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Published on: March 23, 2019
Thoracolumbar Sagittal Shape Varies With Pelvic Morphology and Aging
Solène Prost1, Yann-Philippe Charles2, Brice Ilharreborde3
1AIx-Marseille University, APHM, CNRS, ISM, CHU Timone, Spine surgery, Marseille, France.
Study Design:
Retrospective study of a multicenter prospective database.
Objective:
The objective of this study was to determine the organization and correlations between different spinal segments according to pelvic incidence (PI) and age.
Summary Of Background Data:
When planning surgery for the correction of adult spinal deformities, considering lumbar lordosis (LL) as a uniform segment is an approximation that can lead to planning errors.
Materials And Methods:
Radiographs of 1540 subjects were analyzed and divided into three PI groups: low <45, intermediate 45 to 60, high >60, and stratified by age (<45, 45-70, and >70 yr). The different segments of L1-L4 proximal lumbar lordosis (PLL), L4-S1 distal lumbar lordosis (DLL), and T10-L1 thoracolumbar junction (TLJ) were analyzed.
Results:
The mean age was 53.5 years (SD=17, minimum=20, maximum=93). There was a significant correlation between thoracic kyphosis T5-T12 and TLJ segment T10-L1 ( r =0.581, P <0.001). Only the L1-L4 PLL segment correlated with PI ( r =0.47, P <0.001). The T10-L1 TLJ segment was constant regardless of age or PI groups considered (mean=-8, SD=9). PLL did not vary with aging but differed according to PI. The DLL showed significant differences between age and PI groups but without a significant correlation between PI and DLL.
Conclusions:
Pelvic morphology is known to determine the curvatures of the spine, however, the distribution of LL is not homogeneous. Our study provided a normative value reference and showed that T10-L1 is constant regardless of age or PI.
Level Of Evidence:
III.
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