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Predictive model of global tilt (GT) determined by individual thoracic kyphosis, lumbar lordosis and pelvic incidence in the human degenerative spine

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Abstract

Purpose

Previous studies only investigated the simple linear relationships of global tilt (GT) with thoracic kyphosis (TK), lumbar lordosis (LL) and pelvic incidence (PI). This study aimed to establish multiple linear regressions of GT based on individual TK, LL and PI in patients with degenerative spines.

Methods

Four hundred sixty-nine adult patients aged older than 35 years with various degenerative spinal diseases were enrolled in this two-centre study between January 2017 and December 2020. Full-spine X-rays were performed for all the subjects in a standing position. The following regional and global parameters were measured in the sagittal plane: TK, LL, PI, pelvic tilt (PT), sagittal vertical axis (SVA) and GT. The correlations of the GT, PT and SVA with the TK, LL and PI were analysed, and then multiple linear regressions were constructed.

Results

GT was statistically correlated with TK, LL and PI. Additionally, TK, LL and PI were significant predictors for the GT, PT and SVA models. The relevant predictive formulae were as follows: GT = -9.60 + 1.09*PI + 0.89*LL + 0.42*TK (R2 = 0.935), PT = -4.49 + 0.81*PI + 0.56*LL + 0.24*TK (R2 = 0.792) and SVA = -25.68 + 2.98*LL + 2.37*PI + 1.67*TK (R2 = 0.416).

Conclusion

The specific sagittal spinopelvic morphology, evaluated by GT parameters, should be determined by individual TK, LL and PI values in the degenerative spine. Surgeons can utilize such predictive models to better understand the degenerative evolution of sagittal alignment and recognize the relationships between regional parameters and global sagittal alignment to customize a precise correction strategy.

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Acknowledgements

The authors thank the Department of Imaging in Shandong provincial hospital and The second Xiangya hospital, for providing the image data.

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Authors and Affiliations

  1. Department of Spine Surgery, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, People’s Republic of China

    Changyu Pan, Yunchao Li, Lei Kuang & Guohua Lv

  2. Department of Spine Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China

    Guodong Wang & Jianmin Sun

Authors
  1. Changyu Pan
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  2. Guodong Wang
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  3. Yunchao Li
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  4. Lei Kuang
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  5. Jianmin Sun
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  6. Guohua Lv
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Contributions

CP and GW: conceived the study design. YL and LK: supervised the data collection and analysis. CP: drafted the manuscript. JS and GL: contributed to the revision. CP and GL: are responsible for this article.

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Correspondence to Guohua Lv.

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Pan, C., Wang, G., Li, Y. et al. Predictive model of global tilt (GT) determined by individual thoracic kyphosis, lumbar lordosis and pelvic incidence in the human degenerative spine. Eur Spine J 30, 3191–3199 (2021). https://doi.org/10.1007/s00586-021-06947-5

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  • DOI: https://doi.org/10.1007/s00586-021-06947-5

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