Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
European Spine Journal
Published in: European Spine Journal 7/2014

01-07-2014 | Original Article

Influence of age and sagittal balance of the spine on the value of the pelvic incidence

Author: Legaye Jean

Published in: European Spine Journal | Issue 7/2014

Login to get access

Abstract

Background data

The pelvic incidence (PI) was recognized as the key factor of the sagittal balance of the spine. Its value was described own for each individual and unchanged during adulthood.

Purpose

To bring out the effect of the age and of a sagittal imbalance in the variability of the value of PI.

Materials and methods

200 subjects with chronic low back pain due to sagittal imbalance were compared to 89 normal subjects. For each groups, the cases were divided according to the age (19–40, 6–40 years, over 60 years). The PI and the sagittal positional parameters were measured on large radiographs in standardized standing position.

Results

The correlation between age and PI was observed significant only for the >60 years cases. The mean values of PI were significantly greater for these cases.

Discussion

An increase of the value of PI was attributable to a twisting mobilization within the sacroiliac joint. It results from a forward projection of the gravity due to a sagittal disturbance and a pelvic compensatory backward rotation. This twisting into the sacroiliac joint was incriminated in the origin of chronic low back pain.

Conclusion

The sagittal pelvi-spinal imbalance may be incriminated in the increasing of the value of PI by a painful destabilization sacro-iliac, with leads to an increasing of the value of PI.
Literature
1.
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 7:99–103PubMedCentralPubMedCrossRef
2.
3.
Guigui P, Levassor N, Rillardon L et al (2003) Physiological value of pelvic and spinal parameters of sagital balance: analysis of 250 healthy volunteers. Rev Chir Orthop Reparatrice Appar Mot 89(6):496–506PubMed
4.
Vialle R, Levassor N, Rillardon L et al (2005) Radiographic analysis of the sagittal alignment and balance of the spine in asymptomatic subjects. J Bone Joint Surg Am 87(2):260–267PubMedCrossRef
5.
Boulay C, Tardieu C, Hecquet J et al (2006) Sagittal alignment of spine and pelvis regulated by pelvic incidence: standard values and prediction of lordosis. Eur Spine J 15:415–422PubMedCentralPubMedCrossRef
6.
7.
8.
Roussouly P, Pinheiro-Franco JL (2011) Biomechanical analysis of the spino-pelvic organization and adaptation in pathology. Eur Spine J 20(Suppl 5):609–618PubMedCentralPubMedCrossRef
9.
10.
Marty C, Boisaubert B, Descamps H et al (2002) The sagittal anatomy of the sacrum among young adults, infants, and spondylolisthesis patients. Eur Spine J 11(2):119–125PubMedCentralPubMedCrossRef
11.
12.
13.
Mac-Thiong JM, Berthonnaud E, Dimar JR 2nd et al (2004) Sagittal alignment of the spine and pelvis during growth. Spine 29(15):1642–1647PubMedCrossRef
14.
Mac-Thiong JM, Roussouly P, Berthonnaud E et al (2011) Age- and sex-related variations in sagittal sacropelvic morphology and balance in asymptomatic adults. Eur Spine J 20(Suppl 5):572–577PubMedCentralPubMedCrossRef
15.
Legaye J (2009) Influence of the sagittal balance of the spine on the anterior pelvic plane and on the acetabular orientation. Int Orthop 33(6):1695–1700PubMedCentralPubMedCrossRef
16.
Mooney V (1983) The syndromes of low back disease. Orthop Clin North Am 14(3):505–515PubMed
17.
Maigne JY, Lazareth JP, Guérin Surville H et al (1989) The lateral cutaneous branches of the dorsal rami of the thoraco-lumbar junction. An anatomical study on 37 dissections. Surg Radiol Anat 11(4):289–293PubMedCrossRef
18.
Schwab F, Lafage V, Patel A et al (2009) Sagittal plane considerations and the pelvis in the adult patient. Spine 34(17):1828–1833PubMedCrossRef
19.
20.
