Pelvic rotation parameters related to in-brace correction in patients with idiopathic scoliosis
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European Journal of Medical Research Open Access
RESEARCH
Pelvic rotation parameters related to in‑brace correction in patients with idiopathic scoliosis Kepeng Li1, Jun Miao2* and Jingan Zhang3
Abstract Background: To identify the pelvic parameters affecting in-brace correction (IBC) in patients with idiopathic scoliosis (IS). Methods: Patients with IS receiving Chêneau brace treatment in our scoliosis center from January 2019 to November 2019 were retrospectively analyzed. Pelvic rotation parameters, including pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), L/R ratio, were collected. Other radiographic data, such as Risser sign, coronal and sagittal balance, curve location, kyphosis, lordosis of each patient were also recorded to analyze their correlations with IBC. Correlation analyses were performed to identify the classified variables influencing IBC. The principal component analysis was used to extract common factors of radiographic parameters to eliminate interaction effects. The linear regression equation was established using principal components, the variables influencing IBC were identified. Results: A cohort of 44 patients with IS (36 girls and 8 boys) were included in the present study. The mean IBC was 49.87% (range, 3%–100%). IBC of lumbar IS was negatively correlated with apical rotate factor (ARF, B = –0.385), mainly consisted of pelvic coronal plane rotation (PCPR, 0.449), Cobb angle (CA, 0.575), apical vertebral rotation (AVR, 0.918), and pelvic rotate factor (PRF, B = –0.387), mainly consisted of PT (0.861), PI (0.728), PCPR (–0.570). The regression equation of lumbar IS had statistical significance (F = 6.500, P = 0.005, R2 = 0.317), whereas statistically significance was not found in the regression equation of thoracic IS (F = 2.913, P = 0.106). The remaining parameters were not related to IBC. Conclusions: For lumbar IS, ARF and PRF have negative effects on IBC, coronal and sagittal rotation of the pelvis is related to IBC. Background Idiopathic scoliosis (IS) is a complex 3-dimensional deformity of the spine and pelvis [1]. Different aspects of the interaction between the spine and pelvis were investigated in IS [2]. The pelvis serves as an intermediate structure linking the spine to the lower extremities. Pelvic rotation parameters (PRP) contribute to the instability of *Correspondence: [email protected] 2 Spine Surgery, Tianjin Hospital, 406 Jiefang South Road, Hexi District, Tianjin, China Full list of author information is available at the end of the article
the spine resulting in the development and progression of IS [3]. Brace application has been reported to be an effective approach in treating mild-to-moderate IS [4]. Despite the high rate of bracing success, some patients will still experience bracing failure [5]. Previous studies have found that IBC is an independent predictive factor for curve progression in braced patients with IS [6]. IBC refers to the percentage of improvement in the curve size at the initial brace prescription. Given the significance of
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