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RISS 인기검색어
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- 저자 : George McKay (검색결과 2 건)
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The Relationship between Sacral Kyphosis and Pelvic Incidence
George McKay,Peter Alexander Torrie,Georgina Dempster,Wendy Bertram,Ian Harding 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.1
Study Design: Retrospective cohort study. Purpose: Evaluate the fixed anatomical parameter of sacral kyphosis (SK) and its relationship with pelvic incidence (PI). Overview of Literature: Pelvic parameters determine pelvic and lumbar spinal position. Studies have defined normative values, and have evaluated the role of these parameters in clinical practice. It has been suggested that a ratio of sacral slope (SS)/PI <0.5 predisposes to spinal pathology. PI=SS+pelvic tilt (PT) and therefore for a given PI, patients with a higher SS due to an elevated SK will potentially predispose to an unfavourable SS/PI ratio. Methods: CT measurements of SS and PI were made in 100 consecutive patients from our database. Imagings without clear landmarks were excluded. PI and SK were measured using standardised techniques. Pearson’s correlation was used to assess association between PI and SK, in addition to the correlation between age and the pelvic parameters. Gender specific values for PI and SK were compared using an unpaired Student t -test. Results: Ninety-five patients (52 females) with a mean age 51.3 years were available for analysis. A strong positive correlation between the PI and the SK was identified (Pearson's coefficient=0.636, R2 value=0.404). Neither PI nor SK had a statistically significant correlation with age (p =0.721 and p =0.572, respectively). The mean values of both the PI and SK were statistically significantly lower in females when compared to males (p =0.0461 and p =0.0031, respectively). Conclusions: A strong correlation between PI and SK exists and is a reflection of different pelvic morphologies. SK partially determines SS and a relatively high SK compared to PI will result in less ability to change PT and a potentially unfavourable SS/PI ratio, which could theoretically contribute to clinical pathology.
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George McKay,Peter Alexander Torrie,Wendy Bertram,Priyan Landham,Stephen Morris,John Hutchinson,Roland Watura,Ian Harding 대한척추신경외과학회 2017 Neurospine Vol.14 No.4
Objective: Myelography has been shown to highlight foraminal and lateral recess stenosis more readily than computed tomography (CT) or magnetic resonance imaging (MRI). It also has the advantage of providing dynamic assessment of stenosis in the loaded spine. The advent of weight-bearing MRI may go some way towards improving assessment of the loaded spine and is less invasive, however availability remains limited. This study evaluates the potential role of myelography and its impact upon surgical decision making. Methods: Of 270 patients undergoing myelography during 2006-2009, a period representing peak utilisation of this imaging modality in our unit, we identified 21 patients with degenerative scoliosis who fulfilled our inclusion criteria. An operative plan was formulated by our senior author based initially on interpretation of an MRI scan. Subsequent myelogram and CT myelogram investigations were scrutinised, with any additional abnormalities noted and whether these impacted upon the operative plan. Results: From our 21 patients, 18 (85.7%) had myelographic findings not identified on MRI. Of note, in 4 patients, supine CT myelography yielded additional information when compared to supine MRI in the same patients. The management of 7 patients (33%) changed as a result of myelographic investigation. There were no complications of myelography of the total 270 analysed. Conclusion: MRI scan alone understates the degree of central and lateral recess stenosis. In addition to the additional stenosis displayed by dynamic myelography in the loaded spine, we have also shown that static myelography and CT myelography are also invaluable tools with regards to surgical planning in these patients.
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