{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T04:05:07Z","timestamp":1758945907438,"version":"3.30.1"},"reference-count":20,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>The current Roussouly classification identifies four groups of \u201cnormal\u201d sagittal spine morphology, which has greatly expanded the understanding of normal heterogeneity of the spine. While there has been extensive characterization of the influence of spinopelvic parameters on outcomes after degenerative spine surgery, the influence of spinopelvic parameters on thoracolumbar trauma has yet to be described. The goal of this study was to determine if spinopelvic parameters and global spine morphology influence fracture location, fracture morphology, and rate of neurological deficit in the setting of thoracolumbar trauma.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Of 2896 patients reviewed in the authors\u2019 institutional spine database between January 2014 and April 2020 with an ICD-9\/10 diagnosis of thoracolumbar trauma, 514 met the inclusion criteria of acute thoracolumbar fracture on CT and visible femoral heads on sagittal CT. Pelvic incidence (PI) was calculated on sagittal CT. Demographic and clinical data including age, sex, BMI, smoking status, concomitant cervical fracture, mechanism of injury, major fracture location, neurological deficit, AO Spine thoracolumbar injury classification, and management type (operative vs nonoperative) were collected. Patients were stratified into high-PI (\u2265 50\u00b0) and low-PI (&lt; 50\u00b0) groups.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Patients with high PI had a lower incidence of fractures in the lower lumbar spine (below L2) compared with patients with low PI (16% vs 8%, p &lt; 0.01). The last lordotic vertebrae were observed between T10 and L4, and of fractures that occurred at these levels, 75% were at the last lordotic vertebrae. Fall from height was the most common cause of neurological deficit, accounting for 47%. Of the patients presenting with a fall from height, AO Spine type B distraction injuries were more common in the high-PI group (41% vs 18%, p = 0.01). Similarly, within the same subgroup, AO Spine type A compression injuries were more common in the low-PI group (73% vs 53%, p = 0.01).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Spinopelvic parameters and sagittal balance influence the location and morphology of thoracolumbar fractures. Fractures of the thoracolumbar junction are strongly associated with the inflection point, which is defined by sagittal alignment. While the importance of considering sagittal balance is known for decision-making in degenerative spinal pathology, further studies are required to determine if spinopelvic parameters and sagittal balance should play a role in the decision-making for management of thoracolumbar fractures.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.6.spine23515","type":"journal-article","created":{"date-parts":[[2023,8,12]],"date-time":"2023-08-12T04:14:10Z","timestamp":1691813650000},"page":"700-708","source":"Crossref","is-referenced-by-count":3,"title":["Characterization of the influence of spinopelvic parameters on thoracolumbar trauma"],"prefix":"10.3171","volume":"39","author":[{"given":"Joseph S.","family":"Withrow","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael D.","family":"Monterey","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Analisa","family":"Narro","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren","family":"Haley","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Martinez Cruz","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bradley","family":"Budde","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Duncan","family":"Trimble","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dallas","family":"Sheinberg","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Zaragoza","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Clinical and Translational Sciences, The University of Texas McGovern Medical School at Houston;"},{"name":"Biostatistics\/Epidemiology\/Research Design (BERD) Component, Center for Clinical and Translational Sciences (CCTS), The University of Texas Health Science Center at Houston;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhouxuan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Data Science, The University of Texas School of Public Health, Houston, Texas; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Caridi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Lenox Hill Hospital, Northwell Health, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John C.","family":"Quinn","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"Spine (Phila Pa 1976)","first-page":"346","article-title":"Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position","volume":"30","author":"Roussouly P","year":"2005","unstructured":"Roussouly P, Gollogly S, Berthonnaud E, Dimnet J. Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position. Spine (Phila Pa 1976). 2005;30(3):346\u2013353."},{"issue":"8","key":"b2","series-title":"Eur Spine J","first-page":"2002","article-title":"Classification of normal sagittal spine alignment: refounding the Roussouly classification","volume":"27","author":"Laouissat F","year":"2018","unstructured":"Laouissat F, Sebaaly A, Gehrchen M, Roussouly P. Classification of normal sagittal spine alignment: refounding the Roussouly classification. Eur Spine J. 2018;27(8):2002\u20132011."},{"issue":"6","key":"b3","series-title":"Neurosurgery","first-page":"880","article-title":"The influence of pelvic incidence and lumbar lordosis mismatch on development of symptomatic adjacent level disease following single-level transforaminal lumbar interbody fusion","volume":"80","author":"Tempel ZJ","year":"2017","unstructured":"Tempel ZJ, Gandhoke GS, Bolinger BD,  The influence of pelvic incidence and lumbar lordosis mismatch on development of symptomatic adjacent level disease following single-level transforaminal lumbar interbody fusion. Neurosurgery. 2017;80(6):880\u2013886."},{"issue":"1","key":"b4","series-title":"Eur Spine J","first-page":"54","article-title":"Restoring the ideal Roussouly sagittal profile in adult scoliosis surgery decreases the risk of mechanical complications","volume":"29","author":"Pizones J","year":"2020","unstructured":"Pizones J, Moreno-Manzanaro L, S\u00e1nchez P\u00e9rez-Grueso FJ,  Restoring the ideal Roussouly sagittal profile in adult scoliosis surgery decreases the risk of mechanical complications. Eur Spine J. 2020;29(1):54\u201362."},{"issue":"2","key":"b5","series-title":"Int Orthop","first-page":"104","article-title":"The importance of spinopelvic parameters in patients with lumbar disc lesions","volume":"26","author":"Rajnics P","year":"2002","unstructured":"Rajnics P, Templier A, Skalli W, Lavaste F, Illes T. The importance of spinopelvic parameters in patients with lumbar disc lesions. Int Orthop. 2002;26(2):104\u2013108."},{"issue":"9","key":"b6","series-title":"Eur Spine J","first-page":"1459","article-title":"Sagittal balance of the pelvis-spine complex and lumbar degenerative diseases. A comparative study about 85 cases","volume":"16","author":"Barrey C","year":"2007","unstructured":"Barrey C, Jund J, Noseda O, Roussouly P. Sagittal balance of the pelvis-spine complex and lumbar degenerative diseases. A comparative study about 85 cases. Eur Spine J. 2007;16(9):1459\u20131467."},{"issue":"4","key":"b7","series-title":"J Orthop","first-page":"383","article-title":"The epidemiology of thoracolumbar trauma: a meta-analysis","volume":"13","author":"Katsuura Y","year":"2016","unstructured":"Katsuura Y, Osborn JM, Cason GW. The epidemiology of thoracolumbar trauma: a meta-analysis. J Orthop. 2016;13(4):383\u2013388."},{"issue":"1","key":"b8","series-title":"J Trauma","first-page":"60","article-title":"The epidemiology of seatbelt-associated injuries","volume":"31","author":"Anderson PA","year":"1991","unstructured":"Anderson PA, Rivara FP, Maier RV, Drake C. The epidemiology of seatbelt-associated injuries. J Trauma. 1991;31(1):60\u201367."},{"issue":"suppl 5","key":"b9","series-title":"Eur Spine J","first-page":"578","article-title":"Sagittal parameters of the spine: biomechanical approach","volume":"20","author":"Roussouly P","year":"2011","unstructured":"Roussouly P, Pinheiro-Franco JL. Sagittal parameters of the spine: biomechanical approach. Eur Spine J. 2011;20(suppl 5):578-585."},{"issue":"9","key":"b10","series-title":"Eur Spine J","first-page":"2514","article-title":"Analysis of apex and transitional vertebra of the spine according to pelvic incidence using orientation and position parameters","volume":"30","author":"Roscop C","year":"2021","unstructured":"Roscop C, Mathio P, Gajny L, Kouyoumdjian P, Skalli W, Gille O. Analysis of apex and transitional vertebra of the spine according to pelvic incidence using orientation and position parameters. Eur Spine J. 2021;30(9):2514\u20132519."},{"issue":"23","key":"b11","series-title":"Spine (Phila Pa 1976)","first-page":"2028","article-title":"AOSpine thoracolumbar spine injury classification system: fracture description, neurological status, and key modifiers","volume":"38","author":"Vaccaro AR","year":"2013","unstructured":"Vaccaro AR, Oner C, Kepler CK,  AOSpine thoracolumbar spine injury classification system: fracture description, neurological status, and key modifiers. Spine (Phila Pa 1976). 2013;38(23):2028\u20132037."},{"issue":"6","key":"b12","series-title":"J Orthop Sci","first-page":"671","article-title":"Thoracolumbar injury classification and severity score: a new paradigm for the treatment of thoracolumbar spine trauma","volume":"10","author":"Lee JY","year":"2005","unstructured":"Lee JY, Vaccaro AR, Lim MR,  Thoracolumbar injury classification and severity score: a new paradigm for the treatment of thoracolumbar spine trauma. J Orthop Sci. 2005;10(6):671\u2013675."