Pelvic Parameters: Origin and Significance

Overview

Journal Eur Spine J

Specialty Orthopedics

Date 2011 Aug 11

PMID 21830079

Citations 122

Authors

J C Le Huec

S Aunoble

Leijssen Philippe

Pellet Nicolas

Affiliations

Soon will be listed here.

Abstract

Introduction: The adoption by humans of an upright position resulted in broadening and verticalisation of the pelvis together with the appearance of characteristic spinal curves, has profoundly modified the structure of the muscles supporting the spine.

Material: In order to characterise the sagittal balance of the pelvis, it is necessary to define parameters based on notable biomechanical forces involved in the transmission of constraints. The angle of incidence was constructed to enable reproducible analysis of the anatomical characteristics of the pelvis in the sagittal plane. The angle of incidence is the algebraic sum of two complementary angles: pelvic tilt (PT) and sacral slope (SS). Since the value of incidence is fixed for any given patient, the sum of pelvic tilt and sacral slope is a constant value: when one increases, the other necessarily decreases.

Result: The position of the lumbar spine, attached to the sacral plateau, is thus affected by the pelvic tilt and by the sacral slope. Consequently, the pelvic parameters affect the entire underlying sagittal spinal profile.

Conclusion: Global spinal balance involves harmonisation of lumbar lordosis and thoracic kyphosis taking into account the pelvic parameters.

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References

Berge C . Heterochronic processes in human evolution: an ontogenetic analysis of the hominid pelvis. Am J Phys Anthropol. 1998; 105(4):441-59. DOI: 10.1002/(SICI)1096-8644(199804)105:4<441::AID-AJPA4>3.0.CO;2-R. View

Vialle R, Levassor N, Rillardon L, Templier A, Skalli W, Guigui P . Radiographic analysis of the sagittal alignment and balance of the spine in asymptomatic subjects. J Bone Joint Surg Am. 2005; 87(2):260-7. DOI: 10.2106/JBJS.D.02043. View

Mac-Thiong J, Roussouly P, Berthonnaud E, Guigui P . Sagittal parameters of global spinal balance: normative values from a prospective cohort of seven hundred nine Caucasian asymptomatic adults. Spine (Phila Pa 1976). 2010; 35(22):E1193-8. DOI: 10.1097/BRS.0b013e3181e50808. View

Schwab F, Lafage V, Boyce R, Skalli W, Farcy J . Gravity line analysis in adult volunteers: age-related correlation with spinal parameters, pelvic parameters, and foot position. Spine (Phila Pa 1976). 2006; 31(25):E959-67. DOI: 10.1097/01.brs.0000248126.96737.0f. View

Lazennec J, Riwan A, Gravez F, Rousseau M, Mora N, Gorin M . Hip spine relationships: application to total hip arthroplasty. Hip Int. 2009; 17 Suppl 5:S91-104. View

Vaz G, Roussouly P, Berthonnaud E, Dimnet J . Sagittal morphology and equilibrium of pelvis and spine. Eur Spine J. 2002; 11(1):80-7. PMC: 3610486. DOI: 10.1007/s005860000224. View

During J, Goudfrooij H, Keessen W, Beeker T, Crowe A . Toward standards for posture. Postural characteristics of the lower back system in normal and pathologic conditions. Spine (Phila Pa 1976). 1985; 10(1):83-7. View

Roussouly P, Gollogly S, Berthonnaud E, Dimnet J . Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position. Spine (Phila Pa 1976). 2005; 30(3):346-53. DOI: 10.1097/01.brs.0000152379.54463.65. View

Duval-Beaupere G, Schmidt C, Cosson P . A Barycentremetric study of the sagittal shape of spine and pelvis: the conditions required for an economic standing position. Ann Biomed Eng. 1992; 20(4):451-62. DOI: 10.1007/BF02368136. View

10.

Roussouly P, Gollogly S, Berthonnaud E, Labelle H, Weidenbaum M . Sagittal alignment of the spine and pelvis in the presence of L5-s1 isthmic lysis and low-grade spondylolisthesis. Spine (Phila Pa 1976). 2006; 31(21):2484-90. DOI: 10.1097/01.brs.0000239155.37261.69. View

11.

Dubousset J, Charpak G, Dorion I, Skalli W, Lavaste F, Deguise J . [A new 2D and 3D imaging approach to musculoskeletal physiology and pathology with low-dose radiation and the standing position: the EOS system]. Bull Acad Natl Med. 2005; 189(2):287-97. View

12.

Roussouly P, Gollogly S, Noseda O, Berthonnaud E, Dimnet J . The vertical projection of the sum of the ground reactive forces of a standing patient is not the same as the C7 plumb line: a radiographic study of the sagittal alignment of 153 asymptomatic volunteers. Spine (Phila Pa 1976). 2006; 31(11):E320-5. DOI: 10.1097/01.brs.0000218263.58642.ff. View

13.

Berthonnaud E, Dimnet J, Roussouly P, Labelle H . Analysis of the sagittal balance of the spine and pelvis using shape and orientation parameters. J Spinal Disord Tech. 2005; 18(1):40-7. DOI: 10.1097/01.bsd.0000117542.88865.77. View

14.

Jackson R, Hales C . Congruent spinopelvic alignment on standing lateral radiographs of adult volunteers. Spine (Phila Pa 1976). 2000; 25(21):2808-15. DOI: 10.1097/00007632-200011010-00014. View

15.

Legaye J, Duval-Beaupere G, Hecquet J, Marty C . Pelvic incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves. Eur Spine J. 1998; 7(2):99-103. PMC: 3611230. DOI: 10.1007/s005860050038. View