Relation between sagittal pelvic and thoracolumbar parameters in supine position – Pelvic parameters and their predictive value for spinal Cobb angles

Introduction: Predicting the pre-morbid sagittal profile of the spine or segmental angles could enhance the process of planning the extent of fracture reduction. There is evidence that spinopelvic parameters may be suitable for this purpose. Research question: Is it possible to determine the inflect...

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Main Authors: Arija Jacobi, Philipp Schenk, Esra Aydin, Friederike Klauke, Thomas Mendel, Bernhard W. Ullrich
Format: Article
Language:English
Published: Elsevier 2024-01-01
Series:Brain and Spine
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772529424000353
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author Arija Jacobi
Philipp Schenk
Esra Aydin
Friederike Klauke
Thomas Mendel
Bernhard W. Ullrich
author_facet Arija Jacobi
Philipp Schenk
Esra Aydin
Friederike Klauke
Thomas Mendel
Bernhard W. Ullrich
author_sort Arija Jacobi
collection DOAJ
description Introduction: Predicting the pre-morbid sagittal profile of the spine or segmental angles could enhance the process of planning the extent of fracture reduction. There is evidence that spinopelvic parameters may be suitable for this purpose. Research question: Is it possible to determine the inflection point and the mono- and bi-segmental endplate angles (EPA) in the thoracolumbar transition (from Th9 to L2) based on age, gender, spinopelvic parameters, and the adjacent EPA in the supine position? Material and methods: Based on Polytrauma CT scans in the supine position, the following spinopelvic parameters were measured using non-fractured spines: pelvic incidence (PI), sacral slope (SS), lumbar lordosis (LL), and the apex of the LL. Results: In this study, a total of 287 patients with a mean age of 42±16 years were included. Age-related changes were observed, where LL, thoracic kyphosis (TK), and PI increase with age. Gender-related comparisons showed that females had a more pronounced LL and reduced TK. Significant correlations between IP and spinopelvic parameters, with the apex of LL providing the best prediction, were found. However, the overall model quality remained low. Predicting mEPA and bEPA showed positive correlations. The prediction for mEPA L2/3 demonstrated the highest correlation. For bisegmental angles, the most caudal bEPA (L2) exhibited the highest correlation, albeit with some notable absolute differences in the values between measured and predicted values. Discussion and conclusion: While this study highlights the complexity of the relationship between the pelvis and thoracolumbar parameters, finding a predictive tool for thoracolumbar reduction and stabilization was not possible.
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spelling doaj-art-5fd09a2fea7945788f21e5963873c7f02024-12-15T06:18:15ZengElsevierBrain and Spine2772-52942024-01-014102779Relation between sagittal pelvic and thoracolumbar parameters in supine position – Pelvic parameters and their predictive value for spinal Cobb anglesArija Jacobi0Philipp Schenk1Esra Aydin2Friederike Klauke3Thomas Mendel4Bernhard W. Ullrich5Department of Orthopedic and Trauma Surgery, DIAKO Ev. Diakonie-Krankenhaus gGmbH, 28239, Bremen, Germany; Corresponding author.Department of Science, Research and Education, BG Klinikum Bergmannstrost Halle gGmbH, 06112, Halle, GermanyDepartment of Cardiology, DRK Klinik Köpenick, 12559, Berlin, GermanyDepartment of Trauma and Reconstructive Surgery, BG Klinikum Bergmannstrost Halle gGmbH, 06112, Halle, Germany; Clinic for Trauma, Hand and Reconstructive Surgery, University Hospital Halle, Martin Luther University Halle-Wittenberg, GermanyDepartment of Trauma and Reconstructive Surgery, BG Klinikum Bergmannstrost Halle gGmbH, 06112, Halle, Germany; Clinic for Trauma, Hand and Reconstructive Surgery, University Hospital Halle, Martin Luther University Halle-Wittenberg, GermanyDepartment of Trauma and Reconstructive Surgery, BG Klinikum Bergmannstrost Halle gGmbH, 06112, Halle, Germany; Clinic for Trauma, Hand and Reconstructive Surgery, University Hospital Halle, Martin Luther University Halle-Wittenberg, GermanyIntroduction: Predicting the pre-morbid sagittal profile of the spine or segmental angles could enhance the process of planning the extent of fracture reduction. There is evidence that spinopelvic parameters may be suitable for this purpose. Research question: Is it possible to determine the inflection point and the mono- and bi-segmental endplate angles (EPA) in the thoracolumbar transition (from Th9 to L2) based on age, gender, spinopelvic parameters, and the adjacent EPA in the supine position? Material and methods: Based on Polytrauma CT scans in the supine position, the following spinopelvic parameters were measured using non-fractured spines: pelvic incidence (PI), sacral slope (SS), lumbar lordosis (LL), and the apex of the LL. Results: In this study, a total of 287 patients with a mean age of 42±16 years were included. Age-related changes were observed, where LL, thoracic kyphosis (TK), and PI increase with age. Gender-related comparisons showed that females had a more pronounced LL and reduced TK. Significant correlations between IP and spinopelvic parameters, with the apex of LL providing the best prediction, were found. However, the overall model quality remained low. Predicting mEPA and bEPA showed positive correlations. The prediction for mEPA L2/3 demonstrated the highest correlation. For bisegmental angles, the most caudal bEPA (L2) exhibited the highest correlation, albeit with some notable absolute differences in the values between measured and predicted values. Discussion and conclusion: While this study highlights the complexity of the relationship between the pelvis and thoracolumbar parameters, finding a predictive tool for thoracolumbar reduction and stabilization was not possible.http://www.sciencedirect.com/science/article/pii/S2772529424000353Spinal alignmentSagittal profileThoracolumbar fracturesSupine positionMono-/bi-segmental endplate angleCobb angle
spellingShingle Arija Jacobi
Philipp Schenk
Esra Aydin
Friederike Klauke
Thomas Mendel
Bernhard W. Ullrich
Relation between sagittal pelvic and thoracolumbar parameters in supine position – Pelvic parameters and their predictive value for spinal Cobb angles
Brain and Spine
Spinal alignment
Sagittal profile
Thoracolumbar fractures
Supine position
Mono-/bi-segmental endplate angle
Cobb angle
title Relation between sagittal pelvic and thoracolumbar parameters in supine position – Pelvic parameters and their predictive value for spinal Cobb angles
title_full Relation between sagittal pelvic and thoracolumbar parameters in supine position – Pelvic parameters and their predictive value for spinal Cobb angles
title_fullStr Relation between sagittal pelvic and thoracolumbar parameters in supine position – Pelvic parameters and their predictive value for spinal Cobb angles
title_full_unstemmed Relation between sagittal pelvic and thoracolumbar parameters in supine position – Pelvic parameters and their predictive value for spinal Cobb angles
title_short Relation between sagittal pelvic and thoracolumbar parameters in supine position – Pelvic parameters and their predictive value for spinal Cobb angles
title_sort relation between sagittal pelvic and thoracolumbar parameters in supine position pelvic parameters and their predictive value for spinal cobb angles
topic Spinal alignment
Sagittal profile
Thoracolumbar fractures
Supine position
Mono-/bi-segmental endplate angle
Cobb angle
url http://www.sciencedirect.com/science/article/pii/S2772529424000353
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