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Recent observations in different types of adolescent idiopathic scoliosis indicate that individual pelvic morphology is related to the spinal levels in which scoliosis develops: primary lumbar adolescent scoliosis is associated with a higher pelvic incidence (PI) than thoracic scoliosis and non-scoliotic controls. We hypothesize that adult degenerative scoliosis (ADS) of the lumbar spine follows the same mechanical principles and is associated with a high PI.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This study used an existing CT-scan database, 101 ADS patients were sex and age matched to 101 controls. The PI was measured by two observers with multi-planar reconstruction, perpendicular to the hip-axis according to a previously validated technique.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The PI was 54.1\u00b0\u2009\u00b1\u200910.8\u00b0 in ADS patients and 47.7\u00b0\u2009\u00b1\u200910.8\u00b0 in non-scoliotic controls (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The median ADS curve apex was the disc L2-3 and median curve length was 4 vertebral levels. The mean supine Cobb angle was 21\u00b0\u2009\u00b1\u20098\u00b0 (ranged 10\u00b0\u201347\u00b0). There was no significant correlation between PI and the apex level (<jats:italic>p<\/jats:italic>\u2009=\u20090.883), the curve length (<jats:italic>p<\/jats:italic>\u2009=\u20090.418) or the Cobb angle (<jats:italic>p<\/jats:italic>\u2009=\u20090.518).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>ADS normally develops de novo in the lumbar spine of patients with a higher PI than controls, similar to primary lumbar adolescent idiopathic scoliosis. This suggests a shared mechanical basis of both deformities. Pelvic morphology dictates spinal sagittal alignment, which determines the segments of the spine that are prone to develop scoliosis.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00586-021-06924-y","type":"journal-article","created":{"date-parts":[[2021,7,22]],"date-time":"2021-07-22T07:02:49Z","timestamp":1626937369000},"page":"2467-2472","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["The role of sagittal pelvic morphology in the development of adult degenerative scoliosis"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7319-8327","authenticated-orcid":false,"given":"Steven","family":"de Reuver","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip P.","family":"van der Linden","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moyo C.","family":"Kruyt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom P. 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Philip van der Linden: nothing to declare. Moyo C. Kruyt: nothing to declare. Tom P.C. Schl\u00f6sser: nothing to declare. Ren\u00e9 M. Castelein: Stryker Spine Research Grant. All authors contributed equally to this work by either writing, editing, brainstorming and\/or supervising the current manuscript. Supporting data are available upon request.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}