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Primary Pelvic Anteversion: Definition, Relevance, and History After Surgery for Adult Spine Deformity.
- Source :
-
Spine [Spine (Phila Pa 1976)] 2024 Aug 15; Vol. 49 (16), pp. 1107-1115. Date of Electronic Publication: 2024 Feb 26. - Publication Year :
- 2024
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Abstract
- Study Design: Retrospective analysis of prospectively collected data.<br />Objective: To identify the best definition of primary anteverted pelvis in the setting of adult spine deformity (ASD), and to investigate whether this is a pathologic setting that requires surgical correction.<br />Summary of Background Data: While pelvic retroversion has been thoroughly investigated, pelvic anteversion (AP) is a far lesser discussed topic. Four different AP definitions have been proposed, and AP has been described as a normal or pathologic entity by different authors.<br />Materials and Methods: All patients consulting for ASD at the five participating sites were included. First, the four definitions of AP were compared with descriptive statistics (anatomic method-Pelvic Tilt <0°; Relative Pelvic Version method-RPV >5°; Roussouly method-Pelvic Incidence (PI)<50° and Sacral Slope (SS)>35°); low PT method-PT/PI <25th percentile). Second a subgroup analysis among operated AP patients with a two-year follow-up was performed. Complication rate, radiographic parameters, and clinical scores (ODI, SF-36) were compared in a multivariate analysis between patients who did and did not maintain an AP at the 2-year follow-up.<br />Results: A total of 1163 patients were available for the first analysis. The RPV method seemed to be the most appropriate to define AP in ASD patient. For the second analysis, data on 410 subjects were available, and most of them were young adults with idiopathic scoliosis that did not require pelvic fixation. AP patients who maintained an AP after ASD surgery presented comparable radiographic and clinical outcomes to the patients who presented a normoverted/retroverted pelvis after surgery.<br />Conclusions: According to the results of the presented study, the RPV method is the most appropriate to define primary AP, which is not a pathologic condition and is most often observed in young adults with idiopathic scoliosis. Anteverted pelvis does not require direct surgical correction in this patient group.<br />Competing Interests: LB Consultant: Spineart, Spinevision; I.O.: Royalties : Spineart, alphatec, Clariance, Consultant : Medtronic, Depuy, spinevision Research support : Medtronic, Depuy; JP Consultant: Medtronic, Grants: Medtronic Depuy; F.P.: Research support: DePuySpine Synthes/Medtronic/Nuvasive/Orthofix/SpineArt Consultant: Medtronic/Nuvasive; A.A.: Consultancy: Globus, Zimvie, Research Grant: Depuy, Medtronic Royalty: Zimvie; F.K.: Depuy Spine Speakers Bureau and Research Grant; YPC: Consultant: Clariance, Stryker, Ceraver, Spinevision, Research Grants: Clariance, Stryker, Medtronic; C.Y.: Consultant, Medtronic. The remaining authors report no conflicts of interest.<br /> (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
- Subjects :
- Humans
Female
Male
Adult
Middle Aged
Retrospective Studies
Aged
Pelvis surgery
Pelvis diagnostic imaging
Spinal Curvatures surgery
Spinal Curvatures diagnostic imaging
Spine surgery
Spine diagnostic imaging
Pelvic Bones diagnostic imaging
Pelvic Bones surgery
Young Adult
Postoperative Complications etiology
Postoperative Complications epidemiology
Scoliosis surgery
Scoliosis diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1528-1159
- Volume :
- 49
- Issue :
- 16
- Database :
- MEDLINE
- Journal :
- Spine
- Publication Type :
- Academic Journal
- Accession number :
- 38407226
- Full Text :
- https://doi.org/10.1097/BRS.0000000000004971