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Correlation analysis of the PI-LL mismatch according to the pelvic incidence from a database of 468 asymptomatic volunteers

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Abstract

Purpose

Previous studies on adults with degenerative scoliosis (ADS) have been fixed the threshold of PI-LL mismatch less than 10° for achieving good clinical outcomes. Recent studies discussed that PI-LL mismatch should consider individual pelvic incidence (PI) and should be set first in a normal population. The purpose of this study is to assess the variability of PI-LL mismatch according to PI in an asymptomatic population.

Methods

Full-body low dose stereoradiographic evaluation was done in a multi-ethnic cohort of 468 asymptomatic adult volunteers. Patients were clustered in three groups depending on individual PI values: PI < 45°, 45° < PI < 60° and PI > 60°. 3D measurements were performed using a commercially available 2D/3D modeling software to establish a correlation of PI with other spinopelvic parameters. ANOVA and Tukey’s HSD for post-hoc analysis were used to determine the differences between the three groups.

Results

In our asymptomatic population, the mean value of PI-LL mismatch is − 5.4° ± 10.7°. Clusterization of the population reveals significant differences in the distribution of L1S1 lordosis, pelvic tilt and PI-LL with positive linear correlation according to PI values. As an interestingly result, PI-LL mismatch is equal to 0° when PI is around 64°.

Conclusions

The present study demonstrated that PI-LL mismatch is negative in an asymptomatic population (− 5.4° ± 10.7°) and the value should be customized to each patient to be able to restore the appropriate lordosis in ADS. The PI-LL mismatch is given by the formula PI-LL = − 28.5 + 0.44 × PI.

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Authors and Affiliations

  1. VERTEBRA Institute, Polyclinique Bordeaux Nord Aquitaine, 33 rue du Dr Finlay, 33077, Bordeaux Cedex, France

    Stéphane Bourret & Jean Charles Le Huec

  2. Department of Orthopedic Surgery, Columbia University Medical Center, The Spine Hospital at New York Presbyterian, New York, USA

    Meghan Cerpa, Zeeshan M. Sardar & Lawrence G. Lenke

  3. Department of Orthopaedic Surgery, Washington University, St. Louis, MO, USA

    Michael P. Kelly

  4. Niigata Spine Surgery Center, Niigata City, Japan

    Kazuhiro Hasegawa

  5. Department of Orthopedic Surgery, National University Hospital (Singapore), Singapore, Singapore

    Hwee Weng Dennis Hey, Hee-Kit Wong & Gabriel Liu

  6. Institut Kassab D’orthopédie, Ksar Said La Manouba, Tunis, Tunisia

    Hend Riahi

Authors
  1. Stéphane Bourret
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  2. Meghan Cerpa
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  3. Michael P. Kelly
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  4. Kazuhiro Hasegawa
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  5. Hwee Weng Dennis Hey
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  6. Hee-Kit Wong
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  7. Gabriel Liu
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  8. Zeeshan M. Sardar
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  9. Hend Riahi
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  10. Lawrence G. Lenke
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  11. Jean Charles Le Huec
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by SB and JC LE HUEC. The first draft of the manuscript was written by SB and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jean Charles Le Huec.

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Conflict of interest

Consulting fees for Medtronic (teaching lesson), BD Bard (teaching lesson).

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Data were collected from adult volunteer who provided their written informed consent.

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Bourret, S., Cerpa, M., Kelly, M.P. et al. Correlation analysis of the PI-LL mismatch according to the pelvic incidence from a database of 468 asymptomatic volunteers. Eur Spine J 31, 1413–1420 (2022). https://doi.org/10.1007/s00586-021-07087-6

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  • DOI: https://doi.org/10.1007/s00586-021-07087-6

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