Equilibrium of the human body and the gravity line: the basics

Huec, Jean Charles Le; Saddiki, R.; Franke, Jörg; Rigal, J.; Aunoble, S.

doi:10.1007/s00586-011-1939-7

Cited by 221 publications

(163 citation statements)

References 13 publications

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“…In particular, as already noted by other authors [23], SSA and SPA reductions can be considered as morphological adaptations that are specifically linked to the duration of the disease. In agreement with biomechanics considerations arising from the literature, the ST reduction can be considered as the main radiographic parameter related to the risk of falling in PD patients (see Table 5) [25]. Among the different morphological parameters included in the physical examination, the distance from plumb line to the bony marker of C7 presented a negative correlation with SPA (Table 4).…”

Section: Overall Sagittal Balance Parameters and Their Clinical Consesupporting

confidence: 68%

Spinopelvic balance: new biomechanical insights with clinical implications for Parkinson’s disease

Bissolotti¹,

Gobbo

Villafañe

et al. 2013

Eur Spine J

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Purpose The aim of this study was to describe the disease-related sagittal balance changes in relation to the sacropelvic morphology of PD patients with different durations of disease. Methods Thirty-one consecutive Parkinson's disease patients (26 males, 5 females; age 55-83 years) participated in the cross-sectional study. The clinical assessment included: Hoehn Yahr score; plumb line distance from the spinous process of C7, kyphosis apex, spinous process of L3 and S1. Lumbar lordosis (LL), thoracic kyphosis (TK), spinosacral angle, spinopelvic angle, spinal tilt, pelvic incidence, sacral slope (SS) and pelvic tilt were radiographically assessed.Results Radiographic spinopelvic angles appeared normal, but many patients presented variations from normality. In particular, pelvic tilt increased and SS decreased; spinosacral and spinopelvic angles were greatly reduced compared to healthy people, and spinal tilt increased. Unlike TK, LL was well correlated with most of the parameters. Conclusions Sagittal balance evaluation provides new valuable insights for biomechanical understanding of PD patients. Specific spinal parameters (spinosacral, spinopelvic and spinal tilt angles), and their clinical correlation, as well as pelvic parameters like pelvic tilt and sacral slope, appear particularly interesting for their clinical implications in terms of spinal deformities correction in PD population.

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Section: Overall Sagittal Balance Parameters and Their Clinical Consesupporting

confidence: 68%

Spinopelvic balance: new biomechanical insights with clinical implications for Parkinson’s disease

Bissolotti¹,

Gobbo

Villafañe

et al. 2013

Eur Spine J

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“…Any increased kyphosis in lumbar spine results in compensation, first as rotation in the pelvis and then knee flexion in the lower limbs (21). This compensation maintains the line of gravity inside the base of support but is not ergonomic.…”

Section: Hyper Lordosis Lumbar Sagittal Curvementioning

confidence: 99%

Are Lower Extremity Injuries Related to Spinal form Abnormalities in Professional Football Players? A Prospective Cohort Study

et al. 2017

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“…13 Sitting upon the femoral heads, the pelvis has rotated vertically to act as the foundation for the vertebral column. 14 Reported normal values for LL in asymptomatic adults vary widely. 5,9,19,30,31 After the description of pelvic incidence (PI), sacral slope, and pelvic tilt (PT) to evaluate the size and orientation of the pelvis, 7 it is now understood that the magnitude of ideal lordosis is specific to the given individual and should be estimated based on the PI.…”

mentioning

confidence: 99%

Relative lumbar lordosis and lordosis distribution index: individualized pelvic incidence–based proportional parameters that quantify lumbar lordosis more precisely than the concept of pelvic incidence minus lumbar lordosis

Yılgör

Söğünmez

Yavuz

et al. 2017

Neurosurgical Focus

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OBJECTIVEThe subtraction of lumbar lordosis (LL) from the pelvic incidence (PI) offers an estimate of the LL required for a given PI value. Relative LL (RLL) and the lordosis distribution index (LDI) are PI-based individualized measures. RLL quantifies the magnitude of lordosis relative to the ideal lordosis as defined by the magnitude of PI. LDI defines the magnitude of lower arc lordosis in proportion to total lordosis. The aim of this study was to compare RLL and PI − LL for their ability to predict postoperative complications and their correlations with health-related quality of life (HRQOL) scores.METHODSInclusion criteria were ≥ 4 levels of fusion and ≥ 2 years of follow-up. Mechanical complications were proximal junctional kyphosis/proximal junctional failure, distal junctional kyphosis/distal junctional failure, rod breakage, and implant-related complications. Correlations between PI − LL, RLL, PI, and HRQOL were analyzed using the Pearson correlation coefficient. Mechanical complication rates in PI − LL, RLL, LDI, RLL, and LDI interpreted together, and RLL subgroups for each PI − LL category were compared using chi-square tests and the exact test. Predictive models for mechanical complications with RLL and PI − LL were analyzed using binomial logistic regressions.RESULTSTwo hundred twenty-two patients (168 women, 54 men) were included. The mean age was 52.2 ± 19.3 years (range 18–84 years). The mean follow-up was 28.8 ± 8.2 months (range 24–62 months). There was a significant correlation between PI − LL and PI (r = 0.441, p < 0.001), threatening the use of PI − LL to quantify spinopelvic mismatch for different PI values. RLL was not correlated with PI (r = −0.093, p > 0.05); therefore, it was able to quantify divergence from ideal lordosis for all PI values. Compared with PI − LL, RLL had stronger correlations with HRQOL scores (p < 0.05). Discrimination performance was better for the model with RLL than for PI − LL. The agreement between RLL and PI − LL was high (κ = 0.943, p < 0.001), moderate (κ = 0.455, p < 0.001), and poor (κ = −0.154, p = 0.343), respectively, for large, average, and small PI sizes. When analyzed by RLL, each PI − LL category was further divided into distinct groups of patients who had different mechanical complication rates (p < 0.001).CONCLUSIONSUsing the formula of PI − LL may be insufficient to quantify normolordosis for the whole spectrum of PI values when applied as an absolute numeric value in conjunction with previously reported population-based average thresholds of 10° and 20°. Schwab PI − LL groups were found to constitute an inhomogeneous group of patients. RLL offers an individualized quantification of LL for all PI sizes. Compared with PI − LL, RLL showed a greater association with both mechanical complications and HRQOL. The use of RLL and LDI together, instead of PI − LL, for surgical planning may result in lower mechanical complication rates and better long-term HRQOL.

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Equilibrium of the human body and the gravity line: the basics

Abstract: These parameters are as follows: for the pelvis: incidence angle, pelvis tilt, sacral slope; for the spine: point of inflexion, apex of lumbar lordosis, lumbar lordosis, spinal tilt at C7; for overall analysis: spino-sacral angle, which is an intrinsic parameter.

Cited by 221 publications

References 13 publications

Spinopelvic balance: new biomechanical insights with clinical implications for Parkinson’s disease

Spinopelvic balance: new biomechanical insights with clinical implications for Parkinson’s disease

Are Lower Extremity Injuries Related to Spinal form Abnormalities in Professional Football Players? A Prospective Cohort Study

Relative lumbar lordosis and lordosis distribution index: individualized pelvic incidence–based proportional parameters that quantify lumbar lordosis more precisely than the concept of pelvic incidence minus lumbar lordosis

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