Pelvic motion the key to understanding spine–hip interaction

Pizones, Javier; García-Rey, Eduardo

doi:10.1302/2058-5241.5.200032

Cited by 33 publications

(33 citation statements)

References 70 publications

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“…An increased lumbar lordosis, in turn, may also require increased thoracic and sacral kyphosis (outward curvature). These geometric relationships between spinal curvature and pelvic form are well-documented by the correlations between AP pelvic dimensions, pelvic orientation and lumbar lordosis reported in orthopaedic studies [ 54 – 57 ]. In late pregnancy, lumbar lordosis is even further increased to balance the additional abdominal weight [ 58 ].…”

Section: Discussionmentioning

confidence: 73%

The evolution of pelvic canal shape and rotational birth in humans

et al. 2021

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Background The human foetus typically needs to rotate when passing through the tight birth canal because of the complex shape of the pelvis. In most women, the upper part, or inlet, of the birth canal has a round or mediolaterally oval shape, which is considered ideal for parturition, but it is unknown why the lower part of the birth canal has a pronounced anteroposteriorly oval shape. Results Here, we show that the shape of the lower birth canal affects the ability of the pelvic floor to resist the pressure exerted by the abdominal organs and the foetus. Based on a series of finite element analyses, we found that the highest deformation, stress, and strain occur in pelvic floors with a circular or mediolaterally oval shape, whereas an anteroposterior elongation increases pelvic floor stability. Conclusions This suggests that the anteroposterior oval outlet shape is an evolutionary adaptation for pelvic floor support. For the pelvic inlet, by contrast, it has long been assumed that the mediolateral dimension is constrained by the efficiency of upright locomotion. But we argue that the mediolateral elongation has evolved because of the limits on the anteroposterior diameter imposed by upright posture. We show that an anteroposteriorly deeper inlet would require greater pelvic tilt and lumbar lordosis, which compromises spine health and the stability of upright posture. These different requirements of the pelvic inlet and outlet likely have led to the complex shape of the pelvic canal and to the evolution of rotational birth characteristic of humans.

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Section: Discussionmentioning

confidence: 73%

The evolution of pelvic canal shape and rotational birth in humans

et al. 2021

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“…An increase in AP length of the pelvis requires re-balancing this system by forward rotating the sacrum and increasing lumbar lordosis (Fig. 4) [38][39][40][41] . The amount of lordosis, however, is limited by the size, strength and wedging of the vertebral bodies as well as by necessary adaptations within the spinal musculature.…”

Section: Discussionmentioning

confidence: 99%

The evolution of pelvic canal shape and rotational birth in humans

Stansfield

Fischer

Mitterœcker

2021

Preprint

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The human foetus needs to rotate when passing through the tight birth canal because of the complex shape of the pelvis. In most women the upper part, or inlet, of the birth canal has a round or mediolaterally oval shape, which is considered ideal for parturition, but it is unknown why the lower part, or outlet, of the birth canal has a pronounced anteroposteriorly oval shape. Here we show that the shape of the lower birth canal affects the ability of the pelvic floor to resist pressure exerted by the abdominal organs and the foetus. Based on a series of finite element analyses, we found that the highest deformation, stress and strain occur in pelvic floors with a circular or mediolaterally oval shape, whereas an anteroposterior elongation increases pelvic floor stability. This suggests that the anteroposterior oval outlet shape is an evolutionary adaptation for pelvic floor support. For the pelvic inlet, by contrast, it has long been assumed that the mediolateral dimension is constrained by the efficiency of upright locomotion. But we argue that upright stance limits the anteroposterior dimension of the inlet. A deeper inlet requires greater pelvic tilt and lumbar lordosis, which compromises spine health and the stability of upright posture. These different requirements on the pelvic inlet and outlet have led to the complex shape of the human pelvic canal and to the evolution of rotational birth.

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“…The disparity in PI, sacral inclination, sacral slope (SS), etc., between the pre- and post-treatment measurements denoted destabilized condition of the SIJ complex. A comparison of initial and follow-up measurements is summarized in Table 1 [ 4 - 6 ].…”

Section: Case Reportmentioning

confidence: 99%

“…Pelvic incidence (PI) is a radiographic parameter describing the relative position of the sacral endplate in relation to the pelvis [ 4 ]. PI used to be considered as a constant parameter throughout adult life [ 4 - 6 ]. Minimal PI changes with respect to postural alteration have been described in normal individuals [ 7 ], but the implications of PI change under pathological conditions have not yet fully investigated [ 8 - 10 ].…”

Section: Introductionmentioning

confidence: 99%