Can Pelvic Tilt be Predicated by the Sacrofemoral-Pubic Angel in Patients With Thoracolumbar Kyphosis Secondary to Ankylosing Spondylitis?

Hu, Jun; Ji, Ming-liang; Qian, Bangping; Qiu, Yong; Wang, Bin; Yu, Yang; Zhu, Zhou; Jiang, Jun

doi:10.1097/brs.0000000000000592

Cited by 11 publications

(17 citation statements)

References 22 publications

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“…Blondel et al [ 7 ] showed that the SFP angle obtained from coronal radiographs of the pelvis correlated with PT and suggested the formula PT=74.6−0.942×(SFP angle). Following this report, other authors have demonstrated a correlation between PT and the SFP angle, although these authors focused on different diseases and patients of different ages [ 8 9 10 11 ]. Our formula differs from the formulae reported to date with regard to the intercept and slope.…”

Section: Discussionmentioning

confidence: 84%

“…Because we only observed pelvic radiographs in local medical examinations, it was not possible to confirm the presence or absence of spinal diseases. Hu et al [ 9 ] derived their formula by studying patients with ankylosing spondylitis and showed fewer errors when they compared their formula with that reported by Blondel et al in their patients. Consequently, appropriate formulae for calculating the relationship between PT and the SFP angle may differ in other diseases.…”

Section: Discussionmentioning

confidence: 99%

“…In females and males, the vertical distance between the upper edge of the pubic symphysis and the midpoint of the sacrococcygeal joint showed the strongest correlation among all other parameters (Pearson's correlation coefficient: 0.63 in females, 0.68 in males). However, numerous studies have examined the relationship between PT and the SFP angle [ 8 9 10 11 24 ]. Our results also support the use of the SFP angle in the prediction of PT.…”

Section: Discussionmentioning

confidence: 99%

“…Blondel et al [ 7 ] reported a correlation between PT and the sacro-femoral-pubic (SFP) angle, which is measured from coronal radiographs of the pelvis, and concluded that even if the femoral head is blurred in sagittal radiographs, it is possible to predict PT from the SFP angle. A correlation between PT and the SFP angle has been reported in different diseases and in subjects of various ages [ 8 9 10 11 ]. However, to date there are no reports on the association between PT and the SFP angle in middle-aged and elderly Asian individuals.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of the Relationship between Pelvic Tilt and the Sacro-Femoral-Pubic Angle in Middle-Aged and Elderly Asian Individuals

Kitagawa¹,

Iizuka²,

Kobayashi³

et al. 2017

Asian Spine J

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Study DesignCross-sectional study.PurposeThe purpose of this study was to evaluate the correlation between pelvic tilt (PT) and the sacro-femoral-pubic (SFP) angle, which is easier to identify than PT, in middle-aged and elderly Asian subjects from the general population.Overview of LiteratureMeasuring PT is important in the diagnosis and treatment of adult spinal deformity. However, identifying femoral heads, which are necessary to determine PT, using sagittal radiographs is often difficult.MethodsStanding coronal and sagittal pelvic radiographs of individuals aged more than 50 years were taken during a local medical examination. The subjects were divided into female, male, and total groups at the time of evaluation. Linear regression analysis was performed to investigate the relationship between PT and the SFP angle, which were obtained from the X-rays.ResultsThe present study included 291 subjects. There were no statistically significant differences between the left and right SFP angles, and there was gender difference regarding the SFP angle. However, a gender difference was observed regarding PT. The correlation between PT and the SFP angle was substantiated in each group. Pearson's correlation coefficients between PT and the SFP angle in the total, female, and male groups were 0.696, 0.853, and 0.619, respectively. In the linear regression analysis, PT was calculated as follows: PT=60.1−0.77×(SFP angle) in the total group, PT=62.8−0.80×(SFP angle) in the female group, and PT=51.5−0.64×(SFP angle) in the male group.ConclusionsA significant correlation between PT and the SFP angle was observed in middle-aged and elderly Asian subjects from the general population.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Assessment of the Relationship between Pelvic Tilt and the Sacro-Femoral-Pubic Angle in Middle-Aged and Elderly Asian Individuals

Kitagawa¹,

Iizuka²,

Kobayashi³

et al. 2017

Asian Spine J

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“…As the course of the disease progress, the spinal kyphosis of the patients with AS is gradually aggravated and the gravity center moves anterior accordingly. To compensate for the sagittal imbalance, AS patients retrovert the pelvis and PT is found increasing [ 6 , 8 , 9 ]. In previous studies, PT was regarded as an essential parameter to analyze the sagittal alignment of AS patients with spinal kyphosis [ 6 , 8 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

Can pelvic tilt be restored by spinal osteotomy in ankylosing spondylitis patients with thoracolumbar kyphosis? A minimum follow-up of 2 years

