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Correlation Between Different Sagittal Parameters in Patients With Degenerative Kyphosis

Yan Liang¹, Shuai Xu¹, Chen Guo¹

¹Spinal Surgery, Peking University People's Hospital, Beijing, China.

Frontiers in Molecular Neuroscience

|April 8, 2022

Summary

Lumbar lordosis (LL) in degenerative kyphosis (DK) correlates with pelvic tilt (PT) and thoracic kyphosis (TK). Understanding these spino-pelvic parameters is crucial for surgical planning and preventing proximal junction kyphosis (PJK).

Area of Science:

Spine surgery
Orthopedics
Radiology

Background:

Sagittal balance is a key predictor of clinical outcomes in degenerative kyphosis (DK).
The precise relationships between various sagittal parameters in DK patients remain unclear.
Understanding these relationships is vital for effective treatment strategies.

Purpose of the Study:

To investigate the correlations among different sagittal parameters in patients with degenerative kyphosis (DK).
To establish a fitting formula for spino-pelvic parameters in DK patients.
To differentiate parameter relationships between sagittal balance (SB) and sagittal imbalance (SIB) groups.

Main Methods:

Retrospective analysis of 279 participants, including 168 DK patients.
Division of DK patients into SB (52 cases) and SIB (116 cases) groups.
Radiographic measurements: thoracolumbar kyphosis (TLK), lumbar lordosis (LL), thoracic kyphosis (TK), pelvic incidence (PI), pelvic tilt (PT), and sagittal vertical axis (SVA).

Main Results:

Significant differences in TLK, LL, PI-LL, PT, SVA, sacral slope (SS), and TK were observed between SB and SIB groups.
In DK patients, LL significantly correlated with PT and TK (LL = 22.76 - 0.28 × PT + 0.62 × TK).
In the SB group, TK influenced LL (LL = 33.57 + 0.33 × TK); in the SIB group, PT and TK synergistically affected PI-LL.

Conclusions:

Lumbar lordosis (LL) shows a significant correlation with pelvic tilt (PT) and thoracic kyphosis (TK) in degenerative kyphosis (DK) patients.
In the sagittal balance (SB) group, LL is primarily correlated with TK.
Tailored correction strategies for LL based on sagittal balance status are recommended to prevent proximal junction kyphosis (PJK).

Keywords:

degenerative kyphosis lumbar lordosis pelvic incidence pelvic tilt sagittal balance thoracolumbar kyphosis

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