Evaluation of Global Sagittal Balance in Koreans Adults

Abstract

ObjectvieThe global sagittal postural patterns as characterized by Roussouly classification have been previously described in various ethnicities, there were no studies investigated in Koreans. To analyze the distribution of the global sagittal postural patterns in Korean adults using Roussouly classification, the author prospectively studied.Methods252 asymptomatic Korean adults was recruited. Data was obtained by reviewing the films for each subject. Spinopelvic parameters were measured and sagittal postural patterns were then determined according to Roussouly classification. We compared the data across different ethnicities from our study and a previous study to further characterize Korean sagittal postures.ResultsThe subject included 151 males and 101 females, with mean age of 33.2±8.2 years. The average descriptive results were as below: thoracic kyphosis 28.6±7.7°, lumbar lordosis 48.3±10.2°, sacral slope 37.8±5.8°, pelvic incidence 45.1±7.5°, pelvic tilt 9.4±6.7°, spinosacral angle 130.1±5.4°, and sagittal vertical axis 16.25±22.5 mm. 125 subjects among 252 (49.6%) belonged to Roussouly type 3 (namely neutral). There were also 58 (23%), 33 (13.1%), and 36 (14.3) subjects in type 1, 2, and 4 (namely non-neutral), respectively.ConclusionEnrolling 252 asymptomatic Korean adults, this prospective study found that 49.6% of asymptomatic Korean adults possessed a sagittal posture of Roussouly type 3. All radiologic parameters follows general concept of spinal sagittal balance pattern. Overall, this study might be a basis for further investigation of spinal sagittal balance.

Effects of Sagittal Balance Differences on Spondylolisthesis

“… 15 , 16 In the literature, it was reported that as PI values increased, LLA also increased to maintain the sagittal balance, and sacrum formed a horizontal position secondary to this increase. 1 In our study, PI and LLA values were found significantly higher in the listhesis group in accordance with the literature.…”

“… 9 In the case of decreased PI values, the pelvis forms a vertical position, while the increase of the PI values causes the pelvis to form a horizontal position, andthe force distribution of the secondary gravity on the vertebra varies regarding this. 1 It is known that the change in this force distribution increases the probability of spondylolysis, and the higher PI values found in the spondylolisthesis group in our study showed parallelism with the literature. Duval-Beaupere et al also suggested that PI is effective in the formation of isthmic spondylolisthesis, and the larger PI and sacral slope could lead spine to shift.…”

“…The humans are the only living creatures which have lordotic lumbar curvature and lumbar lordosis (LL) is one of the most important parameters to be examined in sagittal balance evaluations due to its variability. 1 Lumbar lordosis, which varies depending on the shape and the position of the pelvis and the relationship between sacral slope (SS) and pelvic tilt (PT), is thought to be the main mechanical cause of the degenerative diseases of the spine. 2…”

“… 5 – 6 Because PT and SS are variable parameters that are affected by the position, pelvic and other sagittal parameters should be assessed withstanding lateral radiographs. 1 …”

Comparison of lumbosacral alignment in Geriatric and Non-Geriatric patients suffering low back pain

“…Yang et al 18 did not find any differences in lumbosacral parameters between female and male asymptomatic individuals. Cho 31 reported that no significant differences were detected in LLA and sacral slope between female and male volunteers. These conflicting results may be a result of different measurement methods and ethnicity.…”