Global Alignment and Proportion (GAP) Score

Yılgör, Çağlar; Söğünmez, Nuray; Boissière, Louis; Yavuz, Yasemin; Obeid, Ibrahim; Kleinstück, Frank; Pérez-Grueso, Francisco Javier Sánchez; Acaroğlu, Emre; Haddad, Sleiman; Mannion, Anne F.; Pellisé, Ferran; Alanay, Ahmet

doi:10.2106/jbjs.16.01594

Cited by 397 publications

(85 citation statements)

References 25 publications

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“…Radiographic pelvic tilt in the sagittal plane is considered to be a crucial compensatory mechanism for subjects with sagittal malalignment and the maximal amount of pelvic tilt that a subject can perform is known to be limited by his maximal capacity of hip extension [15]. Moreover, rPT is an essential parameter that is used in different classifications of adult spinal deformity patients [24][25][26][27][28][29]44] and is known to be increased in this specific population whose quality of life is affected [15]. Thus, when the hip extension reserve is used, mobility of the pelvis might be limited.…”

Section: Resultsmentioning

confidence: 99%

“…Subjects were enrolled in the study if their age was above 18 years and had no history of orthopedic surgery to either the spine, pelvis or lower limbs. The exclusion criteria were pain, including lower back pain at the time of the study or any musculoskeletal disease (scoliosis, Scheuermann's kyphosis or leg length discrepancies) or the presence of at least one radiological criteria of adult spinal deformity (based on the European and International Spine Study Groups [24][25][26][27][28][29]) or previous orthopedic surgeries. A written informed consent form was signed by each subject.…”

Section: Methodsmentioning

confidence: 99%

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Influence of spino-pelvic and postural alignment parameters on gait kinematics

et al. 2020

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 To study the Influence of postural alignment parameters on gait kinematics  134 asymptomatic adults had gait analysis & postural parameters assessed on X-rays  Increase in sagittal vertical axis is related to larger knee flexion in stance  Increase in radiological pelvic tilt is related to reduced pelvic obliquity  Increase in thoracic kyphosis is related to reduced hip sagittal mobility

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Influence of spino-pelvic and postural alignment parameters on gait kinematics

et al. 2020

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“…Finally, we did not investigate the global alignment and proportion (GAP) score, which can denote 'normal' and 'pathologic' standing sagittal alignment and shape as a single score for every magnitude of pelvic incidence. 33) In the GAP, the optimal sagittal alignment is based on four factors deviating from their ideal curves and these factors are proportionally related to the PI. 34) Therefore, future studies should describe the SSB by measuring a single variable, such as the GAP score, rather than listing several different variables.…”

Section: Discussionmentioning

confidence: 99%

Relationships between Spinal Sarcopenia and Spinal Sagittal Balance in Older Women

Kim

Lee

Park

et al. 2019

Ann Geriatr Med Res

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Background: Spinal sarcopenia is receiving renewed attention as a cause of spinal sagittal imbalance. However, the relationships between spinal sarcopenia and spinal sagittal balance (SSB) have not been thoroughly investigated. We evaluated the relationships between SSB parameters and sarcopenic indices with lumbar paraspinal muscle (LPM) quantity and strength in healthy older adults. Methods: Twenty-four healthy community-dwelling older women were enrolled. Demographic variables, conventional sarcopenic indices, isometric back muscle strength, and SSB parameters, as well as results of functional examinations and lumbar spine computed tomography scan with LPM cross-sectional area (CSA) and density assessments, were examined. The independent effect on the sum of the total LPM CSA was determined using multivariable regression analysis adjusted for age, appendicular skeletal muscle mass, gait speed, handgrip strength, back extensor strength, and pelvic tilt (PT) angle. Results: PT angle was significantly correlated with the sum of the total LPM CSA and mean LPM density (r=-0.502, p=0.015 and r=0.504, p=0.014, respectively). Furthermore, PT angle was an independent factor for the sum of the total LPM CSA (β=-0.610, p=0.021) in the multivariate regression models (R 2 =0.320). Conclusion: Our data suggest that PT angle was significantly correlated with LPM CSA in healthy older women. To our knowledge, this is the first report to investigate the relationships of sarcopenic indices and spinal muscle degeneration with SSB.

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“…The Global Alignment and Proportion (GAP) score takes care of all these parameters, and is a useful tool for planning. 23 …”

Section: Spino-pelvic Interactionsmentioning

confidence: 99%

Pelvic motion the key to understanding spine–hip interaction

Pizones

García-Rey

2020

EFORT Open Reviews

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Pelvic motion acting as a hinge between the spine and hips is essential to maintain proper balance during bipedalism. Pelvic rotation is recruited as a compensation mechanism when spinal malalignment occurs. This pelvic rotation can affect functional acetabular orientation, and consequently functional cup positioning if a total hip arthroplasty (THA) is needed. Pelvic retroversion, frequently associated with degenerative spinal changes, implies an increase of acetabular version. Patients with flexible lumbar spines (spine users) protect the hip joint. Patients with stiff, degenerated or fused lumbar spines (hip users) demand higher hip mobility, placing the THA at risk. Pelvises in retroversion place the THA at risk for anterior dislocation when standing. In contrast, pelvises in anteversion or with low pelvic incidence (PI) can place THA at risk for posterior dislocation when sitting. Try to set the cup in an anatomic position. However, bear in mind that low PI pelvises may need more acetabular ante-inclination, and high PI pelvises more acetabular retroversion. If surgery is needed, start first by addressing the hip, except in patients with compensation (high pelvic retroversion), who may need spine surgery first to place the pelvis, and consequently the acetabulum, in a proper position. Cite this article: EFORT Open Rev 2020;5:522-533. DOI: 10.1302/2058-5241.5.200032

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Global Alignment and Proportion (GAP) Score

Cited by 397 publications

References 25 publications

Influence of spino-pelvic and postural alignment parameters on gait kinematics

Influence of spino-pelvic and postural alignment parameters on gait kinematics

Relationships between Spinal Sarcopenia and Spinal Sagittal Balance in Older Women

Pelvic motion the key to understanding spine–hip interaction

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