Evaluation of Sagittal Spine-Pelvis-Lower Limb Alignment in Elderly Women with Pelvic Retroversion while Standing and Walking Using a Three-Dimensional Musculoskeletal Model.
10.4184/asj.2017.11.4.562
- Author:
Ken SASAKI
1
;
Michio HONGO
;
Naohisa MIYAKOSHI
;
Toshiki MATSUNAGA
;
Shin YAMADA
;
Hiroaki KIJIMA
;
Yoichi SHIMADA
Author Information
1. Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan. kensasaki@med.akita-u.ac.jp
- Publication Type:Original Article
- Keywords:
Musculoskeletal model;
Sagittal alignment;
Pelvic retroversion;
Spine;
Lower limb
- MeSH:
Aged*;
Animals;
Extremities*;
Female;
Head;
Hip;
Hip Joint;
Humans;
Incidence;
Knee;
Leg;
Lordosis;
Lower Extremity;
Pelvis;
Spine;
Walking*
- From:Asian Spine Journal
2017;11(4):562-569
- CountryRepublic of Korea
- Language:English
-
Abstract:
STUDY DESIGN: In vivo biomechanical study using a three-dimensional (3D) musculoskeletal model for elderly individuals with or without pelvic retroversion. PURPOSE: To evaluate the effect of pelvic retroversion on the sagittal alignment of the spine, pelvis, and lower limb in elderly females while standing and walking. OVERVIEW OF LITERATURE: Patients with hip–spine syndrome have concurrent hip-joint and spine diseases. However, the dynamic sagittal alignment between the hip joint and spine has rarely been investigated. We used a 3D musculoskeletal model to evaluate global spinopelvic parameters, including spinal inclination and pelvic tilt (PT). METHODS: A total of 32 ambulant females (mean age=78 years) without assistance were enrolled in the study. On the basis of the radiographic measurement for PT, participants were divided into the pelvic retroversion group (R-group; PT≥20°) and the normal group (N-group; PT<20°). A 3D musculoskeletal motion analysis system was used to analyze the calculated value for the alignment of spine, pelvis, and lower limb, including calculated (C)-PT, sagittal vertical axis (C-SVA), pelvic incidence, lumbar lordosis, T1 pelvic angle (C-TPA), as well as knee and hip flexion angles while standing and walking. RESULTS: While standing, C-PT and C-TPA in the R-group were significantly larger than those in the N-group. Hip angle was significantly smaller in the R-group than in the N-group, unlike knee angle, which did not show difference. While walking, C-SVA and C-TPA were significantly increased, whereas C-PT decreased compared with those while standing. The maximum hip-flexion angle was significantly smaller in the R-group than in the N-group. There was a significant correlation between the radiographic and calculated parameters. CONCLUSIONS: The 3D musculoskeletal model was useful in evaluating the sagittal alignment of the spine, pelvis, and leg. Spinopelvic sagittal alignment showed deterioration while walking. C-PT was significantly decreased while walking in the R-group, indicating possible compensatory mechanisms attempting to increase coverage of the femoral head. The reduction in the hip flexion angle in the R-group was also considered as a compensatory mechanism.
