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BMC Medical Imaging
Published in: BMC Medical Imaging 1/2013

Open Access 01-12-2013 | Research article

Increased pelvic incidence may lead to arthritis and sagittal orientation of the facet joints at the lower lumbar spine

Authors: Thorsten Jentzsch, James Geiger, Samy Bouaicha, Ksenija Slankamenac, Thi Dan Linh Nguyen-Kim, Clément ML Werner

Published in: BMC Medical Imaging | Issue 1/2013

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Abstract

Background

Correct sagittal alignment with a balanced pelvis and spine is crucial in the management of spinal disorders. The pelvic incidence (PI) describes the sagittal pelvic alignment and is position-independent. It has barely been investigated on CT scans. Furthermore, no studies have focused on the association between PI and facet joint (FJ) arthritis and orientation. Therefore, our goal was to clarify the remaining issues about PI in regard to (1) physiologic values, (2) age, (3) gender, (4) lumbar lordosis (LL) and (5) FJ arthritis and orientation using CT scans.

Methods

We retrospectively analyzed CT scans of 620 individuals, with a mean age of 43 years, who presented to our traumatology department and underwent a whole body CT scan, between 2008 and 2010. The PI was determined on sagittal CT planes of the pelvis by measuring the angle between the hip axis to an orthogonal line originating at the center of the superior end plate axis of the first sacral vertebra. We also evaluated LL, FJ arthritis and orientation of the lumbar spine.

Results

596 individuals yielded results for (1) PI with a mean of 50.8°. There was no significant difference for PI and (2) age, nor (3) gender. PI was significantly and linearly correlated with (4) LL (p = < 0.0001). Interestingly, PI and (5) FJ arthritis displayed a significant and linear correlation (p = 0.0062) with a cut-off point at 50°. An increased PI was also significantly associated with more sagitally oriented FJs at L5/S1 (p = 0.01).

Conclusion

PI is not correlated with age nor gender. However, this is the first report showing that PI is significantly and linearly associated with LL, FJ arthritis and more sagittal FJ orientation at the lower lumbar spine. This may be caused by a higher contact force on the lower lumbar FJs by an increased PI. Once symptomatic or in the event of spinal trauma, patients with increased PI and LL could benefit from corrective surgery and spondylodesis.
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Metadata
Title
Increased pelvic incidence may lead to arthritis and sagittal orientation of the facet joints at the lower lumbar spine
Authors
Thorsten Jentzsch
James Geiger
Samy Bouaicha
Ksenija Slankamenac
Thi Dan Linh Nguyen-Kim
Clément ML Werner
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Medical Imaging / Issue 1/2013
Electronic ISSN: 1471-2342
DOI
https://doi.org/10.1186/1471-2342-13-34

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