Correlations between T1 pelvic angle and spino-pelvic sagittal alignment and health related life quality in patients with degenerative scoliosis

English Keywords:Degenerative scoliosis  Spino-pelvic sagittal balance  T1 pelvic angle  Health related quality of life

English Abstract:

  【Abstract】　Objectives: To investigate whether T1 pelvic angle(TPA) can represent sagittal balance, and to investigate the relationship between TPA and health related quality of life(HRQOL) of patients with degenerative scoliosis(DS). Methods: Patients with DS who received surgery from February 2007 to December 2011 wereretrospectively reviewed. Inclusion criteria were as followings: having follow-ups longer than 2 years and the complete radiographic and clinical data. Patients were excluded when they had received spinal surgery or suffered from hip or knee disease. A total of 76 DS patients(male: 9; female: 67) was included with an average age of 58.2±6.1 years(range: 45-72 years) and an average Cobb angle of 42.6°±6.1°(range: 32°-74°). Four patients had apical vertebrae at L2, 4 at L2/3 disc, 26 at L3, 23 at L3/4 disc, 16 at L4 and 4 at L4/5 disc. The sagittal alignment parameters were measured on both preoperative and last follow-up radiographs, including thoracic kyphosis(TK), thoracolumbar kyphosis(TLK), lumbar lordosis(LL), pelvic incidence(PI), sacral slope(SS), pelvic tilt(PT), sagittal vertical axis(SVA) and TPA. Oswestry disability index(ODI), visual analog scale(VAS) and SRS-22 questionnaire were completed by the patients before surgery and at the last follow-up. Spearman′s rank correlation coefficient was used to determine correlations between preoperative and last follow-up SVA and other spino-pelvic parameters, and so as TPA. Correlations between the changes of TPA and the changes of other parameters and overall ODI scores, VAS and SRS-22 total scores were also analyzed. Results: Preoperative and last follow-up TPAs were significantly related to the preoperative and last follow-up LL, PT, SS, PI, and SVA(P<0.05), but not to TK and TLK(P>0.05). The changes of TPA were significantly related to the changes of LL, PT, SS and SVA(P<0.05), but not to TK and TLK(P>0.05). Moreover, the changes of TPA were also significantly related to the changes of ODI(P<0.05), VAS (P<0.05) and SRS-22 total scores(P<0.05). Preoperative SVA was significantly related to the preoperative LL and TPA(P<0.05), but not to TK, TLK, SS, PT and PI(P>0.05). The last follow-up SVA was significantly related to the last follow-up TPA(P<0.05), but not to TK, TLK, LL, SS, PT and PI(P>0.05). The changes of SVA were significantly related to the changes of LL and TPA(P<0.05), but not to TK, TLK, SS and PT(P>0.05). The changes of SVA were also significantly related to the changes of ODI(P<0.05), VAS(P<0.05) and SRS-22 total scores(P<0.05). Conclusions: TPA can better reflect spino-pelvic sagittal alignment and HRQOL for patients with degenerative scoliosis. which can be served as a reference parameter in surgical planning.