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European Spine Journal

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Open Access 01-09-2021 | Scoliosis | Original Article

The role of sagittal pelvic morphology in the development of adult degenerative scoliosis

Authors: Steven de Reuver, Philip P. van der Linden, Moyo C. Kruyt, Tom P. C. Schlösser, René M. Castelein

Published in: European Spine Journal | Issue 9/2021

Abstract

Purpose

Pelvic morphology dictates the alignment and biomechanics of the spine. Recent observations in different types of adolescent idiopathic scoliosis indicate that individual pelvic morphology is related to the spinal levels in which scoliosis develops: primary lumbar adolescent scoliosis is associated with a higher pelvic incidence (PI) than thoracic scoliosis and non-scoliotic controls. We hypothesize that adult degenerative scoliosis (ADS) of the lumbar spine follows the same mechanical principles and is associated with a high PI.

Methods

This study used an existing CT-scan database, 101 ADS patients were sex and age matched to 101 controls. The PI was measured by two observers with multi-planar reconstruction, perpendicular to the hip-axis according to a previously validated technique.

Results

The PI was 54.1° ± 10.8° in ADS patients and 47.7° ± 10.8° in non-scoliotic controls (p < 0.001). The median ADS curve apex was the disc L2-3 and median curve length was 4 vertebral levels. The mean supine Cobb angle was 21° ± 8° (ranged 10°–47°). There was no significant correlation between PI and the apex level (p = 0.883), the curve length (p = 0.418) or the Cobb angle (p = 0.518).

Conclusions

ADS normally develops de novo in the lumbar spine of patients with a higher PI than controls, similar to primary lumbar adolescent idiopathic scoliosis. This suggests a shared mechanical basis of both deformities. Pelvic morphology dictates spinal sagittal alignment, which determines the segments of the spine that are prone to develop scoliosis.

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Title: The role of sagittal pelvic morphology in the development of adult degenerative scoliosis
Authors: Steven de Reuver
Philip P. van der Linden
Moyo C. Kruyt
Tom P. C. Schlösser
René M. Castelein
Publication date: 01-09-2021
Publisher: Springer Berlin Heidelberg
Keywords: Scoliosis
Adolescent Idiopathic Scoliosis
Published in: European Spine Journal / Issue 9/2021
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-021-06924-y

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Springer Medicine

The role of sagittal pelvic morphology in the development of adult degenerative scoliosis

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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