■影像学分析对于成人脊柱畸形(ASD)的评估和手术计划是必要的。恢复整体一致性是提高患者生活质量的关键。然而,大量现有的全局比对参数可能会让外科医生感到困惑.
■确定ASD中临床和功能上最相关的全局比对参数。
■ASD和对照组进行了全身双平面X射线检查,以计算全局对准参数:齿状突与髋部轴角(OD-HA),全局矢状角(GSA),全局倾斜(GT),SVA,耳道中心至髋关节轴(CAM-HA),SSA,T1-倾斜和T9-倾斜。所有受试者填写了HRQoL问卷:ODI,SF-36,疼痛和BDI的VAS(贝克抑郁量表)。进行3D步态分析以计算运动学和时空参数。机器学习模型从全局对齐参数预测步态参数和HRQoL得分。
■纳入124个主要ASD和47个对照。T9倾斜预测最多的BDI(31%),步态时的髋关节屈曲/伸展(36%),和双倍支持时间(39%)。GSA预测ODI最高(26%),步态时胸部屈曲/伸展(33%),和节奏(36%)。
■在所有全局对准参数中,GSA,评估躯干移位和膝关节屈曲,和T9倾斜,评估质心的移动,是大多数HRQoL评分和步态运动学的最佳预测因子。因此,我们建议在临床实践中评估ASD时使用GSA和T9倾斜,因为它们代表了这些患者的最高生活质量和功能运动学.
UNASSIGNED: Radiographic analysis is necessary for the assessment and the surgical planning in adults with spinal deformity (ASD). Restoration of global alignment is key to improving patient\'s quality of life. However, the large number of existing global alignment parameters can be confusing for surgeons.
UNASSIGNED: To determine the most clinically and functionally relevant global alignment parameters in ASD.
UNASSIGNED: ASD and controls underwent full body biplanar X-ray to calculate global alignment parameters: odontoid to hip axis angle (OD-HA), global sagittal angle (GSA), global tilt (GT), SVA, center of auditory meatus to hip axis (CAM-HA), SSA, T1-tilt and T9-tilt. All subjects filled HRQoL questionnaires: ODI, SF-36, VAS for pain and BDI (Beck\'s Depression Inventory). 3D gait analysis was performed to calculate kinematic and spatio-temporal parameters. A machine learning model predicted gait parameters and HRQoL scores from global alignment parameters.
UNASSIGNED: 124 primary ASD and 47 controls were enrolled. T9 tilt predicted the most BDI (31%), hip flexion/extension during gait (36%), and double support time (39%). GSA predicted the most ODI (26%), thorax flexion/extension during gait (33%), and cadence (36%).
UNASSIGNED: Among all global alignment parameters, GSA, evaluating both trunk shift and knee flexion, and T9 tilt, evaluating the shift of the center of mass, were the best predictors for most of HRQoL scores and gait kinematics. Therefore, we recommend using GSA and T9 tilt in clinical practice when evaluating ASD because they represent the most quality of life and functional kinematic of these patients.