Skip to main content
Top
Published in: European Spine Journal 5/2010

01-05-2010 | Original Article

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

Authors: Jean-Sebastien Steffen, Ibrahim Obeid, Nicolas Aurouer, Olivier Hauger, Jean-Marc Vital, Jean Dubousset, Wafa Skalli

Published in: European Spine Journal | Issue 5/2010

Login to get access

Abstract

Relevance of posture assessment has been reported in case of spine disorders. This study explores the interest in quantifying posture using 3D reconstruction from biplanar X-rays in free standing position and a force plate. 93 patients consulting for spine disorders were divided (‘3D deformity’, ‘sagittal imbalance’ and ‘mild deformity’) and compared with 23 asymptomatic volunteers. Registration of the gravity line (GL) in reconstruction yielded transversal position of the center of acoustic meati (CAM) T1, T4, T9, L3, S1 and hip axis (HA) with regard to GL. Transversal position of CAM and L3 appeared as relevant parameters to discriminate patients from volunteers. Sagittal inclination of the axis linking the CAM to HA was correlated with position of the CAM to GL (r = 0.92 for patients). In conclusion, observing posture in 3D with regard to GL provides clinical relevant information. CAM-HA inclination may improve postural evaluation without force plate.
Literature
1.
go back to reference Dubousset J (1994) The pediatric spine: principles and practice. Raven Press, New York Dubousset J (1994) The pediatric spine: principles and practice. Raven Press, New York
2.
go back to reference Jackson RP, Peterson MD, McManus AC, Hales C (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 Jackson RP, Peterson MD, McManus AC, Hales C (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
3.
go back to reference Gelb DE, Lenke LG, Bridwell KH, Blanke K, McEnery KW (1995) An analysis of sagittal spinal alignment in 100 asymptomatic middle and older aged volunteers. Spine 20:1351–1358PubMed Gelb DE, Lenke LG, Bridwell KH, Blanke K, McEnery KW (1995) An analysis of sagittal spinal alignment in 100 asymptomatic middle and older aged volunteers. Spine 20:1351–1358PubMed
4.
go back to reference Glassman SD, Bridwell K, Dimar JR, Horton W, Berven S, Schwab F (2005) The impact of positive sagittal balance in adult spinal deformity. Spine 30:2024–2029CrossRefPubMed Glassman SD, Bridwell K, Dimar JR, Horton W, Berven S, Schwab F (2005) The impact of positive sagittal balance in adult spinal deformity. Spine 30:2024–2029CrossRefPubMed
5.
go back to reference Jackson RP, Phipps T, Hales C, Surber J (2003) Pelvic lordosis and alignment in spondylolisthesis. Spine 28:151–160CrossRefPubMed Jackson RP, Phipps T, Hales C, Surber J (2003) Pelvic lordosis and alignment in spondylolisthesis. Spine 28:151–160CrossRefPubMed
6.
go back to reference El Fegoun AB, Schwab F, Gamez L, Champain N, Skalli W, Farcy J (2005) Center of gravity and radiographic posture analysis: a preliminary review of adult volunteers and adult patients affected by scoliosis. Spine 30:1535–1540CrossRefPubMed El Fegoun AB, Schwab F, Gamez L, Champain N, Skalli W, Farcy J (2005) Center of gravity and radiographic posture analysis: a preliminary review of adult volunteers and adult patients affected by scoliosis. Spine 30:1535–1540CrossRefPubMed
7.
go back to reference Roussouly P, Gollogly S, Noseda O, Berthonnaud E, Dimnet J (2007) 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 31:E320–E325. doi:/10.1097/01.brs.0000218263.58642.ff CrossRef Roussouly P, Gollogly S, Noseda O, Berthonnaud E, Dimnet J (2007) 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 31:E320–E325. doi:/​10.​1097/​01.​brs.​0000218263.​58642.​ff CrossRef
8.
go back to reference Gangnet N, Pomero V, Dumas R, Skalli W, Vital JM (2003) Variability of the spine and pelvis location with respect to the gravity line: a three-dimensional stereoradiographic study using a force platform. Surg Radiol Anat 25:424–433CrossRefPubMed Gangnet N, Pomero V, Dumas R, Skalli W, Vital JM (2003) Variability of the spine and pelvis location with respect to the gravity line: a three-dimensional stereoradiographic study using a force platform. Surg Radiol Anat 25:424–433CrossRefPubMed
