Annals of anatomy = Anatomischer Anzeiger : official organ of the Anatomische Gesellschaft · 2026
Is the morphology of the posterior superior iliac spine in Chinese population related to gender, age and bilateral symmetry? Insights from morphometric analysis based on CT 3D reconstruction and its clinical implications.
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Lin Fangzheng, Xu Shuyan, Li Jing, Chen Junyan, Wang Zhiping, Lin Dingkun, Qi Ji
Аннотация
OBJECTIVE: To investigate the morphological characteristics of posterior superior iliac spine (PSIS) in healthy individuals by high-precision three-dimensional (3D) reconstruction.
MATERIAL AND METHODS: Computed Tomography scans of 444 healthy hips (260 males, 184 females) from patients aged 18-80 years (mean age 36.23 ± 14.03 years) were retrospectively analyzed. 3D pelvises were reconstructed using Amira-Avizo 3D software. Measurements included overall pelvic breadth (AB) and height (CD), PSIS tip width (W0), maximum width (Wmax), transition width (W5), thickness (H0), distance from PSIS to ischial tuberosity (AC), iliac crest apex (AD), pubic tubercle (AE), iliac tubercle (AG), the widest region of posterior iliac crest (D0) and auricular surface (AF).
RESULTS: PSIS was categorized into four distinct types: Type I (V-shape, 26.35%), Type II (U-shape, 42.79%), Type III (W-shape, 18.47%), and Type IV (Ossification-shape, 12.39%). Significant difference was found among types, in CD, AC, W0, and D0 (p < 0.05). Age distribution varied markedly across types, with Type I exhibiting the youngest mean age (29.4 years) and Type IV the oldest (51.3 years) (p < 0.05). The female generally demonstrated larger linear and thickness measurements (p < 0.05). Gender differences involve dimensional parameters (p < 0.05) rather than distribution of morphological types (p > 0.05). Sixty-two cases demonstrated bilateral asymmetry with moderate bilateral classification agreement (Cohen's Kappa=0.574, p < 0.05), of which Type I/II pairing was the most common. Left-right comparisons revealed significant differences in AB, AE, AF, Wmax, and D0 parameters (p < 0.05).
CONCLUSIONS: The PSIS morphology is highly related to age and gender, alongside considerable bilateral asymmetry, which may be clinically applicable to palpation reliability, surgical planning, rehabilitation programs, and forensic examination.
MATERIAL AND METHODS: Computed Tomography scans of 444 healthy hips (260 males, 184 females) from patients aged 18-80 years (mean age 36.23 ± 14.03 years) were retrospectively analyzed. 3D pelvises were reconstructed using Amira-Avizo 3D software. Measurements included overall pelvic breadth (AB) and height (CD), PSIS tip width (W0), maximum width (Wmax), transition width (W5), thickness (H0), distance from PSIS to ischial tuberosity (AC), iliac crest apex (AD), pubic tubercle (AE), iliac tubercle (AG), the widest region of posterior iliac crest (D0) and auricular surface (AF).
RESULTS: PSIS was categorized into four distinct types: Type I (V-shape, 26.35%), Type II (U-shape, 42.79%), Type III (W-shape, 18.47%), and Type IV (Ossification-shape, 12.39%). Significant difference was found among types, in CD, AC, W0, and D0 (p < 0.05). Age distribution varied markedly across types, with Type I exhibiting the youngest mean age (29.4 years) and Type IV the oldest (51.3 years) (p < 0.05). The female generally demonstrated larger linear and thickness measurements (p < 0.05). Gender differences involve dimensional parameters (p < 0.05) rather than distribution of morphological types (p > 0.05). Sixty-two cases demonstrated bilateral asymmetry with moderate bilateral classification agreement (Cohen's Kappa=0.574, p < 0.05), of which Type I/II pairing was the most common. Left-right comparisons revealed significant differences in AB, AE, AF, Wmax, and D0 parameters (p < 0.05).
CONCLUSIONS: The PSIS morphology is highly related to age and gender, alongside considerable bilateral asymmetry, which may be clinically applicable to palpation reliability, surgical planning, rehabilitation programs, and forensic examination.