Wang

Zhao²,

Zheng³

et al. 2018

J Orthop Surg Res

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BackgroundDefining the postoperative pelvic tilt (PT) individually can help to reconstruct sagittal balance. However, the postoperative actual PT is hardly restored to theoretical value. Some cases with theoretical postoperative PT was overcorrected and still did not have normal horizontal visual field after surgery. The objective of this study is to describe the pelvic tilt change after spinal osteotomy in ankylosing spondylitis (AS) kyphotic deformity and evaluate the effect on clinical outcomes.MethodsTwenty-three AS patients including 21 men and two women with thoracolumbar kyphosis, who underwent spinal osteotomy from 2013 to 2015 in our center, were retrospectively reviewed. A series of parameters including sacral slop (SS), pelvic incidence (PI), PT, and sagittal vertical axis (SVA) measured on preoperative and postoperative standing radiographs were analyzed. The theoretical postoperative PT (tPT) was calculated by the formula tPT = 0.37 × PI − 7. The radiographic measurements were compared before surgery, 2 weeks and at least 2 years postoperatively. Clinical outcomes were performed with the Oswestry disability index and Scoliosis Research Society-22 surveys.ResultsMean age of the patients (2 women, 21 men) was 39.8 ± 9.1 years. Mean follow-up was 27.4 ± 3.8 months, at least 24 months. After spinal osteotomy, SS and SVA were corrected from 11.9° ± 11.2° and 18.0 ± 7.6 mm preoperatively to 25.8° ± 8.1° and 9.6 ± 6.3 mm postoperatively, respectively (p < 0.001). PT reduced from 37.6° ± 12.1° to 21.8° ± 9.8° postoperatively (p < 0.001). The tPT was different from postoperative actual PT significantly (p < 0.001). The clinical evaluations were not correlated with postoperative PT.ConclusionThe abnormal PT is corrected by spinal osteotomy but is hard to restore to theoretical normal value. PT is a helpful parameter in making surgery plan. But pursuing postoperative PT being totally equal to tPT is undesirable and even may cause for overcorrection.

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The accuracy in determining pelvic tilt from anteroposterior pelvic radiographs in patients awaiting hip arthroplasty

Innmann

McGoldrick

Ratra

et al. 2021

Journal Orthopaedic Research

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Spinopelvic mobility affects outcome after THA. Whether the sacro‐femoral‐pubic (SFP) angle, measured on AP radiographs, can be reliably used to estimate pelvic tilt (PT) in hip osteoarthritis patients is unknown. This study aimed to (1) validate the use of the SFP angle in the calculation of PT from AP radiographs, and (2) identify individual patient factors affecting the estimation of PT. A cohort of 100 patients awaiting THA for end‐stage hip osteoarthritis was prospectively studied. AP and lateral radiographs, taken in the standing and relaxed‐seated positions were evaluated for spinopelvic measurements (SFP, PT, and pelvic incidence [PI]). To validate the SFP angle, estimated PT values using the formula [PT = 75°‐SFP] were compared to the true, measured values from the lateral radiographs. Despite good agreement for the estimated and true PT (16.2 ± 5.9° vs. 15.5 ± 8.6°; p = .315), a significantly poorer agreement could be found between the two methods at high or low values of PT. Patient‐specific PI correlated with the difference between the two measurement methods (Pearson's r = −0.644; p < .001). However, the change in SFP angle equaled approximately the change in pelvic tilt (∆PT = 2°−∆SFP; Pearson's r = −0.934; p < .001). Absolute values for the sagittal PT should not be estimated from AP pelvic radiographs in patients awaiting total hip arthroplasty. However, the relative change in PT between different positions equals approximately the change in SFP angle. This may allow functional cup orientation after THA to be determined between different postures from an AP radiograph of the pelvis. The SFP angle has moderate accuracy in determining a patient's pelvic tilt; however, it can accurately determine a patient's change in pelvic tilt in different positions.

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Can Pelvic Tilt be Predicated by the Sacrofemoral-Pubic Angel in Patients With Thoracolumbar Kyphosis Secondary to Ankylosing Spondylitis?

Abstract: 4.

Cited by 11 publications

References 22 publications

Assessment of the Relationship between Pelvic Tilt and the Sacro-Femoral-Pubic Angle in Middle-Aged and Elderly Asian Individuals

Assessment of the Relationship between Pelvic Tilt and the Sacro-Femoral-Pubic Angle in Middle-Aged and Elderly Asian Individuals

Can pelvic tilt be restored by spinal osteotomy in ankylosing spondylitis patients with thoracolumbar kyphosis? A minimum follow-up of 2 years

The accuracy in determining pelvic tilt from anteroposterior pelvic radiographs in patients awaiting hip arthroplasty

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