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Comparison of Whole Spine Sagittal Alignment in Patients with Spinal Disease between EOS Imaging System versus Conventional Whole Spine X-ray

 Hyun Jun Jang  ;  Jeong Yoon Park  ;  Sung Uk Kuh  ;  Yoon Ha  ;  Dong Kyu Chin  ;  Keun Su Kim  ;  Yong Eun Cho  ;  Kyung Hyun Kim 
 YONSEI MEDICAL JOURNAL, Vol.63(11) : 1027-1034, 2022-11 
Journal Title
Issue Date
Humans ; Kyphosis* / diagnostic imaging ; Kyphosis* / surgery ; Lordosis* / diagnostic imaging ; Lumbar Vertebrae ; Radiography ; Sacrum ; Spine / diagnostic imaging ; X-Rays
EOS ; compensatory mechanism ; sagittal parameters ; whole spine x-ray
Purpose: The biplanar whole body imaging system (EOS) is a new tool for measuring the whole body sagittal alignment in a limited space. This tool may affect the sagittal balance of patients compared to conventional whole spine X-ray (WSX). This study aimed to investigate the difference in sagittal alignment between WSX and EOS.

Materials and methods: We compared the 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 the sagittally imbalanced group, compared to WSX, the pelvic parameters demonstrated compensation in EOS with smaller PT (27.4±11.6° vs. 24.9±10.9°, p=0.003) and greater sacral slope (SS), and the patients tended to stand more upright with smaller C7-SVA (58.4±17.0 mm vs. 48.9±57.3 mm, p=0.018), T1-pelvic angle (TPA), T5-T12, and T2-T12. However, in the sagittally balanced group, these differences were less pronounced only with smaller PT (10.8±6.9° vs. 9.4±4.7°, p=0.040), TPA and T2-T12 angle, but with similar SS and C7-SVA (p>0.05).

Conclusion: EOS showed a negative SVA shift and lesser PT compared to WSX, especially in patients with sagittal imbalance. When preparing a surgical plan, surgeons should consider these differences between EOS and WSX.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kuh, Sung Uk(구성욱) ORCID logo https://orcid.org/0000-0003-2566-3209
Kim, Kyung Hyun(김경현)
Kim, Keun Su(김근수) ORCID logo https://orcid.org/0000-0002-3384-5638
Park, Jeong Yoon(박정윤) ORCID logo https://orcid.org/0000-0002-3728-7784
Jang, Hyun Jun(장현준)
Cho, Yong Eun(조용은) ORCID logo https://orcid.org/0000-0001-9815-2720
Chin, Dong Kyu(진동규) ORCID logo https://orcid.org/0000-0002-9835-9294
Ha, Yoon(하윤)
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