[Lumbo-pelvino-acetabular Alignment-basics and Clinical Consequences]

Overview

Journal Orthopadie (Heidelb)

Specialty Orthopedics

Date 2022 Oct 12

PMID 36222867

Authors

Bernhard Heimkes

Nina Berger

Vincent Frimberger

Affiliations

Soon will be listed here.

Abstract

The spinal shape and the pelvic ante-/retroversion of an individual are determined by its innate, genetically fixed lumbosacral angulation. This can be measured with little effort in the lateral standing radiograph of the patient. In spinal surgery, there are a lot of original papers on the topic. In hip surgery, however, the individual pelvic version and its consequences for the acetabular orientation have not received the same attention so far.This review focuses on previous data on the relationship between lumbosacral angulation and pelvic ante-/retroversion. Four anatomically definable pelvic types can be distinguished; three of those have to be considered as facultatively pathogenetic. Clinical consequences arise for the clinical pictures of spondylolisthesis, non-specific lower back pain, acetabular retroversion and developmental dysplasia of the hip, as well as for acetabular cup positioning in total hip arthroplasty.

Citing Articles

[Preoperative MR imaging for hip dysplasia : Assessment of associated deformities and intraarticular pathologies].

Lerch T, Schmaranzer F Orthopadie (Heidelb). 2023; 52(4):300-312.

PMID: 36976331 PMC: 10063507. DOI: 10.1007/s00132-023-04356-8.

References

Luthringer T, Vigdorchik J . A Preoperative Workup of a "Hip-Spine" Total Hip Arthroplasty Patient: A Simplified Approach to a Complex Problem. J Arthroplasty. 2019; 34(7S):S57-S70. DOI: 10.1016/j.arth.2019.01.012. View

Tian S, Vahedi H, Goswami K, Parvizi J . Elephant's ear sign: a new radiographic finding indicative of acetabular retroversion. Arthroplast Today. 2020; 6(1):59-61. PMC: 7083708. DOI: 10.1016/j.artd.2019.12.007. View

Haffer H, Adl Amini D, Perka C, Pumberger M . The Impact of Spinopelvic Mobility on Arthroplasty: Implications for Hip and Spine Surgeons. J Clin Med. 2020; 9(8). PMC: 7464017. DOI: 10.3390/jcm9082569. View

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

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

Lequesne M, Laredo J . The faux profil (oblique view) of the hip in the standing position. Contribution to the evaluation of osteoarthritis of the adult hip. Ann Rheum Dis. 1999; 57(11):676-81. PMC: 1752497. DOI: 10.1136/ard.57.11.676. View

Boulay C, Tardieu C, Hecquet J, Benaim C, Mouilleseaux B, Marty C . Sagittal alignment of spine and pelvis regulated by pelvic incidence: standard values and prediction of lordosis. Eur Spine J. 2005; 15(4):415-22. PMC: 3489325. DOI: 10.1007/s00586-005-0984-5. 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

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

10.

Anda S, Svenningsen S, Grontvedt T, Benum P . Pelvic inclination and spatial orientation of the acetabulum. A radiographic, computed tomographic and clinical investigation. Acta Radiol. 1990; 31(4):389-94. View

11.

Lazennec J, Brusson A, Rousseau M . Lumbar-pelvic-femoral balance on sitting and standing lateral radiographs. Orthop Traumatol Surg Res. 2013; 99(1 Suppl):S87-103. DOI: 10.1016/j.otsr.2012.12.003. View

12.

Lerch T, Boschung A, Schmaranzer F, Todorski I, Vanlommel J, Siebenrock K . Lower pelvic tilt, lower pelvic incidence, and increased external rotation of the iliac wing in patients with femoroacetabular impingement due to acetabular retroversion compared to hip dysplasia. Bone Jt Open. 2021; 2(10):813-824. PMC: 8558448. DOI: 10.1302/2633-1462.210.BJO-2021-0069.R1. View

13.

Lazennec J, Brusson A, Folinais D, Zhang A, Pour A, Rousseau M . Measuring extension of the lumbar-pelvic-femoral complex with the EOS® system. Eur J Orthop Surg Traumatol. 2015; 25(6):1061-8. DOI: 10.1007/s00590-015-1603-8. View

14.

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

15.

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

16.

Dubousset J, Charpak G, Skalli W, Kalifa G, Lazennec J . [EOS stereo-radiography system: whole-body simultaneous anteroposterior and lateral radiographs with very low radiation dose]. Rev Chir Orthop Reparatrice Appar Mot. 2007; 93(6 Suppl):141-3. DOI: 10.1016/s0035-1040(07)92729-4. View

17.

Amabile C, Le Huec J, Skalli W . Invariance of head-pelvis alignment and compensatory mechanisms for asymptomatic adults older than 49 years. Eur Spine J. 2016; 27(2):458-466. DOI: 10.1007/s00586-016-4830-8. View

18.

Neumann D . Kinesiology of the hip: a focus on muscular actions. J Orthop Sports Phys Ther. 2010; 40(2):82-94. DOI: 10.2519/jospt.2010.3025. View

19.

Pierrepont J, Hawdon G, Miles B, Connor B, Bare J, Walter L . Variation in functional pelvic tilt in patients undergoing total hip arthroplasty. Bone Joint J. 2017; 99-B(2):184-191. DOI: 10.1302/0301-620X.99B2.BJJ-2016-0098.R1. View

20.

Kim J, Shen Q, Jeon C, Chung N, Jeong S, Lee H . No linear correlation between pelvic incidence and acetabular orientation: Retrospective observational study. Medicine (Baltimore). 2021; 100(15):e25445. PMC: 8051977. DOI: 10.1097/MD.0000000000025445. View