AIREX: Appropriate pelvic obliquity measurement method in Lenke type 5C adolescent idiopathic scoliosis: a preliminary study

タイトル	Appropriate pelvic obliquity measurement method in Lenke type 5C adolescent idiopathic scoliosis: a preliminary study
DOI	https://doi.org/10.21037/jss-23-138
本文（外部サイト）	https://ir.library.osaka-u.ac.jp/repo/ouka/all/97266/JSpineSurg_10_2_255.pdf
著者（英）	Kanie, Yuya; Takenaka, Shota; Kitahara, Takayuki; Furuya, Masayuki; Ukon, Yuichiro; Fujimori, Takahito; Okada, Seiji; Kaito, Takashi
発行日	2024-06-01
発行機関など	AME Publishing Company
刊行物名	Journal of Spine Surgery
巻	10
号	2
開始ページ	255
終了ページ	263
言語	eng
内容記述	Kanie Y., Takenaka S., Kitahara T., et al. Appropriate pelvic obliquity measurement method in Lenke type 5C adolescent idiopathic scoliosis: a preliminary study. Journal of Spine Surgery 10, 255 (2024); https://doi.org/10.21037/jss-23-138. Background: Although pelvic obliquity (PO) is a risk factor for postoperative coronal decompensation in corrective surgery in adolescent idiopathic scoliosis (AIS), especially Lenke 5C, methods of measuring PO are controversial. This study aimed to establish an appropriate measurement method using multiplanar reconstructed computed tomography (MPR-CT) images instead of standing posteroanterior (PA) whole-spine radiographs to evaluate PO in patients with Lenke 5C AIS. Methods: This study was a retrospective cross-sectional study. Twenty-five patients who underwent corrective surgery for AIS in Osaka University Hospital from August 2014 to February 2023 were included. Cobb angle, L5 tilt, C7 plumb line to center sacral vertebral line (C7PL-CSVL), and leg length discrepancy (LLD) were measured on standing PA whole-spine radiographs preoperatively. Sacral obliquity (SO), the slope of the upper endplate of S1, and iliac obliquity (IO), the tilt of the line connecting the iliac crests, were measured on standing PA whole-spine radiographs and MPR-CT (SO/IO-X-ray, SO/IO-CT, respectively). S1 angle and S2 angle were measured on CT. Results: The mean age of the patients was 18.7±3.9 years and all of them were females. SO-X-ray and SO-CT were larger than IO-X-ray and IO-CT, respectively. SO-X-ray was highly correlated with SO-CT (r=0.838, P<0.001). L5 tilt had higher correlation with SO-CT (r=0.884, P<0.001) than with SO-X-ray (r=0.726, P=0.001) and IO-CT (r=0.550, P=0.22). L5 tilt was correlated poorly with IO-X-ray (r=0.104, P=0.69). The S1 angle was 4.5±3.5° meanwhile the S2 angle was 1.2±2.1°, the sacral deformity was mainly due to the S1 vertebral wedging. Conclusions: Given the asymmetric sacral morphology, SO is more appropriate pelvic parameter than IO to represent the sacral tilt of Lenke 5C AIS, especially when measured using CT images to overcome the poor visibility on PA whole-spine radiographs.
キーワード	Adolescent idiopathic scoliosis (AIS); iliac obliquity (IO); pelvic obliquity (PO); pelvic parameters; sacral obliquity (SO)
権利	This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
URI	https://repository.exst.jaxa.jp/dspace/handle/a-is/1246502