Ungar, B Blondel, J Buchowski, J Coe, D Deinlein, C DeWald, H Mehdian, C Shaffrey, C Tribus, V Lafage; citation_volume=37; citation_publication_date=2012; citation_pages=1077-1082; citation_doi=10.1097/BRS.0b013e31823e15e2; citation_id=CR13
citation_journal_title=Spine; citation_title=The impact of positive sagittal balance in adult spinal deformity; citation_author=SD Glassman, K Bridwell, JR Dimar, W Horton, S Berven, F Schwab; citation_volume=30; citation_publication_date=2005; citation_pages=2024-2029; citation_doi=10.1097/01.brs.0000179086.30449.96; citation_id=CR14
citation_journal_title=Spine; citation_title=Adult spinal deformity-postoperative standing imbalance: how much can you tolerate? An overview of key parameters in assessing alignment and planning corrective surgery; citation_author=F Schwab, A Patel, B Ungar, JP Farcy, V Lafage; citation_volume=35; citation_publication_date=2010; citation_pages=2224-2231; citation_doi=10.1097/BRS.0b013e3181ee6bd4; citation_id=CR15
citation_journal_title=Spine; citation_title=Pelvic tilt and truncal inclination: two key radiographic parameters in the setting of adults with spinal deformity; citation_author=V Lafage, F Schwab, A Patel, N Hawkinson, JP Farcy; citation_volume=34; citation_publication_date=2009; citation_pages=E599-E606; citation_doi=10.1097/BRS.0b013e3181aad219; citation_id=CR16
citation_journal_title=Euro Spine J; citation_title=Sagittal plane deformity: an overview of interpretation and management; citation_author=P Roussouly, C Nnadi; citation_volume=19; citation_publication_date=2010; citation_pages=1824-1836; citation_doi=10.1007/s00586-010-1476-9; citation_id=CR17
citation_journal_title=Spine; citation_title=Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity: a prospective multicenter analysis; citation_author=; citation_volume=38; citation_publication_date=2013; citation_pages=E803-E812; citation_doi=10.1097/BRS.0b013e318292b7b9; citation_id=CR18
citation_journal_title=Spine; citation_title=Correlation of radiographic parameters and clinical symptoms in adult scoliosis; citation_author=SD Glassman, S Berven, K Bridwell, W Horton, JR Dimar; citation_volume=30; citation_publication_date=2005; citation_pages=682-688; citation_doi=10.1097/01.brs.0000155425.04536.f7; citation_id=CR19
citation_journal_title=Euro Spine J; citation_title=Accuracy of the sagittal vertical axis in a standing lateral radiograph as a measurement of balance in spinal deformities; citation_author=BJ Royen, HM Toussaint, I Kingma, SD Bot, M Caspers, J Harlaar, PI Wuisman; citation_volume=7; citation_publication_date=1998; citation_pages=408-412; citation_doi=10.1007/s005860050098; citation_id=CR20
citation_journal_title=Euro Spine J; citation_title=Global analysis of sagittal spinal alignment in major deformities: correlation between lack of lumbar lordosis and flexion of the knee; citation_author=I Obeid, O Hauger, S Aunoble, A Bourghli, N Pellet, JM Vital; citation_volume=20; citation_publication_date=2011; citation_pages=681-685; citation_doi=10.1007/s00586-011-1936-x; citation_id=CR21
citation_journal_title=Spine; citation_title=T1 pelvic angle: a new predictor for postoperative sagittal balance and clinical outcomes in adult scoliosis; citation_author=J Qiao, F Zhu, L Xu, Z Liu, Z Zhu, B Qian, X Sun, Y Qiu; citation_volume=39; citation_publication_date=2014; citation_pages=2103-2107; citation_doi=10.1097/BRS.0000000000000635; citation_id=CR22
citation_journal_title=Spine; citation_title=Differences in male and female spino-pelvic alignment in asymptomatic young adults: a three-dimensional analysis using upright low-dose digital biplanar X-rays; citation_author=MM Janssen, X Drevelle, L Humbert, W Skalli, RM Castelein; citation_volume=34; citation_publication_date=2009; citation_pages=E826-E832; citation_doi=10.1097/BRS.0b013e3181a9fd85; citation_id=CR23
citation_journal_title=Euro Spine J; citation_title=Classification of sagittal imbalance based on spinal alignment and compensatory mechanisms; citation_author=C Lamartina, P Berjano; citation_volume=23; citation_publication_date=2014; citation_pages=1177-1189; citation_doi=10.1007/s00586-014-3227-9; citation_id=CR24
citation_journal_title=Euro Spine J; citation_title=A comparative analysis of sagittal spinopelvic alignment between young and old men without localized disc degeneration; citation_author=YB Kim, YJ Kim, YJ Ahn, GB Kang, JH Yang, H Lim, SW Lee; citation_volume=23; citation_publication_date=2014; citation_pages=1400-1406; citation_doi=10.1007/s00586-014-3236-8; citation_id=CR25