Lumbopelvic alignment on standing lateral radiograph of adult volunteers and the classification in the sagittal alignment of lumbar spine

Abstract

The analysis of the sagittal balance is important for the understanding of the lumbopelvic biomechanics. Results from previous studies documented the correlation between sacro-pelvic orientation and lumbar lordosis and a uniqueness of spino-pelvic alignment in an individual person. This study was subjected to determine the lumbopelvic orientation using pelvic radius measurement technique. The standing lateral radiographs in a standardized standing position were taken from 100 healthy volunteers. The measurements which included hip axis (HA), pelvic radius (PR), pelvic angle (PA), pelvic morphology (PR-S1), sacral translation distance (HA-S1), total lumbosacral lordosis (T12-S1), total lumbopelvic lordosis (PR-T12) and regional lumbopelvic lordosis angles (PR-L2, PR-L4 and PR-L5) were carried out with two independent observers. The relationships between the parameters were as follows. PR-S1 demonstrated positive correlation to regional lumbopelvic lordosis and revealed negative correlation to T12-S1. PA showed negative correlation to PR-S1 and regional lumbopelvic lordosis, but revealed positive correlation to HA-S1. T12-S1 was significantly increased when PR-S1 was lesser than average (35°-45°) and was significantly decreased when PR-S1 was above the average. PR-L4 and PR-L5 were significantly reduced when PR-S1 was smaller than average and only PR-L5 was significantly increased when PR-S1 was above the average. In conclusion, this present study supports that lumbar spine and pelvis work together in order to maintain lumbopelvic balance.

L'équilibre lombo-pelvi-fémoral en vue de profil, debout et assis

“…La détérioration de cet état d'équilibre, souvent associée au vieillissement du rachis, peut générer une cascade d'événements fonctionnels, neurologiques ou mécaniques [1]. La place du secteur pelvien dans l'équilibre sagittal du sujet debout est évidente pour les chirurgiens du rachis qui tiennent compte dans leurs raisonnements de la pente sacrée (PS), de l'angle incidence (I) et de la version pelvienne (VP) [2][3][4][5][6]. L'analyse des paramètres spinopelviens est au centre de leurs préoccupations pour la détection et l'analyse des déséquilibres sagittaux, compensés ou non [7].…”

Effect of growing rod on sagittal and spinopelvic parameters in early-onset scoliosis patients

“…Recently, studies have focused on spinopelvic alignment because of the close relationship between the spine and pelvis. Thus, analysis of the sagittal balance should not be limited to the spine but must also include the pelvis [2,3].…”

Classification system of the sagittal standing alignment in young adolescent girls

“…For sagittal standing alignment among a general population of pre-peak height velocity (pre-PHV) boys, Dolphens et al [1] have recently published an innovative classification system thereby providing a refinement of several other classification systems. The concepts that underlie this grading system were derived from clinical and scientific publications [2][3][4][5][6][7][8] as well as from clinical experience. Essentially, posture characteristics that might have clinical relevance were quantified using a screening protocol with clinical applicability and were incorporated into a consistent clustering framework in which the clinical relevance of the identified posture types was appreciated in terms of their association with spinal pain measures [1].…”