关键词:
Adult spinal deformity
Sagittal alignment
Scoliosis
Balance
Ground reaction force
摘要:
BACKGROUND CONTEXT: During quiet standing, the gravity line (GL) can be located according to the sum of the ground reaction forces (GRFs) measured with a force platform. C7 plumb line (C7PL) is an easy method to estimate sagittal trunk balance, but discordance between C7PL and the GL is widely recognized. However, the prevalence of occiput-trunk (O-T) discordance (GL-C7PLO3 cm) and the factors affecting this type of discordance have not yet been determined. PURPOSE: The purpose of this study was to report the prevalence of O-T discordance in adult spinal deformity (ASD) patients and identify the factors affecting this type of discordance. STUDY DESIGN: This was a retrospective consecutive case series of ASD. PATIENT SAMPLE: This retrospective case series included 300 consecutive ASD patients. The inclusion criteria were age more than 50 years, Cobb angle of the main curve more than 20 degrees, and C7PL more than 5 cm. The exclusion criteria consisted of inappropriate radiography;syndromic, neuromuscular, or other pathologic conditions;and previous joint replacement. OUTCOME MEASURES: The outcome measures included self-reported (Scoliosis Research Society 22 and Oswestry disability index [ODI]) and radiographic measures. METHODS: In a retrospective consecutive case series, demographic and radiographic patient data were reviewed. Demographic data included age, gender, curve type, SRS22, and ODI. Radiographic data included GL, C7PL, C2-C7, T2-T5, T5-T12, T10-L2, T2 tilt, lumbar lordosis (LL), sacrum slope (SS), pelvic tilt (PT), and pelvic incidence (PI). Global sagittal and spinopelvic alignments were also reviewed. Patients were categorized in either a O-T concordance (C group, GL-C7PL<3 cm) or a O-T discordance (D group, GL-C7PL more than +3 cm) group, and the demographic, radiographic, and clinical outcome data were compared between these groups. One-way analysis of variance, correlation coefficient tests, and multiple regression and logistic regression analyses we