Novel Measurement Technique for the Sagittal Vertical Axis and Its Clinical Application in Adult Spinal Deformity

Asian Spine Journal

Kenta Kurosu¹  Go Yoshida¹  Tatsuya Yasuda²  Daisuke Togawa²  Tomohiko Hasegawa²  Yukihiro Matsuyama²  Yu Yamato² 

[1] Department of Orthopedic Surgery, Hamamatsu Medical Center, Hamamatsu, Japan.;Department of Orthopedic Surgery, Hamamatsu Medical University, Hamamatsu, Japan.;

关键词: Sagittal alignment;    Sagittal vertical axis;    Adult spinal deformity;    Cranial center of gravity;    Gastroesophageal reflux;   

DOI  :  10.4184/asj.2017.11.2.190

来源: DOAJ

【 摘 要 】

Study DesignProspective physical measurement of the sagittal vertical axis (SVA).PurposeTo evaluate a simple method for measuring SVA by analyzing its relationship with radiographic measurements and clinical appearance.Overview of LiteratureNo studies have examined physical measurements using the cranial center of gravity (CCG) in a relaxed standing position.MethodsThe physical measurement of the horizontal distance between CCG and spina iliaca posterior superior (CCG-SIPS) was measured using a straight ruler in 252 healthy volunteers and 56 patients with adult spinal deformity. Health-related quality of life (HRQOL) was evaluated using the Oswestry disability index (ODI), and clinical symptoms were assessed according to standing status and the presence of gastroesophageal reflux disease (GERD).ResultsCCG-SIPS increased with age in the volunteer group and strongly correlated with radiographic SVA in the patient group (r=0.984). Differences increased between CCG-SIPS in patients in the relaxed position and radiographic SVA with an increase in sagittal malalignment (r=0.692, p<0.001). ODI with high sagittal malalignment (CCG-SIPS>120 mm) was significantly larger in the patient group than in the group with low sagittal malalignment (59.9±18.8 vs. 45.1±17.0; p=0.004); these patients (CCG-SIPS>120 mm) needed crutches or walkers for standing. The patient group with GERD had significantly larger sagittal malalignment than the group without GERD (160.3 mm vs. 81.0 mm).ConclusionsThe CCG-SIPS correlated with age and strongly reflected radiographic SVA and HRQOL in the patients. Moreover, it reflects a relaxed posture without a backward shift in the radiographic position even in patients with severe sagittal malalignment. The critical limit of CCG-SIPS can be relevant to clinical appearance, including standing assistance (>120 mm) and the existence of GERD (>150 mm). Thus, it will be a useful predictor of true SVA in clinical practice before radiographic evaluation.

【 授权许可】

Unknown