Global Spinal Alignment Following Unilateral and Bilateral Periacetabular Osteotomy: A Standing Spine Radiographic...

Area of Science:

• Orthopedic surgery
• Radiology
• Spine alignment

Background:

• Periacetabular osteotomy (PAO) improves hip dysplasia outcomes.
• The effect of PAO on spinopelvic alignment remains unclear.
• This study investigates PAO's impact on coronal and sagittal spinopelvic parameters.

Purpose of the Study:

• To evaluate changes in spinopelvic parameters after PAO.
• To assess coronal and sagittal alignment post-unilateral and bilateral PAO.
• To determine if PAO influences pelvic tilt, sacral slope, or lumbar lordosis.

Main Methods:

• Included skeletally mature patients undergoing PAO for hip dysplasia.
• Analyzed EOS spine radiographs (AP and lateral) preoperatively and postoperatively.
• Used statistical tests (Paired Sample t test, Wilcoxon Signed-Rank test) to assess radiographic changes.

Main Results:

• 31 patients (44 hips) were analyzed; 18 unilateral PAO, 13 bilateral PAO.
• Significant improvements in Lateral Central Edge Angle (LCEA) and Acetabular Index (AI) were observed post-PAO.
• No statistically significant changes in Pelvic Tilt, Sacral Slope, Pelvic Incidence, or Lumbar Lordosis were found.

Conclusions:

• PAO surgery does not significantly alter spinopelvic alignment.
• Pelvic tilt in skeletally mature patients with acetabular dysplasia is likely a fixed morphologic characteristic.
• Findings suggest pelvic tilt is not a compensatory or reversible mechanism in this population.