Differences in sacral sagittal parameters between adolescent idiopathic scoliosis patients and normal individuals

English Keywords:Adolescent idiopathic scoliosis  Imaging study  Sacral sagittal parameters  Gender differences

English Abstract:

  【Abstract】 Objectives: To investigate the differences in sacral sagittal parameters between patients with adolescent idiopathic scoliosis(AIS) and normal individuals, as well as between different genders of AIS patients. Methods: A retrospective analysis was conducted on the full-length spinal X-ray images of 141 AIS patients aged 10 to 19 years and 388 normal individuals. The following spinal-pelvic sagittal parameters were measured: thoracic kyphosis(TK), thoracolumbar kyphosis(TLK), lumbar lordosis(LL), sacral slope(SS), pelvic tilt(PT), and pelvic incidence(PI). Sacral sagittal parameters were measured, including the angle between S1 upper-endplate and S1-2 tilt(ST12), angle between S1 tilt and S2 tilt(S1T-S2T), angle between S1-2 tilt and S5Co1 tilt(sacral kyphosis, SK), angle between S1 upper-endplate and S1Co1 tilt(sacral convergence angle, SCA), and angle between S1 upper-endplate and S2Co1 tilt(S2 convergence angle, S2CA). Descriptive statistics and difference tests were conducted on the relevant parameters. Results: Overall, AIS patients had smaller TK, TLK, S1T-S2T, and ST12(absolute value), and larger PI, SS, and LL(absolute value) compared to normal individuals. There was no significant difference between the two groups in terms of PT, SK, SCA, and S2CA. In Lenke 1 AIS patients, there were significant differences in TK, TLK, SS, PT, and S1T-S2T compared to normal individuals, with smaller TK, TLK, PT, and S1T-S2T, and larger SS. In Lenke 5 AIS patients, there were significant differences in TK, SS, PI, and S1T-S2T compared to normal individuals, with smaller TK and S1T-S2T, and larger SS and PI. There were significant differences in TLK, ST12, SCA, and S2CA between female and male AIS patients, with female AIS patients having larger ST12, SCA, and S2CA(absolute value). In male patients, there were significant differences in ST12, SCA, and S2CA compared to normal individuals, while in female patients, there were no significant differences in the above parameters compared to normal individuals(P<0.05). Conclusions: AIS patients exhibit differences in sacral sagittal parameters compared to normal individuals, which vary by gender, with male patients demonstrating more pronounced changes.