9.
go back to reference Vital JM, Senegas J (1986) Anatomical bases of the study of the constraints to which the cervical spine is subject in the sagittal plane. A study of the center of gravity of the head. Surg Radiol Anal 8:169–173CrossRef Vital JM, Senegas J (1986) Anatomical bases of the study of the constraints to which the cervical spine is subject in the sagittal plane. A study of the center of gravity of the head. Surg Radiol Anal 8:169–173CrossRef
10.
go back to reference Schwab F, Lafage V, Boyce R, Skalli W, Farcy J (2006) Gravity line analysis in adult volunteers: age-related correlation with spinal parameters, pelvic parameters, and foot position. Spine 31:E959–E967CrossRefPubMed Schwab F, Lafage V, Boyce R, Skalli W, Farcy J (2006) Gravity line analysis in adult volunteers: age-related correlation with spinal parameters, pelvic parameters, and foot position. Spine 31:E959–E967CrossRefPubMed
11.
go back to reference Lafage V, Schwab F, Skalli W, Hawkinson N, Gagey PM, Ondra S, Farcy JP (2008) Standing balance and sagittal plane spinal deformity: analysis of spinopelvic and gravity line parameters. Spine 33:1572–1578CrossRefPubMed Lafage V, Schwab F, Skalli W, Hawkinson N, Gagey PM, Ondra S, Farcy JP (2008) Standing balance and sagittal plane spinal deformity: analysis of spinopelvic and gravity line parameters. Spine 33:1572–1578CrossRefPubMed
12.
go back to reference Glassman SD, Berven S, Bridwell K, Horton W, Dimar JR (2005) Correlation of radiographic parameters and clinical symptoms in adult scoliosis. Spine 30:682–688CrossRefPubMed Glassman SD, Berven S, Bridwell K, Horton W, Dimar JR (2005) Correlation of radiographic parameters and clinical symptoms in adult scoliosis. Spine 30:682–688CrossRefPubMed
13.
go back to reference Gangnet N, Dumas R, Pomero V, Mitulescu A, Skalli W, Vital JM (2006) Three-dimensional spinal and pelvic alignment in an asymptomatic population. Spine 31:E507–E512CrossRefPubMed Gangnet N, Dumas R, Pomero V, Mitulescu A, Skalli W, Vital JM (2006) Three-dimensional spinal and pelvic alignment in an asymptomatic population. Spine 31:E507–E512CrossRefPubMed
14.
go back to reference Faro F, Marks MC, Pawelek J, Newton PO (2004) Evaluation of a functional position for lateral radiograph acquisition in adolescent idiopathic scoliosis. Spine 29:2284–2289CrossRefPubMed Faro F, Marks MC, Pawelek J, Newton PO (2004) Evaluation of a functional position for lateral radiograph acquisition in adolescent idiopathic scoliosis. Spine 29:2284–2289CrossRefPubMed
15.
go back to reference Humbert L, De Guise JA, Aubert B, Godbout B, Skalli W (2009) 3d reconstruction of the spine from biplanar X-rays using transversal and longitudinal inferences. Med Biol Eng Comput 31:681–687 Humbert L, De Guise JA, Aubert B, Godbout B, Skalli W (2009) 3d reconstruction of the spine from biplanar X-rays using transversal and longitudinal inferences. Med Biol Eng Comput 31:681–687
16.
go back to reference Mitton D, Deschenes S, Laporte S, Godbout B, Bertrand S, De Guise J, Skalli W (2006) 3D reconstruction of the pelvis from bi-planar radiography. Comput Methods Biomech Biomed Eng 9:1–5CrossRef Mitton D, Deschenes S, Laporte S, Godbout B, Bertrand S, De Guise J, Skalli W (2006) 3D reconstruction of the pelvis from bi-planar radiography. Comput Methods Biomech Biomed Eng 9:1–5CrossRef
17.
go back to reference Dubousset J, Charpak G, Dorion I, Skalli W, Lavaste F, Deguise J, Kalifa G, Ferey S (2005) 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 189:287–297PubMed Dubousset J, Charpak G, Dorion I, Skalli W, Lavaste F, Deguise J, Kalifa G, Ferey S (2005) 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 189:287–297PubMed
Metadata
Title
3D postural balance with regard to gravity line: an evaluation in the transversal plane on 93 patients and 23 asymptomatic volunteers
Authors
Jean-Sebastien Steffen
Ibrahim Obeid
Nicolas Aurouer
Olivier Hauger
Jean-Marc Vital
Jean Dubousset
Wafa Skalli
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/s00586-009-1249-5

Other articles of this Issue 5/2010

European Spine Journal 5/2010 Go to the issue