Skip to main content
SpringerLink
Log in

Estimation of sagittal pelvic orientation from frontal standard radiograph using the sacral-femoral-pubic angle: feasibility study in the pediatric population

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Purpose

Pelvic tilt is usually measured on a full spine sagittal view. The sacral-femoral-pubic angle (SFP) has been previously described as a reproducible method to estimate pelvic tilt on a pelvis AP view. The aim of our study is to determine the reliability of the extrapolated pelvic tilt (ePT) using the SFP angle in the pediatric population.

Methods

We selected 240 full spine X-rays in our pediatric imaging database. The cohort was equally distributed according gender and age. The following parameters were measured: SFP angle on the AP view, pelvic tilt (PT), pelvic incidence (PI) and sacral slope (SS) on the sagittal view. Concordance between the measured pelvic tilt (mPT) and the calculated (ePT) value of PT was tested by a correlation test. Intra- and inter-observer reliability was tested for each parameter using ANOVA.

Results

Our cohort included 240 children aged from 1 to 20 years (mean age 10.7 years). Mean SFP angle was 68.98° ± 6.8, mPT was 6.67° ± 8.56, ePT was 6.04° ± 6.79. The mean PI (45.04° ± 11.09) and SS (38.63° ± 8.12) were comparable to previously published pediatric data according to age groups. Intra- and inter-observer reliability showed acceptable correlation. Concordance between mPT and ePT was higher in older children (patients >10 years).

Conclusions

Estimated value of pelvic tilt using the SFP angle showed acceptable correlation to the pelvic tilt measured on sagittal view of the pelvis in children over 10 years. However, correlation rates were lower than previous publication in adult population. This simple method could accurately estimate the pelvic orientation on a single frontal view of the pelvis, which may be of particular interest in understanding the relationship between pelvic orientation and hip pathology.

Level of evidence

IV.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Dubousset J (1994) Three-dimensional analysis of the scoliotic deformity. In: Weinstein SL (ed) The pediatric spine: principles and practice. Raven Press, New York, pp 236–248

    Google Scholar 

  2. Lazennec JY, Saillant G (2005) Relations hanche-rachis: application aux arthroplasties totales de hanche. Cahiers d’enseignement de la SOFCOT. Elsevier, Paris, pp 161–190

    Google Scholar 

  3. Mac-Thiong JM, Bertonnaud E, Dimar JR 2nd, Betz RR, Labelle H (2004) Sagittal alignment of the spine and pelvis during growth. Spine 29:1642–1649

    Article  PubMed  Google Scholar 

  4. Legaye J, Duval-Beaupère G, Hecquet J, Marty C (1998) Pelvic incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves. Eur Spine J 7:99–103

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  5. Pasha S, Aubin CE, Sangole AP, Labelle H, Parent S, Mac Thiong JM (2014) Three-dimensional spinopelvic relative alignment in adolescent idiopathic scoliosis. Spine 39:564–570

    Article  PubMed  Google Scholar 

  6. Blondel B, Schwab F, Patel A et al (2012) Sacro-femoral-pubic angle: a coronal parameter to estimate pelvic tilt. Eur Spine J 21:719–724

    Article  PubMed Central  PubMed  Google Scholar 

  7. Lucas B, Asher M, Mclff T, Lark R, Burton D (2005) Estimation of transverse plane pelvic rotation using a posterior-anterior radiograph. Spine 30:20–27

    Article  Google Scholar 

  8. Rampal V, Hausselle J, Thoreux P, Wicart P, Skalli W (2013) Three-dimensional morphologic study of the child’s hip: which parameters are reproducible? Clin Orthop Related Res 471:1343–1348

    Article  Google Scholar 

  9. Broughton NS, Brougham DI, Cole WG, Menelaus MB (1989) Reliability of radiological measurements in the assessment of the child’s hip. J Bone Joint Surg Br 71:6–8

    CAS  PubMed  Google Scholar 

  10. Inan M, Senaran Mackenzie WG (2006) Center of the femoral head: a magnetic resonance imaging study. J Pediatr Orthop 26:471–473

    Article  PubMed  Google Scholar 

  11. Mac-Thiong JM, Labelle H, Roussouly P (2011) Pediatric sagittal alignment. Eur Spine J 20:586–590

    Article  PubMed Central  PubMed  Google Scholar 

  12. Tardieu C, Hecquet J, Boulay C et al (2008) Two key describers of the sacro-acetabular relationships: the angles of sacral and acetabular incidence. Analysis by the software De-Visu. Orthop Traumatol Surg Res 94:327–335

    CAS  Google Scholar 

Download references

Conflict of interest

Authors declare they have no conflict of interest.

Author information

Authors and Affiliations

  1. Laboratoire UMR 7268, ADéS, Anthropologie bio-culturelle, Droit Ethique et Santé, Aix-Marseille Université, 13344, Marseille cedex 15, France

    S. Raux & J. L. Jouve

  2. Service Orthopédie pédiatrique, Hôpital Femme Mère Enfant, Hospices civils de Lyon, Bron, France

    K. Abelin-Genevois

  3. Service Orthopédie pédiatrique, Hôpital Timone enfant, Assistance Publique Hôpitaux de Marseille, Aix Marseille Université, 13385, Marseille cedex 5, France

    B. Blondel

  4. Service Santé publique, épidémiologie, Assistance publique des hôpitaux de Marseille, Aix Marseille Université, 13385, Marseille cedex 5, France

    J. Mancini

Authors
  1. S. Raux
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K. Abelin-Genevois
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B. Blondel
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Mancini
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. L. Jouve
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. Raux.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Raux, S., Abelin-Genevois, K., Blondel, B. et al. Estimation of sagittal pelvic orientation from frontal standard radiograph using the sacral-femoral-pubic angle: feasibility study in the pediatric population. Eur Spine J 24, 1143–1147 (2015). https://doi.org/10.1007/s00586-014-3404-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-014-3404-x

Keywords

Search

Navigation