The sagittal anatomy of the sacrum among young adults, infants, and spondylolisthesis patients

Marty, C.; Boisaubert, B.; Descamps, H.; Montigny, J. P.; Hecquet, J.; Legaye, Jean; Duval-Beaupère, G

doi:10.1007/s00586-001-0349-7

Cited by 259 publications

(205 citation statements)

References 7 publications

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“…A significant difference in the sagittal pelvic and sacral morphology was already reported between the normal subjects and those suffering from a spondylolysis [4,6,12,17,22,23]. This consists of a sagittal widening of the pelvis, expressed by an increase in the values of the anatomical parameters (PI, Jackson's angle PR-S1, FSPA, STA).…”

Section: Discussionmentioning

confidence: 90%

“…From this enlargement emanates an accentuation of the positional pelvic parameters (SS, PT, PA, angle SI) traducing a more tilted sacral plate. Some authors consider an important pelvic incidence as a pejorative factor for the progression of the vertebral listhesis [4,11,17]. But others did not observe it as significant [5].…”

Section: Discussionmentioning

confidence: 99%

“…Both describe well identically the same reality and both refer to the upper plate of S1. Only a variation of the 'sacral table angle (STA) should be susceptible to induce an alteration in the value of 'FSPA' and of the 'Jackson's angle' (in a lesser manner of the 'pelvic incidence') [17]. This STA is indeed the algebraic sum of the 'FSPA' and of the 'Jackson's angle'.…”

Section: Discussionmentioning

confidence: 99%

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The femoro-sacral posterior angle: an anatomical sagittal pelvic parameter usable with dome-shaped sacrum

Legaye

2006

Eur Spine J

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IntroductionThe interdependence between the pelvis and the sagittal spinal curvatures is obvious. The leading part of the pelvic sagittal anatomy in this orientation was well established by Duval-Beaupe`re thanks to the description of the angle 'Pelvic Incidence' (PI) [14]. It is the angle between the line perpendicular to the superior plate of the first sacral vertebra (S1) at its midpoint and the line connecting this point to the middle axis of the femoral heads. It is own for every individual and independent of the position of pelvis. A strict relation was described between this anatomical parameter and the sagittal tilt of the superior plate of the sacrum, and between this sacral tilt and the amount of lumbar lordosis. So the pelvic morphology modulates the sagittal spinal alignment. During and Itoi [1,7] described also these relations using an angle complementary of the incidence. As well Jackson observed this relation between the pelvic morphology, the sacral inclination and the lumbar curvature. He expressed the pelvic sagittal shape by the 'Pelvic Lordosis' (PR-S1) [8][9][10][11][12]. The measurement of these angles is easy in most of the cases. Their reliability and their reproducibility were established. Each author agrees to use as femoral axis the middle point of the line connecting the centers of the two femoral heads.However, the exact assessment of the upper plate of the sacrum (and consequently the values of the anatomical Jean LegayeThe femoro-sacral posterior angle: an anatomical sagittal pelvic parameter usable with dome-shaped sacrum Abstract The sagittal pelvic morphology modulates the individual alignment of the spine.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The femoro-sacral posterior angle: an anatomical sagittal pelvic parameter usable with dome-shaped sacrum

Legaye

2006

Eur Spine J

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“…Because of its close relationship with the spine, many studies have investigated the influence of sacropelvic balance and morphology in the evaluation and treatment of spinal disorders, such as developmental spondylolisthesis [1][2][3][4][5][6][7][8][9][10][11][12], degenerative spondylolisthesis [13,14], adolescent idiopathic scoliosis [15][16][17], and adult spinal deformity [18][19][20]. Some authors have also raised the role of sacropelvic morphology and balance in the pathogenesis and surgical treatment of hip osteoarthritis [21][22][23][24].…”

Section: Introductionmentioning

confidence: 99%

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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“…Several studies have shown that the sagittal pelvic morphology greatly influences the standing balance in normal adults, especially by regulating the lumbar lordosis [11,14,15,20,22,25].…”

Section: Introductionmentioning

confidence: 99%

Lumbosacral lordosis in fetal spine: genetic or mechanic parameter

et al. 2009

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Many believe that the fetus spine had only one curvature from cranial to caudal which is a global kyphosis and that the lumbosacral lordosis appears with the erect posture. They agree that the sacrum of Homo sapiens is not positioned posteriorly at birth and that it is during the first few years that the sacrum, in humans, moves dorsally in relation with the progressive acquisition of erect posture and the ontogeny of bipedal locomotion. Nevertheless, there is no biometric study assessing these parameters in vivo in utero during the fetal life. Cross-sectional biometric study of the lumbosacral junction of the spine in in utero fetuses was to document the presence of a lumbosacral lordosis in the fetal population in utero long before standing and walking and its change during growth. Fortyfive MRIs (magnetic resonance imaging) of fetuses aged of 23-40 weeks of gestation were analyzed. The measurements were performed on computerized MRI DICOM images using a professional software to calculate the curvature and radius of the lumbosacral junction. The presence or absence of visual lumbosacral lordosis was noted for each case. Correlation tests were performed in order to disclose a correlation between the gestational age and the curvature calculated. A test was considered significant for P \ 0.01. There were 14 males, 17 females and 14 undetermined. All the curves (100%) showed mathematically the presence of a lordosis in the lumbosacral region. The visual lumbosacral lordosis was present in 60% of cases. The measurement of the lumbosacral curvature varies between -0.133 and -0.033 mm -1 and a mean of -0.054 mm -1 with a corresponding radius ranging from -7 to -303 mm with a mean of -18.7 mm. The statistical analysis showed no correlation between the gestational age and the lumbosacral curvature (R 2 = 0.11). The hypothesis of increased lumbosacral lordosis with gestational age is rejected. It is difficult to accurately determine the role played separately by genetics and by erect posture. A visual lumbosacral lordosis was noted in 60% of cases with mean radius of -18.6691 mm. This lordosis was not correlated statistically to gestational age which means that it is not related to growth and might be genetically determined. Mechanical factors may play a major role in the determination of the shape of the growing pelvis. One can ask if the pelvis morphology is genetically determined or if it is mechanically determined under muscular and ligamentous stresses. This study shows that the sacrum of human fetuses is oriented posteriorly mathematically in 100% of cases, and in 60% of cases based on the morphologic appearance of the lumbosacral junction. So beside the effect of progressive acquisition of erect posture and bipedalism in determining the formation of lumbosacral angle, we believe that genetics play an important role in the formation of the lumbosacral angle.

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The sagittal anatomy of the sacrum among young adults, infants, and spondylolisthesis patients

Cited by 259 publications

References 7 publications

The femoro-sacral posterior angle: an anatomical sagittal pelvic parameter usable with dome-shaped sacrum

The femoro-sacral posterior angle: an anatomical sagittal pelvic parameter usable with dome-shaped sacrum

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

Lumbosacral lordosis in fetal spine: genetic or mechanic parameter

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