Association of Pelvic Incidence with Age, Sex, and Degenerative Spinal Pathology: A Retrospective Radiological Study.

IF 1.3 4区医学 Q3 ORTHOPEDICS

Indian Journal of Orthopaedics Pub Date : 2026-07-02 eCollection Date: 2026-10-01 DOI:10.1007/s43465-026-01888-x

Mustafa Bulut, Muhammed Furkan Darılmaz

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引用次数: 0

Abstract

Background: Pelvic incidence (PI) is a fundamental morphologic parameter of spinopelvic alignment and is traditionally considered largely constant in adulthood. However, the extent to which PI is influenced by age, sex, or degenerative spinal pathology remains uncertain.

Objective: To evaluate the relationship of PI with age, sex, and degenerative disc disease (DDD) in an adult population and to identify independent predictors of lumbar lordosis (LL) and DDD.

Methods: This retrospective cross-sectional study included adults aged 40-60 years who underwent standardized lateral lumbopelvic radiography between 2019 and 2024. Individuals with prior spinal surgery, congenital anomalies, infection, tumor, or inadequate imaging were excluded. Spinopelvic parameters (PI, pelvic tilt [PT], sacral slope [SS], LL) were measured by two independent observers, and interobserver reliability was assessed using intraclass correlation coefficients. Group comparisons were performed using the Mann-Whitney U test, correlations with Spearman analysis, and multivariable regression models were constructed to determine independent predictors of LL and DDD.

Results: A total of 319 participants (mean age 49.7 ± 6.1 years) were analyzed. No sex-related differences were observed in PI, PT, SS, or LL (p > 0.05). Individuals with DDD had higher SS and LL (both p < 0.001), whereas PI did not differ between the groups (p = 0.166). Age showed a moderate negative correlation with PI (ρ = -0.346, p < 0.001). In multivariable analysis, SS (β = 1.83), PI (β = -0.88), PT (β = 0.44), and female sex (β = 5.01) independently predicted LL. Age was the sole independent predictor of DDD (OR = 1.29 per year).

Conclusion: In adults aged 40-60 years, pelvic incidence was not significantly associated with sex or radiographically detectable degenerative disc disease and appeared largely stable, although lower PI values were associated with older age in this cross-sectional cohort. Degenerative changes predominantly affect positional parameters (SS and LL) rather than the morphologic parameter PI. These findings reinforce the role of pelvic incidence as a key structural reference in the assessment of sagittal balance.

Level of evidence: Level III (retrospective cross-sectional study).

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骨盆发病率与年龄、性别和退行性脊柱病理的关系：回顾性放射学研究。

背景：骨盆发生率（PI）是脊柱-骨盆排列的基本形态学参数，传统上认为在成年期基本不变。然而，PI在多大程度上受年龄、性别或退行性脊柱病理的影响仍不确定。目的：评估成年人群中PI与年龄、性别和退行性椎间盘疾病（DDD）的关系，并确定腰椎前凸（LL）和DDD的独立预测因素。方法：这项回顾性横断面研究包括40-60岁的成年人，他们在2019年至2024年间接受了标准化的腰盂外侧x线摄影。既往有脊柱手术、先天性异常、感染、肿瘤或影像不全者排除在外。脊柱骨盆参数（PI，骨盆倾斜[PT]，骶骨倾斜[SS]， LL）由两个独立的观察者测量，并使用类内相关系数评估观察者间的信度。采用Mann-Whitney U检验进行组间比较，采用Spearman分析进行相关性分析，并构建多变量回归模型以确定LL和DDD的独立预测因子。结果：共纳入319例患者，平均年龄49.7±6.1岁。PI、PT、SS、LL均无性别差异（p < 0.05）。DDD个体的SS和LL较高（p = 0.166）。年龄与PI （ρ = -0.346, p β = 1.83）呈中度负相关，PI （β = -0.88）、PT （β = 0.44）、女性性别（β = 5.01）独立预测LL。年龄是DDD的唯一独立预测因子（OR = 1.29 /年）。结论：在40-60岁的成年人中，尽管在这个横断面队列中，较低的PI值与年龄较大有关，但骨盆发病率与性别或x线可检测到的退变性椎间盘疾病没有显著相关性，并且表现出很大的稳定性。退行性改变主要影响位置参数（SS和LL）而不是形态参数PI。这些发现强化了骨盆发生率作为评估矢状面平衡的关键结构参考的作用。证据等级：III级（回顾性横断面研究）。

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来源期刊

Indian Journal of Orthopaedics ORTHOPEDICS-

CiteScore

1.80

自引率

0.00%

发文量

185

审稿时长

9 months

期刊介绍： IJO welcomes articles that contribute to Orthopaedic knowledge from India and overseas. We publish articles dealing with clinical orthopaedics and basic research in orthopaedic surgery. Articles are accepted only for exclusive publication in the Indian Journal of Orthopaedics. Previously published articles, articles which are in peer-reviewed electronic publications in other journals, are not accepted by the Journal. Published articles and illustrations become the property of the Journal. The copyright remains with the journal. Studies must be carried out in accordance with World Medical Association Declaration of Helsinki.