Accepted Manuscript Analysis of Hip Dysplasia and Spino-Pelvic Alignment in Cerebral Palsy Dong-Hun Suh, MD Jae-Young Hong, MD Seung-Woo Suh, MD Jong-Woong Park, MD Sang-Hee Lee, MD. PII:
S1529-9430(14)00299-X
DOI:
10.1016/j.spinee.2014.03.025
Reference:
SPINEE 55820
To appear in:
The Spine Journal
Received Date: 6 September 2012 Revised Date:
30 November 2013
Accepted Date: 16 March 2014
Please cite this article as: Suh D-H, Hong J-Y, Suh S-W, Park J-W, Lee S-H, Analysis of Hip Dysplasia and Spino-Pelvic Alignment in Cerebral Palsy, The Spine Journal (2014), doi: 10.1016/ j.spinee.2014.03.025. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT
Title: Analysis of Hip Dysplasia and Spino-Pelvic Alignment in
RI PT
Cerebral Palsy.
SC
Authors:
Park1 MD, Sang-Hee Lee1 MD.
From 1
M AN U
Dong-Hun Suh1 MD; Jae-Young Hong1 MD; Seung-Woo Suh2 MD; Jong-Woong
Department of Orthopedics, Korea University Ansan Hospital, Ansan, South Korea.
2
TE D
Scoliosis Research Institute, Department of Orthopedics, Korea University Guro
Hospital, Seoul, South Korea.
EP
Corresponding Author:
Jae-Young Hong; Department of Orthopedics, Korea University Ansan Hospital,
AC C
Gojan Dong, Danwon Gu, Ansan 425-707, South Korea. Ph: +82-31-412-6577 Fax: +82-31-487-9502 Email: [email protected]
Dong-Hun Suh and Jae-Young Hong evenly distributed to the paper as a cofirst author.
ACCEPTED MANUSCRIPT Abstract:
2
Background of Context: Knowledge of sagittal spino-pelvic parameters and hip
3
dysplasia is important in cerebral palsy patients because these parameters differ
4
from those found in the general population and can be related to symptoms.
5
Purpose: The purpose of this study was to analyze sagittal spino-pelvic alignment
6
and determine its relation to hip dysplasia in cerebral palsy patients.
7
Study Design: Radiological analysis was conducted of patients with cerebral palsy.
8
Patient Sample: 54 patients with cerebral palsy and 24 normal controls were
9
included in this study.
M AN U
SC
RI PT
1
Outcome measures: Participants underwent radiographs of the whole spine.
11
Methods: The patient and control groups were composed of 54 cerebral palsy
12
patients and 24 volunteers, respectively. All underwent lateral radiography of the
13
whole spine and hip joint antero-posterior radiography. The radiographic parameters
14
examined were: sacral slope, pelvic tilt, pelvic incidence, S1 overhang, thoracic
15
kyphosis, thoraco-lumbar kyphosis, lumbar lordosis, sagittal balance, center edge
16
angle, acetabular angle, and migration index. Statistical analysis was performed to
17
identify significant differences and correlations between the two groups.
18
Results: Sacral slope, thoraco-lumbar kyphosis, lumbar lordosis, sagittal balance,
19
acetabular angle and migration index were significantly higher in cerebral palsy
20
patients, whereas pelvic tilt, S1 overhang and center edge angle were significantly
21
lower (P0.92, 95% CI = 0.88-
5
0.96; ICCs > 0.90, 95% CI = 0.85-0.94). The mean ages of the cerebral palsy and
6
control groups were 28.0 (13 to 46) and 28.5 years (17 to 32), respectively. Table 1
7
summarizes sagittal parameters in cerebral palsy patients and normal controls. A
8
significant difference between groups was found for several parameters. Sacral
9
slope, thoraco-lumbar kyphosis, L1-5 lumbar lordosis, sagittal balance, acetabular
10
angle and migration index were significantly higher in patients than controls, whereas
11
pelvic tilt, S1 overhang and center edge angle were significantly lower (P0.05).
14
Correlation analysis revealed a significant relationship between parameters (Table 2).
