Francesco Langella1, Jorge Hugo Villafañe2, Virginie Lafage3, Justin S Smith4, Christopher Shaffrey4, Han Jo Kim5, Douglas Burton6, Richard Hostin7, Shay Bess8, Christopher Ames9, Gregory Mundis10, Eric Klineberg11, Frank Schwab3, Renault Lafage5, Pedro Berjano12. 1. IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. Francesco.langella.md@gmail.com. 2. IRCCS Fondazione Don Carlo Gnocchi, 20121, Milan, Italy. 3. Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, 301 E 17th St, New York, NY, 10003, USA. 4. Department of Neurosurgery, University of Virginia School of Medicine, P.O. Box 800212, Charlottesville, VA, 22908, USA. 5. Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, 10021, USA. 6. Department of Orthopedic Surgery, University of Kansas School of Medicine, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA. 7. Baylor Scoliosis Center, 4708 Alliance Boulevard, Suite 800, Plano, TX, 75093, USA. 8. Rocky Mountain Hospital for Children, Presbyterian/St Luke's Medical Center, 2055 High Street, Suite 130, Denver, CO, 80205, USA. 9. Department of Neurosurgery, University of California San Francisco, 505 Parnassus Avenue, Room M779, San Francisco, CA, 94143, USA. 10. San Diego Center for Spinal Disorders, 5130 La Jolla Village Drive, Suite 300, La Jolla, CA, 92037, USA. 11. Department of Orthopedic Surgery, University of California Davis, 4860 Y Street, Suite 3800, Sacramento, CA, 95817, USA. 12. IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
Abstract
STUDY DESIGN: Retrospective multi-center cohort study. PURPOSE: Sagittal misalignment causes changes in the abdominal shape. Xipho-pubic angle (XPA) has been previously described to radiographically evaluate the shape of the abdominal cavity in patients with spine deformity. The aims of this study are to evaluate the correlation of XPA-to-spinopelvic sagittal parameters and to patients' health-related quality-of-life (HRQoL) scores. METHODS: 278 patients from a multi-center database with diagnosis adult spinal deformity (ASD) (one or more of: coronal Cobb angle > 20°, sagittal vertical axis (SVA) > 50 mm, pelvic tilt (PT) > 25°, and thoracic kyphosis > 60°) were included. Cut-off values for moderate and severe disability (ODI-Oswestry Disability Index-20 and 40%) were calculated. Pearson's correlation was tested between XPA and spinopelvic parameters and between XPA and HRQoL scores. RESULTS: The cut-off value of XPA to identify ODI severe disability (40/100) was identified with XPA smaller than 103°; minimal (20/100) disability was identified by XPA greater than 113°. XPA showed strong correlation to sagittal spinopelvic parameters-PT, SVA, lumbar lordosis (LL), pelvic incidence (PI) minus LL-and to HRQoL scores-ODI, SF-36 PCS and SRS-22 activity and pain. XPA was the parameter with the strongest correlation to HRQoL scores. CONCLUSIONS: Xipho-pubic angle reflects changes in spinal changes and has strong correlation to HRQoL and spinopelvic parameters. It can discriminate between patients with minimal, moderate, and severe disability as measured by ODI scores. These slides can be retrieved under Electronic Supplementary Material.
STUDY DESIGN: Retrospective multi-center cohort study. PURPOSE: Sagittal misalignment causes changes in the abdominal shape. Xipho-pubic angle (XPA) has been previously described to radiographically evaluate the shape of the abdominal cavity in patients with spine deformity. The aims of this study are to evaluate the correlation of XPA-to-spinopelvic sagittal parameters and to patients' health-related quality-of-life (HRQoL) scores. METHODS: 278 patients from a multi-center database with diagnosis adult spinal deformity (ASD) (one or more of: coronal Cobb angle > 20°, sagittal vertical axis (SVA) > 50 mm, pelvic tilt (PT) > 25°, and thoracic kyphosis > 60°) were included. Cut-off values for moderate and severe disability (ODI-Oswestry Disability Index-20 and 40%) were calculated. Pearson's correlation was tested between XPA and spinopelvic parameters and between XPA and HRQoL scores. RESULTS: The cut-off value of XPA to identify ODI severe disability (40/100) was identified with XPA smaller than 103°; minimal (20/100) disability was identified by XPA greater than 113°. XPA showed strong correlation to sagittal spinopelvic parameters-PT, SVA, lumbar lordosis (LL), pelvic incidence (PI) minus LL-and to HRQoL scores-ODI, SF-36 PCS and SRS-22 activity and pain. XPA was the parameter with the strongest correlation to HRQoL scores. CONCLUSIONS: Xipho-pubic angle reflects changes in spinal changes and has strong correlation to HRQoL and spinopelvic parameters. It can discriminate between patients with minimal, moderate, and severe disability as measured by ODI scores. These slides can be retrieved under Electronic Supplementary Material.
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Authors: Mònica Solana-Tramunt; Alberto Ortegón; José Morales; Ainhoa Nieto; María Betina Nishishinya; Jorge Hugo Villafañe Journal: J Orthop Date: 2019-06-06