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Preoperative supine pelvic incidence predicts standing pelvic incidence following S2AI fixation in patients with adult spinal deformity: a prospective study

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Abstract

Study design

A prospective study.

Objective

The aim of this study was to investigate the PI change in different postures and before and after S2‑alar‑iliac (S2AI) screw fixation, and to investigate whether pre-op supine PI could predict post-op standing PI.

Summary of background data

Previous studies have reported PI may change with various positions. Some authors postulated that the unexpected PI change in ASD patients could be due to sacroiliac joint laxity, S2-alar-iliac (S2AI) screw placement, or aggressive sagittal cantilever technique. However, there was a lack of investigation on how to predict post-op standing PI when making surgical strategy.

Methods

A prospective case series of ASD patients undergoing surgical correction with S2AI screw placement was conducted. Full-spine X-ray films were obtained at pre-op standing, pre-op supine, pre-op prone, as well as post-op standing postures. Pelvic parameters were measured. Spearman correlation analysis was used to determine relationships between each parameter.

Results

A total of 83 patients (22 males, 61females) with a mean age of 58.4 ± 9.5 years were included in this study. Pre-op standing PI was significantly lower than post-op standing PI (p = 0.004). Pre-op prone PI was significantly lower than post-op standing PI (p = 0.001). By contrast, no significant difference was observed between pre-op supine and post-op standing PI (p = 0.359) with a mean absolute difference of 2.2° ± 1.9°. Correlation analysis showed supine PI was significantly correlated with post-op standing PI (r = 0.951, p < 0.001).

Conclusion

This study revealed the PI changed after S2AI screw fixation. The pre-op supine PI can predict post-op standing PI precisely, which facilitates to provide correction surgery strategy with a good reference for ideal sagittal alignment postoperatively.

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Funding

This work was supported by the National Natural Science Foundation of China (NSFC) (No. 82072518) and the Nanjing Medical Science and Technique Development Foundation (No. QRX17126) funds.

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Author notes

  1. Zongshan Hu and Zhikai Qian are contributed equally to this work.

Authors and Affiliations

  1. Division of Spine Surgery, Department of Orthopedic Surgery, Drum Tower Hospital of Nanjing University Medical School, Nanjing, China

    Zongshan Hu, Weibiao Li, Jie Li, Yanjie Xu, Zhen Liu, Zezhang Zhu & Yong Qiu

  2. Division of Spine Surgery, Department of Orthopedic Surgery, Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China

    Zhikai Qian, Ziyang Tang & Chen Ling

Authors
  1. Zongshan Hu
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  2. Zhikai Qian
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  3. Weibiao Li
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  4. Jie Li
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  5. Ziyang Tang
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  6. Chen Ling
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  7. Yanjie Xu
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  8. Zhen Liu
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  9. Zezhang Zhu
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Correspondence to Zhen Liu.

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Hu, Z., Qian, Z., Li, W. et al. Preoperative supine pelvic incidence predicts standing pelvic incidence following S2AI fixation in patients with adult spinal deformity: a prospective study. Eur Spine J (2024). https://doi.org/10.1007/s00586-024-08195-9

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  • DOI: https://doi.org/10.1007/s00586-024-08195-9

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