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01-02-2018 | Original Article

Lumbosacral stress and age may contribute to increased pelvic incidence: an analysis of 1625 adults

Authors: Hongda Bao, Barthelemy Liabaud, Jeffrey Varghese, Renaud Lafage, Bassel G. Diebo, Cyrus Jalai, Subaraman Ramchandran, Gregory Poorman, Thomas Errico, Feng Zhu, Themistocles Protopsaltis, Peter Passias, Aaron Buckland, Frank Schwab, Virginie Lafage

Published in: European Spine Journal | Issue 2/2018

Abstract

Purpose

While there is a consensus that pelvic incidence (PI) remains constant after skeletal maturity, recent reports argue that PI increases after 60 years. This study aims to investigate whether PI increases with age and to determine potential associated factors.

Methods

1510 patients with various spinal degenerative and deformity pathologies were enrolled, along with an additional 115 asymptomatic volunteers. Subjects were divided into six age subgroups with 10-year intervals.

Results

PI averaged 54.1° in all patients. PI was significantly higher in the 45–54-year age group than 35–44-year age group (55.8° vs. 49.7°). There were significant PI differences between genders after age 45. Linear regression revealed age, gender and malalignment as associated factors for increased PI with R ² of 0.22 (p < 0.001).

Conclusions

PI is higher in female patients and in older patients, especially those over 45 years old. Spinal malalignment also may have a role in increased PI due to increased L5–S1 bending moment.

Lafage V, Schwab FJ, Patel A et al (2009) Pelvic tilt and truncal inclination: two key radiographic parameters in the setting of adults with spinal deformity. Spine (Phila Pa 1976) 34:E599–E606. doi:10.1097/BRS.0b013e3181aad219 CrossRef

During J, Goudfrooij H, Keessen W et al (1985) Toward standards for posture. Postural characteristics of the lower back system in normal and pathologic conditions. Spine (Phila Pa 1976) 10:83–87CrossRef

Duval-Beaupère G, Schmidt C, Cosson P (1992) A barycentremetric study of the sagittal shape of spine and pelvis: the conditions required for an economic standing position. Ann Biomed Eng 20:451–462. doi:10.1007/BF02368136 CrossRefPubMed

Legaye J, Duval-Beaupère G, Hecquet J, Marty C (1998) Pelvic incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves. Eur Spine J 7:99–103. doi:10.1007/s005860050038 CrossRefPubMedPubMedCentral

Mac-Thiong J-M, Berthonnaud E, Dimar JR et al (2004) Sagittal alignment of the spine and pelvis during growth. Spine (Phila Pa 1976) 29:1642–1647CrossRef

Legaye J, Jean L (2014) Influence of age and sagittal balance of the spine on the value of the pelvic incidence. Eur Spine J 23:1394–1399. doi:10.1007/s00586-014-3207-0 CrossRef

Kim D-H, Choi D-H, Park J-H et al (2015) What is the effect of spino-pelvic sagittal parameters and back muscles on osteoporotic vertebral fracture? Asian Spine J 9:162–169. doi:10.4184/asj.2015.9.2.162 CrossRefPubMedPubMedCentral

Weinberg DS, Morris WZ, Gebhart JJ, Liu RW (2015) Pelvic incidence: an anatomic investigation of 880 cadaveric specimens. Eur Spine J. doi:10.1007/s00586-015-4317-z

Deschênes S, Charron G, Beaudoin G et al (2010) Diagnostic imaging of spinal deformities: reducing patients radiation dose with a new slot-scanning X-ray imager. Spine (Phila Pa 1976) 35:989–994. doi:10.1097/BRS.0b013e3181bdcaa4 CrossRef

10.

Horton WC, Brown CW, Bridwell KH et al (2005) Is there an optimal patient stance for obtaining a lateral 36″ radiograph? A critical comparison of three techniques. Spine (Phila Pa 1976) 30:427–433CrossRef

11.

Lafage R, Ferrero E, Henry JK et al (2015) Validation of a new computer-assisted tool to measure spino-pelvic parameters. Spine J. doi:10.1016/j.spinee.2015.08.067

12.

