T1 Pelvic Angle A New Predictor for Postoperative Sagittal Balance and Clinical Outcomes in Adult Scoliosis
T1 Pelvic Angle A New Predictor for Postoperative Sagittal Balance and Clinical Outcomes in Adult Scoliosis
复制标题
DOI：
10.1097/brs.0000000000000635
复制
发表时间：
2014-12-01
期刊：
影响因子：
3
通讯作者：
Qiu, Yong
中科院分区：
文献类型：
--
作者：
Qiao, Jun;Zhu, Feng;Qiu, Yong
研究设计.一项回顾性放射学研究。比较T1骨盆角（TPA）和其他参数对术后矢状面平衡的预测能力，并探讨这些参数与健康相关生活质量的关系。矢状面垂直轴（SVA）评价矢状面对线时未考虑骨盆代偿。一个新的参数，TPA，已被推荐代表成人脊柱侧凸的整体矢状面平衡。对2009年5月至2013年3月接受矫正手术的成人脊柱侧凸患者进行了回顾性分析。斯皮尔曼。确定X线摄影参数（术前、术后和变化）与总体奥斯韦斯特里功能障碍指数（ODI）、视觉模拟评分（VAS）和脊柱侧凸研究协会-22（SRS-22）问卷评分之间的相关性。TPA的变化与腰椎前凸、骨盆倾斜、骶骨倾斜、骨盆倾斜度、SVA、腰骶角、ODI、VAS、SRS-22、椎弓根截骨（PSO）度的变化有显著相关性（P < 0.05）。SVA的变化与腰椎前凸、TPA、C7-骶股距离、ODI、VAS、SRS-22的变化有显著相关性（P < 0.05），而与PSO的变化无显著相关性（P > 0.05）。胸腰椎后凸度、TPA、ODI、VAS、SRS-22、PSO度与椎骶角的变化有显著相关性（P < 0.05）。C7垂线与骶股距离比值的变化与SVA的变化有显著相关性（P <0. 05），而与ODI、VAS、SRS-22、PSO的变化无显著相关性（P > 0. 05）。TPA能较好地反映成人脊柱侧凸患者术后矢状面的变化及健康相关生活质量。此外，TPA的变化与PSO的截骨程度密切相关，TPA可以作为手术计划的参考参数。
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. 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.