Sagittal spinopelvic balance in normal children and adolescents

Mac-Thiong, Jean-Marc; Labelle, Hubert; Berthonnaud, Éric; Betz, Randal R.; Roussouly, Pierre

doi:10.1007/s00586-005-0013-8

Cited by 317 publications

(261 citation statements)

References 28 publications

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“…In children and adolescents, PI, PT, and SS are similar between boys and girls [25]. Also, sagittal sacropelvic morphology as measured by the PI tends to change slightly during growth and results in a proportionally slight increase in PT in the presence of a stable SS.…”

Section: Discussionmentioning

confidence: 81%

“…With increasing age during adulthood, PI remained stable, as opposed to pediatric subjects [25]. This suggests that, not only does the growth of the pelvis in the sagittal plane between the femoral heads and the upper sacral endplate ceases during adulthood, but also that normal degenerative changes to the hips, sacrum and sacro-iliac joints do not significantly influence the PI.…”

Section: Discussionmentioning

confidence: 86%

“…As a basis for comparison, it is therefore important to document the sacropelvic balance and morphology in the normal population. So far, normal values of sacropelvic parameters have been published for pediatric [25], adult [26][27][28][29][30], and elderly subjects [31].…”

Section: Introductionmentioning

confidence: 99%

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Age- and sex-related variations in sagittal sacropelvic morphology and balance in asymptomatic adults

et al. 2011

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Introduction Many studies suggest the importance of the sagittal sacropelvic balance and morphology in spinal and hip disorders. This study describes the normal age-and sex-related changes in sacropelvic morphology and balance in a prospective cohort of asymptomatic adults without spinal disorder. Materials and methods A prospective cohort of 709 asymptomatic adults without spinal pathology was recruited. There were 354 males and 355 females aged 37.9 ± 14.7 and 35.7 ± 13.9 years, respectively. For each subjects, pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS) were measured from standing lateral radiographs. Ratios of SS to PI (SS/PI), PT to PI (PT/PI), and PT to SS (PT/SS) were also calculated. Results There was no significant difference in PI (pelvic incidence), SS (sacral slope), PT (pelvic tilt), PT/PI, SS/PI, or PT/SS between males and females. The mean ± 2 standard deviations (SD) range was 32°-74°, 0°-27°, and 24°-55°for PI, PT and SS, respectively. The mean ± 2 SD range was greater than 0.5 for SS/PI and less than 0.5 for PT/PI. PI was not related to age in either sex group. PT, SS, PT/PI, SS/PI, and PT/SS presented only weak correlation coefficients (r B 0.21) with respect to age. Conclusion The current study presents the largest cohort of asymptomatic adults in the literature dedicated to the evaluation of sagittal sacropelvic morphology and balance. The range of values corresponding to the mean ± 2 SD can provide invaluable information to clinicians about the normal range of values expected in 95% of the normal population.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 86%

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Age- and sex-related variations in sagittal sacropelvic morphology and balance in asymptomatic adults

et al. 2011

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“…A validation study comparing the Cobb measurement technique to the best-fit arcs methodology demonstrated that both techniques exhibit similar reliability and accuracy [2,3]. Additional studies using the computerized best-fit arcs technique have established normal human sagittal plane alignment patterns and identified pathological variations by combining geometric pelvic measurements with various sagittal spinal alignment parameters [14,18,22].…”

Section: Introductionmentioning

confidence: 99%

Intra- and inter-observer reliability of determining radiographic sagittal parameters of the spine and pelvis using a manual and a computer-assisted methods

Dimar¹,

Carreon²,

Labelle

et al. 2008

Eur Spine J

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Sagittal imbalance is a significant factor in determining clinical treatment outcomes in patients with deformity. Measurement of sagittal alignment using the traditional Cobb technique is frequently hampered by difficulty in visualizing landmarks. This report compares traditional manual measurement techniques to a computerassisted sagittal plane measurement program which uses a radius arc methodology. The intra and inter-observer reliability of the computer program has been shown to be 0.92-0.99. Twenty-nine lateral 90 cm radiographs were measured by a computer program for an array of sagittal plane measurements. Ten experienced orthopedic spine surgeons manually measured the same parameters twice, at least 48 h apart, using a digital caliper and a standardized radiographic manual. Intraclass correlations were used to determine intra-and interobserver reliability between different manual measures and between manual measures and computer assisted-measures. The inter-observer reliability between manual measures was poor, ranging from -0.02 to 0.64 for the different sagittal measures. The intra-observer reliability in manual measures was better ranging from 0.40 to 0.93. Comparing manual to computer-assisted measures, the ICC ranged from 0.07 to 0.75. Surgeons agreed more often with each other than with the machine when measuring the lumbar curve, the thoracic curve, and the spinosacral angle. The reliability of the computer program is significantly higher for all measures except for lumbar lordosis. A computer-assisted program produces a reliable measurement of the sagittal profile of the spine by eliminating the need for distinctly visible endplates. The use of a radial arc methodology allows for infinite data points to be used along the spine to determine sagittal measurements. The integration of this technique with digital radiography's ability to adjust image contrast and brightness will enable the superior identification of key anatomical parameters normally not available for measurement on traditional radiographs, improving the consistency of sagittal measurement.

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“…As seen before, there is a direct correlation between the thoracic and the lumbar; therefore, in patients with sagittal imbalance, the restoration of lordosis is not enough but it is necessary to cover the kyphosis to give a correct balance and make sure the arthrodesis lasts as much as the correction [9]. As referred by many authors, the sagittal spinal orientation parameters are interdependent; their interaction results and leads to a stable and compensated posture [11]. Therefore, the correction of the sagittal balance in kyphotic deformities goes through a close analysis of the above listed spinopelvic parameters as well as of the kind of deformity to reach a harmonic and well-compensated restoration of the rachis overall sagittal balance.…”

Section: S104mentioning

confidence: 95%