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The individual pelvic sagittal inclination (PSI) is an issue for cup alignment in total hip arthroplasty (THA). The chronological PSI change is larger in standing than that in supine. It is expected that PSI in standing position may improve when spinal long fusion was performed. Therefore, the purpose of this study was to evaluate the change of PSI between preand postcorrective long fusion for adult spinal deformity (ASD). Total eight patients underwent corrective surgery for ASD between May 2014 and October 2016 were the subjects of this study. There were two cases that underwent bilateral THA before spine surgery. PSI was defined as the angle between the anterior pelvic plane and the vertical axis on the sagittal plane DRR. The mean change in the preoperative PSI from supine to standing was 17° posteriorly. The mean change in the supine PSI from preto post-operation was 6.9° anteriorly, and that in the standing PSI was 17° anteriorly. The mean change in the postoperative PSI from supine to standing was 6.7° posteriorly. When we measured PSI on standard AP radiographs of the pelvis in two patients who underwent THA, the mean change in postoperative PSI from supine to standing was less than 3°.The mean change in cup anteversion on supine AP radiographs were 2.7°. As we expected, the change in PSI from supine to standing position was reduced by performing corrective surgery. In this study, PSI in standing changed into the direction which reduce posterior impingement and anterior dislocation..

Change in pelvic sagittal tilt after corrective long fusion of spine