An analysis of radiographic parameters comparison between lumbar spine latericumbent and full-length lateral standing radiographs

Publication date: Available online 8 July 2017
Source:The Spine Journal
Author(s): Zhiwei Yang, Fang Xie, Jianxin Zhang, Zhuowen Liang, Zhe Wang, Xueyu Hu, Zhuojing Luo
Background ContextThe lumbar spine latericumbent and full-length lateral standing radiographs are most commonly used to assess lumbar disorder. However, there are few literatures regarding the difference and correlation of the sagittal parameters between the two shooting positions.PurposeTo investigate the difference of sagittal parameters in spine lateral radiographs between latericumbent and upright positions, identify the correlation and establish a preliminary linear fitting formula.Study DesignThe study is a prospective study on radiographic evaluation of sagittal alignment using latericumbent and upright positions.Patient Sample157 patients were recruited from orthopaedics clinic of a single medical center.Outcome MeasureAngle measurement, the intra- and interobserver measurement reliability of measurement and analysis of the angle measurement were carried out.MethodThe sagittal alignment of 157 patients were assessed using Surgimap software from two kinds of lateral radiographs, to acquire the following parameters: lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), L4-L5 intervertebral angle (IVA4-5), L4-L5 intervertebral height index (IHI4-5), and PI-LL. The Kolmogorov-Smirnov Test, Pair t-test, Pearson correlation analysis, and Multivariate linear regression analysis were used to analyze the data.ResultsThe results showed significantly statistical difference in LL, SS, PT, IVA4-5, and PI-LL, except for PI and IHI4-5 between the two positions. There was a significant relativity between standing LL and latericumbent LL (r=0.733, P<0.01), PI (r=0.611, P<0.01), and SS (r=0.626, P<0.01). The predictive formula of standing LL was: 12.791 + 0.777 latericumbent LL+0.395 latericumbent PI - 0.506 latericumbent SS (Adjusted R² = 0.619, P < 0.05).ConclusionNot all of sagittal parameters obtained from two positions are identical. Thus, the full-spine lateral standing films are difficult to be replaced. Surgeon should give sufficient consideration to difference between the two views. We may primarily predict standing LL with the formula when we couldn't get whole-spine lateral standing radiographs.



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