Top

Published in:

01-05-2010 | Original Article

Clasped position for measurement of sagittal spinal alignment

Authors: Hidekazu Suzuki, Kenji Endo, Jun Mizuochi, Hiroto Kobayashi, Hidetoshi Tanaka, Kengo Yamamoto

Published in: European Spine Journal | Issue 5/2010

Abstract

Lateral whole-spine radiography is a useful tool in the management of spinal deformity, but the most appropriate arm position during radiography has yet to be determined. In this prospective study, we evaluated 26 adult volunteers and 22 patients with lumbar spinal canal stenosis. Lateral whole-spine radiographs were acquired in the most stable and relaxed position while the subjects were standing with their arms extended and their hand gently clasped in front of the trunk (clasped position). The following parameters were measured: sagittal vertical axis (SVA), lumbar lordotic angle (LLA), pelvic angle (PA), pelvic lordosis angle (PRS1), pelvic tilt (PT), and pelvic incidence (PI). The reliability of measurements was assessed by interclass correlation coefficients. The SVA was slightly positive in volunteers. LLA, PA, PRS1, PT, and PI were compatible with standard normal values. The results showed “almost perfect agreement” with regard to intra- and interobserver reliability. The clasped position can be used effectively and reliably for measurement of sagittal spinal alignment for the lumbar region in adults.

Aota Y, Saito T, Uesugi M et al (2009) Does fists-on-clavicles position represent a functional standing position? Spine 34:808–812CrossRefPubMed

Dimar JR II, Carreon LY, Labelle H et al (2008) Intra- and inter-observer reliability of determining radiographic sagittal parameters of the spine and pelvis using a manual and a computer-assisted methods. Eur Spine J 17:1373–1379CrossRefPubMed

Faro FD, Marks MC, Pawelek J et al (2004) Evaluation of a functional position for lateral radiograph acquisition in adolescent idiopathic scoliosis. Spine 29:2284–2289CrossRefPubMed

Gelb DE, Lenke LG, Bridwell KH et al (1995) An analysis of sagittal spinal alignment in 100 asymptomatic middle and older aged volunteers. Spine 20:1351–1358PubMed

Hammerberg EM, Wood KB (2003) Sagittal profile of the elderly. J Spinal Disord Tech 16:44–50PubMed

Horton WC, Brown CW, Bridwell KH et al (2005) Is there an optimal patient stance for obtaining a lateral 36″ radiograph? A critical comparison of three techniques. Spine 30:427–433CrossRefPubMed

Jackson RP, Hales C (2000) Congruent spinopelvic alignment on standing lateral radiographs of adult volunteers. Spine 25:2808–2815CrossRefPubMed

Jackson RP, McManus AC (1994) Radiographic analysis of sagittal plane alignment and balance in standing volunteers and patients with low back pain matched for age, sex, and size: a prospective controlled clinical study. Spine 19:1611–1618CrossRefPubMed

Jackson RP, Peterson MD, McManus AC et al (1998) Compensatory spinopelvic balance over the “hip axis” and better reliability in measuring lordosis to the pelvic radius on standing lateral radiographs of adult volunteers and patients. Spine 23:1750–1767CrossRefPubMed

10.

Jackson RP, Kanemura T, Kawakami N et al (2000) Lumbopelvic lordosis and pelvic balance on repeated standing lateral radiographs of adult volunteers and untreated patients with constant low back pain. Spine 25:575–586CrossRefPubMed

11.

Jackson RP, Phipps T, Hales C et al (2003) Pelvic lordosis and alignment in spondylolisthesis. Spine 28:151–160CrossRefPubMed

12.

Kanemura T, Imagama S et al (2009) Spino-pelvic alignment in an asymptomatic Japanese population—mean and variance of upright thoracolumbar spino-pelvic alignment in Japanese. J Joint Surg 28:558–567 (in Japanese)

13.

Landis JR, Koch CG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174CrossRefPubMed

14.

Legaye J, Duval-Beaupère G, Hecquet J et al (1998) Pelvic incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves. Eur Spine J 7:99–103CrossRefPubMed

15.

Marks MC, Stanford CF, Mahar AT et al (2003) Standing lateral radiographic positioning does not represent customary standing balance. Spine 28:1176–1182CrossRefPubMed

16.

Matsuoka H, Komagata M, Nishiyama M et al (2004) Radiographic assessment of sagittal spinal alignment to correlate standards classified by age and low back pain. J Tokyo Med Univ 62:64–71

17.

Ochiai J, Kanzaki K, Saito G et al (2006) The study of sagittal alignment for Japanese. J Jpn Soc Spine Surg Relat Res 17:274 (in Japanese)

18.

Schwab F, Lafage V, Boyce R et al (2006) Gravity line analysis in adult volunteers. Age-related correlation with spinal parameters, pelvic parameters, and foot position. Spine 31:E959–E967CrossRefPubMed

19.

Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86:420–428CrossRefPubMed

20.

Suzuki H, Endo K, Kobayashi H et al (2008) Correlation of sagittal spinal alignment with clinical symptoms in lumbar canal stenosis. J Lumbar Spine Disord 14:23–27 (in Japanese with English abstract)CrossRef

21.

Vedantam R, Lenke LG, Bridwell KH et al (2000) The effect of variation in arm position on sagittal spinal alignment. Spine 25:2204–2209CrossRefPubMed

22.

Wiltse LL, Winter RB (1983) Terminology and measurement of spondylolisthesis. J Bone Joint Surg (Am) 65:768–772

Title: Clasped position for measurement of sagittal spinal alignment
Authors: Hidekazu Suzuki
Kenji Endo
Jun Mizuochi
Hiroto Kobayashi
Hidetoshi Tanaka
Kengo Yamamoto
Publication date: 01-05-2010
Publisher: Springer-Verlag
Published in: European Spine Journal / Issue 5/2010
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-010-1352-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clasped position for measurement of sagittal spinal alignment

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 5/2010

Cervical myelopathy in athetoid and dystonic cerebral palsy: retrospective study and literature review

Noncontiguous anterior decompression and fusion for multilevel cervical spondylotic myelopathy: a prospective randomized control clinical study

3D postural balance with regard to gravity line: an evaluation in the transversal plane on 93 patients and 23 asymptomatic volunteers

A morphological adaptation of the thoracic and lumbar vertebrae to lumbar hyperlordosis in young and adult females

Expert’s comment concerning Grand Rounds case entitled “Revision of a lumbar disc arthroplasty following late infection” (by Jeffrey M. Spivak and Anthony M. Petrizzo)

A randomised controlled trial on the effectiveness of bracing patients with idiopathic scoliosis: failure to include patients and lessons to be learnt