},{"issue":"2","key":"b13","series-title":"Eur Spine J","first-page":"241","article-title":"Comparison of pelvic incidence measurement using lateral x-ray, standard CT versus CT with 3D reconstruction","volume":"31","author":"Lee CM","year":"2022","unstructured":"Lee CM, Liu RW. Comparison of pelvic incidence measurement using lateral x-ray, standard CT versus CT with 3D reconstruction. Eur Spine J. 2022;31(2):241\u2013247."},{"issue":"1","key":"b14","series-title":"Spine (Phila Pa 1976)","first-page":"E22","article-title":"Dedicated spine measurement software quantifies key spino-pelvic parameters more reliably than traditional picture archiving and communication systems tools","volume":"41","author":"Gupta M","year":"2016","unstructured":"Gupta M, Henry JK, Schwab F,  Dedicated spine measurement software quantifies key spino-pelvic parameters more reliably than traditional picture archiving and communication systems tools. Spine (Phila Pa 1976). 2016;41(1):E22\u2013E27."},{"issue":"1","key":"b15","series-title":"Eur Spine J","first-page":"80","article-title":"Sagittal morphology and equilibrium of pelvis and spine","volume":"11","author":"Vaz G","year":"2002","unstructured":"Vaz G, Roussouly P, Berthonnaud E, Dimnet J. Sagittal morphology and equilibrium of pelvis and spine. Eur Spine J. 2002;11(1):80\u201387."},{"key":"b16","article-title":"Sagittal Balance of the Spine: From Normal to Pathology: A Key for Treatment Strategy","author":"Roussouly P","year":"2019","unstructured":"Roussouly P, Pinheiro-Franco J, Labelle H, Gehrchen M, eds. Sagittal Balance of the Spine: From Normal to Pathology: A Key for Treatment Strategy. Thieme; 2019."},{"issue":"5","key":"b17","series-title":"Int J Spine Surg","first-page":"875","article-title":"Validity and reliability of spinopelvic parameters measured on computed tomography","volume":"16","author":"\u0130plik\u00e7io\u011flu AC","year":"2022","unstructured":"\u0130plik\u00e7io\u011flu AC, Karaba\u011f H. Validity and reliability of spinopelvic parameters measured on computed tomography. Int J Spine Surg. 2022;16(5):875\u2013880."},{"issue":"1","key":"b18","series-title":"Orthop Traumatol Surg Res","first-page":"70","article-title":"Pelvic balance in sagittal and Lewinnek reference planes in the standing, supine and sitting positions","volume":"95","author":"Philippot R","year":"2009","unstructured":"Philippot R, Wegrzyn J, Farizon F, Fessy MH. Pelvic balance in sagittal and Lewinnek reference planes in the standing, supine and sitting positions. Orthop Traumatol Surg Res. 2009;95(1):70\u201376."},{"issue":"2","key":"b19","series-title":"Surg Radiol Anat","first-page":"105","article-title":"Variations of pelvic anteversion in the lying and standing positions: analysis of 24 control subjects and implications for CT measurement of position of a prosthetic cup","volume":"23","author":"Eddine TA","year":"2001","unstructured":"Eddine TA, Migaud H, Chantelot C, Cotten A, Fontaine C, Duquennoy A. Variations of pelvic anteversion in the lying and standing positions: analysis of 24 control subjects and implications for CT measurement of position of a prosthetic cup. Surg Radiol Anat. 2001;23(2):105\u2013110."},{"issue":"5","key":"b20","series-title":"Eur Spine J","first-page":"1470","article-title":"Reliability assessment of AOSpine thoracolumbar spine injury classification system and Thoracolumbar Injury Classification and Severity Score (TLICS) for thoracolumbar spine injuries: results of a multicentre study","volume":"26","author":"Kaul R","year":"2017","unstructured":"Kaul R, Chhabra HS, Vaccaro AR,  Reliability assessment of AOSpine thoracolumbar spine injury classification system and Thoracolumbar Injury Classification and Severity Score (TLICS) for thoracolumbar spine injuries: results of a multicentre study. Eur Spine J. 2017;26(5):1470\u20131476."}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/39\/5\/article-p700.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/39\/5\/article-p700.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/39\/5\/article-p700.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T13:13:13Z","timestamp":1733490793000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/39\/5\/article-p700.xml"}},"subtitle":["Presented at the 2023 AANS\/CNS Joint Section on Disorders of the Spine and Peripheral Nerves"],"short-title":[],"issued":{"date-parts":[[2023,11,1]]},"references-count":20,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2023.6.spine23515","relation":{},"ISSN":["1547-5654"],"issn-type":[{"type":"print","value":"1547-5654"}],"subject":[],"published":{"date-parts":[[2023,11,1]]}}}