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C7 sacral tilt (C7ST): a novel spinopelvic parameter reveals the relationship between pelvic parameters and global spinal sagittal balance and converts pelvic parameters into spinal parameters

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Abstract

Purpose

The aim is to propose a novel spinopelvic parameter C7 sacral tilt (C7ST), of which its sum with global tilt (GT) is equal to pelvic incidence (PI), from a geometrical point of view.

Methods

A cohort of 198 patients was recruited and the whole lateral spine and pelvic radiographs were performed. The following sagittal parameters were measured: sagittal vertical axis (SVA), C7 vertical tilt (C7VT), sacral slope (SS), pelvic tilt (PT), PI, GT and C7ST. The correlations between them were analyzed using the Pearson or Spearman correlation coefficient, and simple linear regressions were simultaneously conducted. P < 0.05 was set as the level of significance.

Results

Geometric construction by complementary angles revealed that PI = C7ST + GT, GT = PT + C7VT, and C7ST = SS − C7VT. Both C7ST and GT were moderately correlated with PI (R = 0.52 and 0.596, respectively), strongly correlated with SS and PT, respectively (SS = 0.9 * C7ST + 1.15, R = 0.955; PT = 0.87 * GT + 3.86, R = 0.96). The correlation coefficients of the SVA and C7VT, SVA and SS − C7ST, and SVA and GT − PT were 0.935, 0.925 and 0.863, respectively.

Conclusion

The novel proposed spinopelvic parameter C7ST has the advantages of convenient measurement, reduced error, and extrapolation of other parameters. The greatest significance of proposing C7ST is that pelvic parameters (PI, PT and SS) are converted into spinal parameters (C7ST and GT), which is very helpful for a more intuitive understanding of the progression of spinal sagittal imbalance.

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Acknowledgements

The authors thank the Department of Imaging in Shandong Provincial Hospital for providing the image data of patients.

Funding

This article did not receive any funding and grants.

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Author notes

  1. Wen Zhang and Tao Li contributed equally to this work.

Authors and Affiliations

  1. Department of Spine Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong Provincial Hospital Affiliated to Shandong University, No. 9677 in Jingshi Road, Jinan City, China

    Wen Zhang, Tao Li, Xiaoyang Liu, Guodong Wang, Bingxiang Wang, Jianmin Sun, Xingang Cui & Zhensong Jiang

  2. Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, China

    Mengmeng Xu

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  1. Wen Zhang
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  2. Tao Li
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by [Wen Zhang], [Tao Li] and [Zhensong Jiang]. The first draft of the manuscript was written by [Wen Zhang] and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Zhensong Jiang.

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Zhang, W., Li, T., Xu, M. et al. C7 sacral tilt (C7ST): a novel spinopelvic parameter reveals the relationship between pelvic parameters and global spinal sagittal balance and converts pelvic parameters into spinal parameters. Eur Spine J 29, 2384–2391 (2020). https://doi.org/10.1007/s00586-020-06548-8

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