Mohammad Karam, Aren Joe Bizdikian, Nour Khalil, Ziad Bakouny, Ibrahim Obeid, Joe Ghanimeh, Chris Labaki, Georges Mjaess, Aya Karam, Wafa Skalli, Khalil Kharrat, Ismat Ghanem, Ayman Assi

August 2020, Volume 29, Issue 8, pp 2010 - 2017 Original Article Read Full Article 10.1007/s00586-020-06397-5

First Online: 03 April 2020


To evaluate the 3D deformity of the acetabula and lower limbs in subjects with adolescent idiopathic scoliosis (AIS) and their relationship with spino-pelvic alignment.


Two hundred and seventy-four subjects with AIS (frontal Cobb: 33.5° ± 18° [10°–110°]) and 84 controls were enrolled. All subjects underwent full-body biplanar X-rays with subsequent 3D reconstructions. Classic spino-pelvic and lower limb parameters were collected as well as acetabular parameters: acetabular orientation in the 3 planes (tilt, anteversion and abduction), center–edge angle (CEA) and anterior and posterior sector angles. Subjects with AIS were represented by both lower limb sides and classified by elevated (ES) or lowered (LS), depending on the frontal pelvic obliquity. Parameters were then compared between groups. Determinants of acetabular and lower limb alterations were investigated among spino-pelvic parameters.


Acetabular abduction was higher on the ES in AIS (59.2° ± 6°) when compared to both LS (55.6° ± 6°) and controls (57.5° ± 3.9°, p 


Subjects with AIS had a more abducted acetabulum at the lowered side, more anteverted acetabulum and a lack of anterior coverage of both acetabula. These alterations were strongly related to pelvic tilt.

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