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KMID : 1148120230130010023
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Journal of Advanced Spine Surgery
2023 Volume.13 No. 1 p.23 ~ p.32
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Comparison of Whole Spine Sagittal Alignment in Patients With Spinal Disease Between EOS Imaging System Versus Conventional Whole Spine Radiography
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Jang Hyun-Jun
Park Jeong-Yoon
Kuh Sung-Uk
Ha Yoon
Chin Dong-Kyu
Kim Keun-Su
Kim Kyung-Hyun
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Abstract
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Purpose : The biplanar whole body imaging system (EOS) is a new tool for measuring whole body sagittal alignment
in a limited space. This tool may affect the sagittal balance of patients compared to conventional whole spine
radiography (WSX). This study is to investigate the difference in sagittal alignment between WSX and EOS.
Materials and Methods : We compared spinal and pelvic sagittal parameters in 80 patients who underwent EOS
and WSX within one month between July 2018 and September 2019.The patients were divided based on sagittally
balanced and imbalanced groups according to pelvic tilt (PT) >20˚, pelvic incidence-lumbar lordosis >10°, C7-sagittal
vertical axis (SVA) > 50 mm in WSX.
Results : In sagitally imbalanced group, for WSX versus EOS, the pelvic parameters demonstrated compensation in
EOS with smaller PT (27.4±11.6° vs. 24.9±10.9°, p=0.003), greater sacral slope (SS), and patients tended to stand more
upright with smaller C7-SVA (58.4±17 mm vs. 48.9±57.3 mm, p=0.003), T1-pelvic angle (TPA), T5-T12, and T2-T12.
However, in sagitally balanced group, these differences were less pronounced only with smaller PT (10.8±6.9° vs.
9.4±4.7°, p=0.04), TPA and T2-T12 angle, but SS and C7-SVA were similar (p>0.05).
Conclusions : EOS shows a negative SVA shift and lesser pelvic tilt than WSX especially in patients with sagittal
imbalance. When making a surgical plan, surgeon should consider these differences between EOS and WSX.
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KEYWORD
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EOS, Whole spine x-ray, Compensatory mechanism, Sagittal parameters
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