Relationship between hip joint proximity area and sagittal balance parameters: an upright computed tomography study
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ORIGINAL ARTICLE
Relationship between hip joint proximity area and sagittal balance parameters: an upright computed tomography study Shunsuke Kikuchi1 · Daisuke Nakashima1 · Yoshitake Yamada2 · Minoru Yamada2 · Yoichi Yokoyama2 · Arihiko Kanaji1 · Masaya Nakamura1 · Takeo Nagura1 · Masahiro Jinzaki2 Received: 23 February 2020 / Revised: 9 October 2020 / Accepted: 10 November 2020 © The Author(s) 2020
Abstract Purpose A close relationship between sagittal spinal alignment and hip osteoarthritis (OA) has been documented. This study aimed to examine the relationship between hip joint proximity area and sagittal balance parameters in healthy subjects. Methods This prospective study enrolled 47 healthy volunteers who underwent 320-detector row upright computed tomography. Acquired data were reconstructed in a virtual three-dimensional space. The proximity area was determined by 0.05).
Radiographic analysis The intra- and interobserver reliabilities of the spinal and spinopelvic parameters were 0.915 (95% confidence interval, 0.863–0.986) and 0.897 (95% confidence interval, 0.847–0.993), respectively, so these data were highly reliable. The sagittal balance parameters of the anterior and posterior proximity groups were compared, and the results are shown in Table 2. The two groups had similar morphology, as proven by their PI (48.1° ± 7.2° vs. 50.1° ± 10.0°, p = 0.433), and similar severity of thoracolumbar deformity, as proven by the TPA (12.1° ± 5.9° vs. 12.0° ± 5.1°, p = 0.974). Despite these similarities, the SVA (23.5 ± 18.9 mm vs. 11.6 ± 13.5 mm, p = 0.016) and T1-Spi (-2.6 ± 1.7 mm vs. -3.9 ± 1.8, p = 0.015) were significantly higher in the anterior than in the posterior proximity group. In addition, CAMHA-offset (5.8 ± 16.8 mm vs. 24.7 ± 15.6 mm, p 0.05).
European Spine Journal Fig. 3 Hausdorff distance. a 3D model of the acetabulum. b Enlarged view of the 3D model. The 3D model consisted of small triangles. c Enlarged view of small triangles. d One triangle of the acetabulum was defined as set A (each vetex A1, A2, and A3), and the 3D model of the femoral head was defined as set B (large blue circle). e The shortest distance between A1 and set B was d1. f The shortest distance between A2 and set B was d2. g The shortest distance between A3 and set B was d3. h Comparing d1, d2, and d3, the maximum shortest distance was A1. A1 was defined as dH (Hausdorff distance)
Discussion To the best of our knowledge, this is the first study to evaluate the relationship between the 3D distance of the hip joint
space and the sagittal alignment of the whole body in healthy subjects. Upright CT enabled us to evaluate both of these parameters simultaneously in a natural standing position. Our data showed that SVA and T1-Spi were significantly
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European Spine Journal
Fig. 4 Case 1. Threshold was set a 1.5 mm. b 1 mm. c 0.5 mm. Proximity area is expressed as red area
Fig. 5 Case 2. Threshold was set a 1.5 mm. b 1 mm. c 0.5 mm. Proximity area is expressed as red area
Fig. 6 Definition of the two groups. a Def
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