| Background The clinical manifestations of gluteal muscle contracture(GMC)are hip joint snapping,limitation of motion,pelvic deformity,abnormal gait,etc.But some patients with GMC show spinal-pelvic symptoms.However,there are few studies on spinal sequence for GMC patients.There is only one study focused on the changes of coronal Cobb angle in patients with gluteal muscle contracture.The spinal-pelvic alignment of patients with GMC is not clarified sufficiently.This study aimed to describe the sagittal alignment of spine-pelvis in patients with GMC by roentgenogram study and to analyse the correlation of various sagittal parameters.Methods Retrospective radiological analysis was performed in 100patients with GMC(35 men and 65 women,age 17-46 years[average,28.50±5.41 years])and 100 asymptomatic people(35 men and 65 women,age 17-47 years[average,28.56 ± 7.22 years])from January 2019 to July 2020.All subjects were taken full-length anteroposterior and lateral radiographs.Sagittal parameters were measured on lateral radiographs of the whole spine,including pelvic incidence(PI),sagittal vertical axis(SVA),pelvic tilt(PT),lumbar lordosis(LL),sacral slope(SS),Cobb angle of thoracic kyphosis(TK)and the relationship betweenPI and LL(expressed as PI-LL).All cases were classified into three types by the apes position of lumbar lordosis and divided into three groups by PI.Parameters were compared between the GMC group and the control group.Correlations between parameters in the GMC gorup were analysed.The statistical level of significance was set at 0.05.Using the Independent-sample Student’s t-test or rank-sum test to compare the parameters between the Two groups.The categorical variable is described as rate(100 percent).To analyse the correlation between parameters in the GMC group,a Pearson correlation analysis was used.χ2-test was used to analyse the frequency components of each group.Results The average age of GMC patients,which included 35 males and 65 females,was(28.5 ± 5.4)years(range,17-46 years).And the control group also included 35 males and 65 females with a mean age of 28.6±7.2.The PI value of the GMC group was significantly less than that of the control group(42.37±10.84° vs 45.65±7.49°,P<0.05),as well as LL and TK.GMC group showed lower average LL(42.78±10.98 vs 46.38±8.98,P<0.05)and TK(17.33±9.43 vs 20.47±7.98,P<0.05)compared with the control group.There was no difference in SVA,PT,SS and PI-LL between the two groups.In GMC group,LL was correlated with PI,SS,PT,TK and SVA.Besides,pairwise correlations were found among PI,SS and PT.The distributions of PI groups(the most common category was 40°≤PI<50°)and apex groups[The least common category(L3)contained 6 patients(GMC group)vs 5 individuals(control group),whereas the most common category(L4)contained 74 patients(GMC group)vs 64 objects(control group)]between GMC and Control were not different,but the range of SS in apex group 3 presented difference between the two groups(38.28±4.68° vs 47.40±1.20°,p<0.05).Conclusions Gluteal muscle contracture causes lower PI,LL and TK.The patients with GMC present the excessive flat lumbar and thoracic curves compared to asymptomatic individuals.The sagittal imbalance in patients with GMC is mainly regulated by lumbar lordosis.Further investigations between the both relations of spinal-pelvic sagittal alignment and spinal symptoms are necessary. |
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