Comparison of Whole Spine Sagittal Alignment in Patients with Spinal Disease between EOS Imaging System versus Conventional Whole Spine X-ray
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: The biplanar whole body imaging system (EOS) is a new tool for measuring the whole body sagittal alignment in a lim ited space. This tool may affect the sagittal balance of patients compared to conventional whole spine X-ray (WSX). This study aimed to investigate the difference in sagittal alignment between WSX and EOS. Materials and Methods: We compared the spinal and pelvic sagittal parameters in 80 patients who underwent EOS and WSX within one month between July 2018 and September 2019. The patients were divided based on sagittally balanced and imbalanced groups according to pelvic tilt (PT) >20°, pelvic incidence-lumbar lordosis >10°, C7-sagittal vertical axis (SVA) > 50 mm in WSX. Results: In the sagittally imbalanced group, compared to WSX, the pelvic parameters demonstrated compensation in EOS with smaller PT (27.4±11.6° vs. 24.9±10.9°, p=0.003) and greater sacral slope (SS), and the patients tended to stand more upright with smaller C7-SVA (58.4±17.0 mm vs. 48.9±57.3 mm, p=0.018), T1-pelvic angle (TPA), T5-T12, and T2-T12. However, in the sagittally balanced group, these differences were less pronounced only with smaller PT (10.8±6.9° vs. 9.4±4.7°, p=0.040), TPA and T2-T12 angle, but with similar SS and C7-SVA (p>0.05). Conclusion: EOS showed a negative SVA shift and lesser PT compared to WSX, especially in patients with sagittal imbalance. When preparing a surgical plan, surgeons should consider these differences between EOS and WSX.
Abstract
Purpose: The biplanar whole body imaging system (EOS) is a new tool for measuring the whole body sagittal alignment in a lim ited space. This tool may affect the sagittal balance of patients compared to conventional whole spine X-ray (WSX). This study aimed to investigate the difference in sagittal alignment between WSX and EOS. Materials and Methods: We compared the spinal and pelvic sagittal parameters in 80 patients who underwent EOS and WSX within one month between July 2018 and September 2019. The patients were divided based on sagittally balanced and imbalanced groups according to pelvic tilt (PT) >20°, pelvic incidence-lumbar lordosis >10°, C7-sagittal vertical axis (SVA) > 50 mm in WSX. Results: In the sagittally imbalanced group, compared to WSX, the pelvic parameters demonstrated compensation in EOS with smaller PT (27.4±11.6° vs. 24.9±10.9°, p=0.003) and greater sacral slope (SS), and the patients tended to stand more upright with smaller C7-SVA (58.4±17.0 mm vs. 48.9±57.3 mm, p=0.018), T1-pelvic angle (TPA), T5-T12, and T2-T12. However, in the sagittally balanced group, these differences were less pronounced only with smaller PT (10.8±6.9° vs. 9.4±4.7°, p=0.040), TPA and T2-T12 angle, but with similar SS and C7-SVA (p>0.05). Conclusion: EOS showed a negative SVA shift and lesser PT compared to WSX, especially in patients with sagittal imbalance. When preparing a surgical plan, surgeons should consider these differences between EOS and WSX.
참고문헌 (23)
- Glassman SD, "The impact of positive sagittal balance in adult spinal deformity", Spine(Phila Pa 1976), 30, pp.2024~2029 (2005)
- Schwab F, "Adult spinal deformity-postoperative standing imbalance: how much can you tolerate? An overview of key parameters in assessing alignment and planning corrective surgery", Spine(Phila Pa 1976), 35, pp.2224~2231 (2010)
- Lafage V, "Pelvic tilt and truncal inclination : two key radiographic parameters in the setting of adults with spinal deformity", Spine(Phila Pa 1976), 34, pp.E599~606 (2009)
- Berjano P, "Successful correction of sagittal imbalance can be calculated on the basis of pelvic incidence and age", Eur Spine J, 23(Suppl 6), pp.587~596 (2014)
- Dubousset J, "Skeletal and spinal imaging with EOS system", Arch Pediatr, 15, pp.665~666 (2008)[DOI]
- Lazennec JY, "Measuring extension of the lumbar-pelvic-femoral complex with the EOS® system", Eur J Orthop Surg Traumatol, 25, pp.1061~1068 (2015)
- Dubousset J, "The pediatric spine: principles and practice", pp.479~496 (1994), Raven Press
- Jackson RP, "Radiographic analysis of sagittal plane alignment and balance in standing volunteers and patients with low back pain matched for age, sex, and size. A prospective controlled clinical study", Spine (Phila Pa 1976), 19, pp.1611~1618 (1994)
- Vanneuville G, "Mechanisms of orientation of the pelvifemoral base during static loading of the lumbar spine in weight-lifters", Surg Radiol Anat, 14, pp.29~33 (1992)
- Legaye J, "Sagittal plane alignment of the spine and gravity : a radiological and clinical evaluation", Acta Orthop Belg, 71, pp.213~220 (2005)
- Barrey C, "Compensatory mechanisms contributing to keep the sagittal balance of the spine", Eur Spine J, 22(Suppl 6), pp.S834~S841 (2013)
- Ferrero E, "Role of pelvic translation and lower-extremity compensation to maintain gravity line position in spinal deformity", J Neurosurg Spine, 24, pp.436~446 (2016)
- Janssen MM, "Differences in male and female spino-pelvic alignment in asymptomatic young adults : a three-dimensional analysis using upright lowdose digital biplanar X-rays", Spine(Phila Pa 1976), 34, pp.E826~32 (2009)
- Hey HWD, "Lumbar spine alignment in six common postures", Spine(Phila Pa 1976), 42, pp.1447~1455 (2017)
- Hey HWD, "Comparison of whole body sagittal alignment during directed vs natural, relaxed standing postures in young, healthy adults", Spine J, 19, pp.1832~1839 (2019)
- Marks M, "Which lateral radiographic positioning technique provides the most reliable and functional representation of a patient’s sagittal balance", Spine (Phila Pa 1976), 34, pp.949~954 (2009)
- Vidal C, "Reliability of cervical lordosis and global sagittal spinal balance measurements in adolescent idiopathic scoliosis", Eur Spine J, 22, pp.1362~1367 (2013)
- Scheer JK, "Outcomes of surgical treatment for one hundred and thirty-eight patients with severe sagittal deformity at a minimum 2-year follow-up", Neurosurgery, 66, pp.310~408 (2019)
- 현승재, "Proximal Junctional Kyphosis and Proximal Junctional Failure Following Adult Spinal Deformity Surgery", Neurospine, 14(4), pp.126~132 (2017), 대한척추신경외과학회[DOI]
- Kati Kristiina Kyrölä, "Intra- and Interrater Reliability of Sagittal Spinopelvic Parameters on Full-Spine Radiographs in Adults With Symptomatic Spinal Disorders", Neurospine, 15(2), pp.175~181 (2018), 대한척추신경외과학회
- Protopsaltis T, "TheT1 pelvic angle, a novel radiographic measure of global sagittal deformity, accounts for both spinal inclination and pelvic tilt and correlates with health-related quality of life", J Bone Joint Surg Am, 96, pp.1631~1640 (2014)
- Horton WC, "Is there an optimal patient stance for obtaining a lateral 36"radiograph? A critical comparison of three techniques", Spine(Phila Pa 1976), 30, pp.427~433 (2005)
- Kaneko K, "Validation study of arm positions for evaluation of global spinal balance in EOS imaging", Eur J Orthop Surg Traumatol, 26, pp.725~733 (2016)