Lafage V, Liabaud B, Lafage R et al (2015) Unlocking TPA’s clinical and sagittal significance by analyzing its relation to pelvic tilt. Spine J 15:S162. doi:10.1016/j.spinee.2015.07.183 CrossRef

13.

Lafage V, Obeid I, Lafage R, et al (2016) An updated analysis of gravity line with pelvic and lower limb compensation: now where do we stand?. In: SRS 51st Annu. Meet. Course Scoliosis Res. Soc

14.

Le Huec JC, Demezon H, Aunoble S (2014) Sagittal parameters of global cervical balance using EOS imaging: normative values from a prospective cohort of asymptomatic volunteers. Eur Spine J 24:63–71. doi:10.1007/s00586-014-3632-0 CrossRefPubMed

15.

Lee J-H, Na K-H, Kim J-H et al (2015) Is pelvic incidence a constant, as everyone knows? Changes of pelvic incidence in surgically corrected adult sagittal deformity. Eur Spine J. doi:10.1007/s00586-015-4199-0

16.

Mangione P, Gomez D, Senegas J (1997) Study of the course of the incidence angle during growth. Eur Spine J 6:163–167CrossRefPubMedPubMedCentral

17.

Robert Kent Merrill SKC, Dante M. Leven, Jun S. Kim, et al (2016) Fundamental differences and changes in pelvic parameters depending on age, gender, and race. In: IMAST 23rd Int. Meet. Adv. Spine Tech

18.

Smidt GL, Wei SH, McQuade K et al (1997) Sacroiliac motion for extreme hip positions. A fresh cadaver study. Spine (Phila Pa 1976) 22:2073–2082CrossRef

19.

Frymoyer JW, Howe J, Kuhlmann D (1978) The long-term effects of spinal fusion on the sacroiliac joints and ilium. Clin Orthop Relat Res 134:196–201

20.

Ha K-Y, Lee J-S, Kim K-W (2008) Degeneration of sacroiliac joint after instrumented lumbar or lumbosacral fusion: a prospective cohort study over five-year follow-up. Spine (Phila Pa 1976) 33:1192–1198. doi:10.1097/BRS.0b013e318170fd35 CrossRef

21.

Sturesson B, Uden A, Vleeming A (2000) A radiostereometric analysis of movements of the sacroiliac joints during the standing hip flexion test. Spine (Phila Pa 1976) 25:364–368CrossRef

22.

Charles YP, Yu B, Steib JP (2016) Sacroiliac joint luxation after pedicle subtraction osteotomy: report of two cases and analysis of failure mechanism. Eur Spine J 25:63–74. doi:10.1007/s00586-015-4094-8 CrossRefPubMed

23.

Davey DA (1995) The menopause and climacteric. Dewhurst’s Textb Obstet Gynaecol post Grad. Blackwell Science, New York, p 609

24.

Richelson LS, Wahner HW, Melton LJ, Riggs BL (1984) Relative contributions of aging and estrogen deficiency to postmenopausal bone loss. N Engl J Med 311:1273–1275. doi:10.1056/NEJM198411153112002 CrossRefPubMed

25.

Xu L, Sun X, Huang S et al (2013) Degenerative lumbar scoliosis in Chinese Han population: prevalence and relationship to age, gender, bone mineral density, and body mass index. Eur Spine J 22:1326–1331. doi:10.1007/s00586-013-2678-8 CrossRefPubMedPubMedCentral

Title: Lumbosacral stress and age may contribute to increased pelvic incidence: an analysis of 1625 adults
Authors: Hongda Bao
Barthelemy Liabaud
Jeffrey Varghese
Renaud Lafage
Bassel G. Diebo
Cyrus Jalai
Subaraman Ramchandran
Gregory Poorman
Thomas Errico
Feng Zhu
Themistocles Protopsaltis
Peter Passias
Aaron Buckland
Frank Schwab
Virginie Lafage
Publication date: 01-02-2018
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 2/2018
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-017-5324-z

2024 ASCO Annual Meeting

Springer Medicine

Lumbosacral stress and age may contribute to increased pelvic incidence: an analysis of 1625 adults

Abstract

Purpose

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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