Correlation between Iliac Tilt and traditional sagittal parameters in adolescents

This study aims to systematically validate the reliability and applicability of Iliac Tilt (IT) as a parameter for sagittal balance assessment, explore its relationship with traditional parameters such as Pelvic Tilt (PT) and Pubic-Sacral Angle (PSA), and analyze its performance across different stages of skeletal development.

A retrospective study was conducted with 118 healthy pediatric participants. Full-length sagittal radiographs were obtained using the advanced EOS imaging system, and relevant sagittal plane parameters were measured using standardized methods. Participants were grouped based on Risser staging, and statistical analyses, including one-way analysis of variance (ANOVA), Pearson correlation analysis, and linear regression, were performed.

Iliac Tilt (IT) was significantly negatively correlated with Pelvic Tilt (PT) (r = -0.761, p < 0.001) and significantly positively correlated with Pubic-Sacral Angle (PSA) (r = 0.814, p < 0.001). Linear regression analysis revealed that IT was a significant predictor of both PT and PSA, with R² values of 0.736 and 0.717, respectively. Additionally, across different Risser stages, IT demonstrated high stability, while PSA and T1 Slope-Pelvic Incidence (T1SPI) showed significant changes with staging.

As a novel parameter, Iliac Tilt (IT) demonstrates high reliability and broad applicability in reflecting posterior pelvic tilt and sagittal spinal balance. Compared to traditional parameters, IT offers a simpler measurement process, making it suitable for complex cases with limited imaging quality. It provides an efficient evaluation tool for clinical and research applications.