Preoperative sacroiliac joint degeneration predicts dynamic changes in pelvic incidence and clinical…

Cohort studyEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society· Sep 2026

Preoperative sacroiliac joint degeneration predicts dynamic changes in pelvic incidence and clinical outcomes following degenerative lumbar scoliosis correction.

Xing Chen, Rongkun Xu, Wenyang Fu … Xinyu Liu

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Spine SurgeryCohort studyQ1IF 3.2

Significant pelvic incidence change after degenerative lumbar scoliosis correction was seen in 39.1% of patients and linked to preoperative sacroiliac joint degeneration.

Preoperative sacroiliac joint degeneration predicts dynamic changes in pelvic incidence and clinical outcomes following degenerative lumbar scoliosis correction.

Xing Chen … Xinyu Liu

European spine journal · Sep 2026 · Q1 in Orthopedics

Purpose

To investigate longitudinal changes in pelvic incidence (pelvic incidence) and its association with preoperative sacroiliac joint (sacroiliac joint) degeneration, and to evaluate the subsequent effect on surgical outcomes following degenerative lumbar scoliosis (degenerative lumbar scoliosis) corrective surgery.

Methods

A total of 138 patients with degenerative lumbar scoliosis who underwent long‑segment fusion (≥ 4 levels) were retrospectively analyzed.

n = 138 patients

39.1%

Results

39.1%

of patients had a pelvic incidence shift of more than 5° after surgery, nearly two in five

n = 138 patients

More results

Among patients undergoing sacropelvic fixation, pelvic incidence tended to decrease postoperatively, whereas pelvic incidence increased in patients fused to L5 or the sacrum.

Patients in group C demonstrated greater PI-LL mismatch and worse sagittal vertical axis at the final follow‑up.

More results

Moreover, group C exhibited inferior PROMs and lower rates of achieving minimal clinically important difference in VAS‑back pain, ODI, and SRS‑22r pain and activity domains.

Preoperative sacroiliac joint degeneration was identified as an independent predictor of significant pelvic incidence change.

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Conclusion · 1 of 3

Pelvic incidence changed in nearly half of patients undergoing degenerative lumbar scoliosis correction surgery, which is associated with preoperative sacroiliac joint degeneration.

Conclusion · 2 of 3

Patients who demonstrated significant pelvic incidence increases after fusion to L5 or the sacrum tended to have greater postoperative pelvic incidence-LL mismatch and global sagittal imbalance, as well as inferior pain- and activity-related outcomes.

Conclusion · 3 of 3

These findings highlight the importance of considering sacroiliac joint degeneration when planning sagittal alignment targets and distal fusion strategies in degenerative lumbar scoliosis surgery.

Preoperative sacroiliac joint degeneration predicts dynamic changes in pelvic incidence and clinical outcomes following degenerative lumbar scoliosis correction.

Preoperative sacroiliac joint degeneration predicts dynamic changes in pelvic incidence and clinical outcomes following degenerative lumbar scoliosis correction.

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