15
Among sagittal pelvic parameters, pelvic incidence, sacral slope, pelvic tilt and S1
16
overhang were inter-related. Among sagittal spinal parameters, thoraco-lumbar
17
kyphosis was related to thoracic kyphosis, and L1-5 lumbar lordosis was related to
18
L1-S1 lumbar lordosis (P
S1529-9430(14)00299-X
DOI:
10.1016/j.spinee.2014.03.025
Reference:
SPINEE 55820
To appear in:
The Spine Journal
Received Date: 6 September 2012 Revised Date:
30 November 2013
Accepted Date: 16 March 2014
Please cite this article as: Suh D-H, Hong J-Y, Suh S-W, Park J-W, Lee S-H, Analysis of Hip Dysplasia and Spino-Pelvic Alignment in Cerebral Palsy, The Spine Journal (2014), doi: 10.1016/ j.spinee.2014.03.025. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT
Title: Analysis of Hip Dysplasia and Spino-Pelvic Alignment in
RI PT
Cerebral Palsy.
SC
Authors:
Park1 MD, Sang-Hee Lee1 MD.
From 1
M AN U
Dong-Hun Suh1 MD; Jae-Young Hong1 MD; Seung-Woo Suh2 MD; Jong-Woong
Department of Orthopedics, Korea University Ansan Hospital, Ansan, South Korea.
2
TE D
Scoliosis Research Institute, Department of Orthopedics, Korea University Guro
Hospital, Seoul, South Korea.
EP
Corresponding Author:
Jae-Young Hong; Department of Orthopedics, Korea University Ansan Hospital,
AC C
Gojan Dong, Danwon Gu, Ansan 425-707, South Korea. Ph: +82-31-412-6577 Fax: +82-31-487-9502 Email: [email protected]
Dong-Hun Suh and Jae-Young Hong evenly distributed to the paper as a cofirst author.
ACCEPTED MANUSCRIPT Abstract:
2
Background of Context: Knowledge of sagittal spino-pelvic parameters and hip
3
dysplasia is important in cerebral palsy patients because these parameters differ
4
from those found in the general population and can be related to symptoms.
5
Purpose: The purpose of this study was to analyze sagittal spino-pelvic alignment
6
and determine its relation to hip dysplasia in cerebral palsy patients.
7
Study Design: Radiological analysis was conducted of patients with cerebral palsy.
8
Patient Sample: 54 patients with cerebral palsy and 24 normal controls were
9
included in this study.
M AN U
SC
RI PT
1
Outcome measures: Participants underwent radiographs of the whole spine.
11
Methods: The patient and control groups were composed of 54 cerebral palsy
12
patients and 24 volunteers, respectively. All underwent lateral radiography of the
13
whole spine and hip joint antero-posterior radiography. The radiographic parameters
14
examined were: sacral slope, pelvic tilt, pelvic incidence, S1 overhang, thoracic
15
kyphosis, thoraco-lumbar kyphosis, lumbar lordosis, sagittal balance, center edge
16
angle, acetabular angle, and migration index. Statistical analysis was performed to
17
identify significant differences and correlations between the two groups.
18
Results: Sacral slope, thoraco-lumbar kyphosis, lumbar lordosis, sagittal balance,
19
acetabular angle and migration index were significantly higher in cerebral palsy
20
patients, whereas pelvic tilt, S1 overhang and center edge angle were significantly
21
lower (P0.92, 95% CI = 0.88-
5
0.96; ICCs > 0.90, 95% CI = 0.85-0.94). The mean ages of the cerebral palsy and
6
control groups were 28.0 (13 to 46) and 28.5 years (17 to 32), respectively. Table 1
7
summarizes sagittal parameters in cerebral palsy patients and normal controls. A
8
significant difference between groups was found for several parameters. Sacral
9
slope, thoraco-lumbar kyphosis, L1-5 lumbar lordosis, sagittal balance, acetabular
10
angle and migration index were significantly higher in patients than controls, whereas
11
pelvic tilt, S1 overhang and center edge angle were significantly lower (P0.05).
14
Correlation analysis revealed a significant relationship between parameters (Table 2).
15
Among sagittal pelvic parameters, pelvic incidence, sacral slope, pelvic tilt and S1
16
overhang were inter-related. Among sagittal spinal parameters, thoraco-lumbar
17
kyphosis was related to thoracic kyphosis, and L1-5 lumbar lordosis was related to
18
L1-S1 lumbar lordosis (P
