STUDY DESIGN: A retrospective radiographical study. OBJECTIVE: To compare the prediction abilities of T1 pelvic angle (TPA) and other parameters for postoperative sagittal balance, and investigate the relationships between these parameters and health-related quality of life. SUMMARY OF BACKGROUND DATA: Using sagittal vertical axis (SVA) to assess sagittal alignment fails to take account of the pelvic compensation. A new parameter, TPA, has been recommended to represent the global sagittal balance of adult scoliosis. METHODS: A retrospective review was performed on patients with adult scoliosis undergoing correction surgery from May 2009 to March 2013. The Spearman ρ was used to determine the correlations between the radiographical parameters (preoperative, postoperative, and changes) and the overall Oswestry Disability Index (ODI), visual analogue scale (VAS), and Scoliosis Research Society-22 (SRS-22) questionnaire scores. RESULTS: Significant correlations were found between the changes of TPA and the changes of lumbar lordosis, pelvic tilt, sacral slope, pelvic incidence, SVA, spinosacral angle, ODI, VAS, SRS-22, and pedicle subtraction osteotomy (PSO) degrees (P < 0.05). The changes of SVA were significantly related to the changes of lumbar lordosis, TPA, C7-sacrofemoral distance, ODI, VAS, SRS-22 (P < 0.05) but not PSO degrees (P > 0.05). Significant correlations were found between the changes of spinosacral angle and the changes of thoracolumbar kyphosis, TPA, ODI, VAS, SRS-22, and PSO degrees (P < 0.05). The changes of C7 plumb line to sacrofemoral distance ratio were significantly related to the changes of SVA (P < 0.05), but not the changes of ODI, VAS, SRS-22, or PSO degrees (P > 0.05). CONCLUSION: TPA could better reflect the postoperative changes of sagittal alignment and health-related quality of life for patients with adult scoliosis. Moreover, the changes of TPA are strongly correlated to the osteotomy degrees for PSO and, TPA could be used as a reference parameter in surgical planning. LEVEL OF EVIDENCE: 4.
STUDY DESIGN: A retrospective radiographical study. OBJECTIVE: To compare the prediction abilities of T1 pelvic angle (TPA) and other parameters for postoperative sagittal balance, and investigate the relationships between these parameters and health-related quality of life. SUMMARY OF BACKGROUND DATA: Using sagittal vertical axis (SVA) to assess sagittal alignment fails to take account of the pelvic compensation. A new parameter, TPA, has been recommended to represent the global sagittal balance of adult scoliosis. METHODS: A retrospective review was performed on patients with adult scoliosis undergoing correction surgery from May 2009 to March 2013. The Spearman ρ was used to determine the correlations between the radiographical parameters (preoperative, postoperative, and changes) and the overall Oswestry Disability Index (ODI), visual analogue scale (VAS), and Scoliosis Research Society-22 (SRS-22) questionnaire scores. RESULTS: Significant correlations were found between the changes of TPA and the changes of lumbar lordosis, pelvic tilt, sacral slope, pelvic incidence, SVA, spinosacral angle, ODI, VAS, SRS-22, and pedicle subtraction osteotomy (PSO) degrees (P < 0.05). The changes of SVA were significantly related to the changes of lumbar lordosis, TPA, C7-sacrofemoral distance, ODI, VAS, SRS-22 (P < 0.05) but not PSO degrees (P > 0.05). Significant correlations were found between the changes of spinosacral angle and the changes of thoracolumbar kyphosis, TPA, ODI, VAS, SRS-22, and PSO degrees (P < 0.05). The changes of C7 plumb line to sacrofemoral distance ratio were significantly related to the changes of SVA (P < 0.05), but not the changes of ODI, VAS, SRS-22, or PSO degrees (P > 0.05). CONCLUSION:TPA could better reflect the postoperative changes of sagittal alignment and health-related quality of life for patients with adult scoliosis. Moreover, the changes of TPA are strongly correlated to the osteotomy degrees for PSO and, TPA could be used as a reference parameter in surgical planning. LEVEL OF EVIDENCE: 4.
Authors: I Obeid; L Boissière; C Yilgor; D Larrieu; F Pellisé; A Alanay; E Acaroglu; F J Perez-Grueso; F Kleinstück; J M Vital; A Bourghli Journal: Eur Spine J Date: 2016-06-20 Impact factor: 3.134