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Purpose <p>This study aimed to evaluate the potential for changes in pelvic incidence (PI) as a secondary outcome following lumbar or lumbosacral fusion surgery, to identify preoperative factors—particularly sacroiliac joint (SIJ) degeneration—associated with such changes, and to analyze their subsequent impact on postoperative clinical outcomes.</p> Methods <p>This retrospective study included 472 patients (mean age 64.8 ± 8.5&#xa0;years; 46% male) who underwent lumbar or lumbosacral fusion surgery between February 2020 and February 2023. Patients were divided into two groups based on postoperative changes in PI at 6&#xa0;months: the PI-change group (ΔPI ≥ 5°) and the no-change group (ΔPI &lt; 5°). Preoperative and 6-month postoperative spinopelvic parameters were assessed using standardized standing whole-spine lateral radiographs. Clinical outcomes were assessed at 6&#xa0;months postoperative using the Visual Analog Scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), and EuroQol-5 Dimension (EQ-5D). The clinical outcomes of the two groups were compared to evaluate the impact of PI change on functional recovery.</p> Results <p>Ninety patients (19.1%) exhibited significant PI changes postoperatively. The PI change group had higher intraoperative blood loss (711.8 ± 508.8&#xa0;mL vs. 558.7 ± 464.8&#xa0;mL), higher preoperative SI joint degeneration scores (7.1 ± 3.0 vs. 5.4 ± 3.7), and less frequent use of OLIF (5.6% vs. 16.0%). Multivariable logistic regression identified preoperative SI joint degeneration as an independent factor predicting PI change (odds ratio: 2.903, 95% confidence interval: 1.444–5.837). Functional outcomes at 6&#xa0;months were significantly worse in the PI change group, reflected by higher ODI scores (29.5 ± 20.4 vs. 18.3 ± 16.3) and lower EQ-5D scores (0.7 ± 0.2 vs. 0.8 ± 0.1).</p> Conclusions <p>PI, traditionally considered a constant parameter, may be altered following lumbar or lumbosacral fusion, particularly in patients with preoperative SI joint degeneration, emphasizing the importance of SI joint assessment in preoperative planning and postoperative management.</p>

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Preoperative sacroiliac joint degeneration can predict changes in pelvic incidence and functional outcomes following lumbar fusion

  • 期刊论文

  • 发表日期：

    2026年2月24日

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  • Tae Jeong Park,
  • Woo Seok Jung,
  • Kyung Soo Suk,
  • Byung Ho Lee,
  • Jaenam Lee,
  • Ji-Won Kwon

摘要

Purpose

This study aimed to evaluate the potential for changes in pelvic incidence (PI) as a secondary outcome following lumbar or lumbosacral fusion surgery, to identify preoperative factors—particularly sacroiliac joint (SIJ) degeneration—associated with such changes, and to analyze their subsequent impact on postoperative clinical outcomes.

Methods

This retrospective study included 472 patients (mean age 64.8 ± 8.5 years; 46% male) who underwent lumbar or lumbosacral fusion surgery between February 2020 and February 2023. Patients were divided into two groups based on postoperative changes in PI at 6 months: the PI-change group (ΔPI ≥ 5°) and the no-change group (ΔPI < 5°). Preoperative and 6-month postoperative spinopelvic parameters were assessed using standardized standing whole-spine lateral radiographs. Clinical outcomes were assessed at 6 months postoperative using the Visual Analog Scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), and EuroQol-5 Dimension (EQ-5D). The clinical outcomes of the two groups were compared to evaluate the impact of PI change on functional recovery.

Results

Ninety patients (19.1%) exhibited significant PI changes postoperatively. The PI change group had higher intraoperative blood loss (711.8 ± 508.8 mL vs. 558.7 ± 464.8 mL), higher preoperative SI joint degeneration scores (7.1 ± 3.0 vs. 5.4 ± 3.7), and less frequent use of OLIF (5.6% vs. 16.0%). Multivariable logistic regression identified preoperative SI joint degeneration as an independent factor predicting PI change (odds ratio: 2.903, 95% confidence interval: 1.444–5.837). Functional outcomes at 6 months were significantly worse in the PI change group, reflected by higher ODI scores (29.5 ± 20.4 vs. 18.3 ± 16.3) and lower EQ-5D scores (0.7 ± 0.2 vs. 0.8 ± 0.1).

Conclusions

PI, traditionally considered a constant parameter, may be altered following lumbar or lumbosacral fusion, particularly in patients with preoperative SI joint degeneration, emphasizing the importance of SI joint assessment in preoperative planning and postoperative management.