• Alice Baroncini, Louis Boissiere, Caglar Yilgor, Daniel Larrieu, Ahmet Alanay, Ferran Pellisé, Frank Kleinstueck, Javier Pizones, Yann Philippe Charles, Cecile Roscop, Anouar Bourghli, Ibrahim Obeid, and European Spine Study Group (ESSG).
• Department of Orthopaedics and Trauma Surgery, RWTH Uniklinik Aachen, Germany.
• Spine. 2024 Aug 15; 49 (16): 110711151107-1115.

Study DesignRetrospective analysis of prospectively collected data.ObjectiveTo identify the best definition of primary anteverted pelvis in the setting of adult spine deformity (ASD), and to investigate whether this is a pathologic setting that requires surgical correction.Summary Of Background DataWhile pelvic retroversion has been thoroughly investigated, pelvic anteversion (AP) is a far lesser discussed topic. Four different AP definitions have been proposed, and AP has been described as a normal or pathologic entity by different authors.Materials And MethodsAll patients consulting for ASD at the five participating sites were included. First, the four definitions of AP were compared with descriptive statistics (anatomic method-Pelvic Tilt <0°; Relative Pelvic Version method-RPV >5°; Roussouly method-Pelvic Incidence (PI)<50° and Sacral Slope (SS)>35°); low PT method-PT/PI <25th percentile). Second a subgroup analysis among operated AP patients with a two-year follow-up was performed. Complication rate, radiographic parameters, and clinical scores (ODI, SF-36) were compared in a multivariate analysis between patients who did and did not maintain an AP at the 2-year follow-up.ResultsA total of 1163 patients were available for the first analysis. The RPV method seemed to be the most appropriate to define AP in ASD patient. For the second analysis, data on 410 subjects were available, and most of them were young adults with idiopathic scoliosis that did not require pelvic fixation. AP patients who maintained an AP after ASD surgery presented comparable radiographic and clinical outcomes to the patients who presented a normoverted/retroverted pelvis after surgery.ConclusionsAccording to the results of the presented study, the RPV method is the most appropriate to define primary AP, which is not a pathologic condition and is most often observed in young adults with idiopathic scoliosis. Anteverted pelvis does not require direct surgical correction in this patient group.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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