Aota Y, Saito T, Uesugi M et al (2009) Does the fists-on-clavicles position represent a functional standing position? Spine 34(8):808–812PubMedCrossRef
21.
Marks M, Stanford C, Newton P (2009) Which lateral radiographic positioning technique provides the most reliable and functional representation of a patient’s sagittal balance? Spine 34(9):949–954PubMedCrossRef
22.
Gelb DE, Lenke LC, Bridwell KH et al (1995) An analysis of the sagittal alignment in 100 asymptomatic middle and older ages volunteers. Spine 20:1351–1358PubMedCrossRef
23.
Van Royen BJ, Toussaint HM, Kingma I et al (1998) Accuracy of the sagittal vertical axis in a standing lateral radiograph as a measurement of balance in spinal deformities. Eur Spine J 7(5):408–412PubMedCentralPubMedCrossRef
24.
Schwab F, Patel A, Ungar B, Farcy JP, Lafage V (2010) Adult spinal deformity-postoperative standing imbalance: how much can you tolerate. An overview of key parameters in assessing alignment and planning corrective surgery. Spine 35(25):2224–2231PubMedCrossRef
25.
Boulay C, Tardieu C, Hecquet J et al (2005) Anatomical reliability of two fundamental radiological and clinical pelvic parameters : incidence and thickness. Eur J Orthop Surg Traumatol 15:197–204CrossRef
26.
Blondel B, Jouve JL, Panuel M et al (2008) Pelvic incidence reliability in spine sagittal balance. Rev Chir Orthop Reparatrice Appar Mot 94(4):321–326PubMedCrossRef
27.
Wang Z, Parent S, de Guise JA et al (2010) A variability study of computerized sagittal sacral radiologic measures. Spine 35(1):71–75PubMedCrossRef
28.
Jacob HA, Kissling RO (1995) The mobility of the sacroiliac joints in healthy volunteers between 20 and 50 years of age. Clin Biomech 10(7):352–361CrossRef
29.
Gottfried ON, Omeis I, Mehta VA et al (2011) Sacral tumor resection and the impact on pelvic incidence. J Neurosurg Spine 14(1):78–84PubMedCrossRef
30.
Morel E, Ilharreborde B, Lenoir T et al (2005) Sagittal balance of the spine and degenerative spondylolisthesis. Rev Chir Orthop Reparatrice Appar Mot 91(7):615–626PubMedCrossRef
31.
Barrey C, Jund J, Noseda O et al (2007) Sagittal balance of the pelvis-spine complex and lumbar degenerative diseases. A comparative study about 85 cases. Eur Spine J 16(9):1459–1467PubMedCentralPubMedCrossRef
32.
Vialle R, Dauzac C, Khouri N et al (2007) Sacral and lumbar-pelvic morphology in high-grade spondylolisthesis. Orthopedics 30(8):642–649PubMed
33.
Labelle H, Roussouly P, Chopin D et al (2008) Spino-pelvic alignment after surgical correction for developmental spondylolisthesis. Eur Spine J 17(9):1170–1176PubMedCentralPubMedCrossRef
34.
Labelle H, Mac-Thiong JM, Roussouly P (2011) Spino-pelvic sagittal balance of spondylolisthesis: a review and classification. Eur Spine J 20(Suppl 5):641–646PubMedCentralPubMedCrossRef
35.
Derincek A, Mehbod A, Pinto M et al (2008) Degeneration of non-fused segments after floating lumbar fusion. Acta Orthop Belg 74(4):507–511PubMed
36.
Kim MK, Lee SH, Kim ES et al (2011) The impact of sagittal balance on clinical results after posterior interbody fusion for patients with degenerative spondylolisthesis: a pilot study. BMC Musculoskelet Disord 12:69PubMedCentralPubMedCrossRef
37.
Duval-Beaupère G, Schmidt C, Cosson P (1992) A Barycentremetric study of the sagittal shape of spine and pelvis: the conditions required for an economic standing position. Ann Biomed Eng 20(4):451–462PubMedCrossRef
38.
Legaye J, Duval-Beaupere G (2008) Gravitational forces and sagittal shape of the spine. Clinical estimation of their relations. Int Orthop 32(6):809–816PubMedCentralPubMedCrossRef
39.
Vidal J, Marnay T (1983) Morphology and anteroposterior body equilibrium in spondylolisthesis L5-S1. Rev Chir Orthop Reparatrice Appar Mot 69(1):17–28PubMed
40.
Katz V, Schofferman J, Reynolds J (2003) The sacroiliac joint: a potential cause of pain after lumbar fusion to the sacrum. J Spinal Disord Tech 16(1):96–99PubMedCrossRef
41.
Lazennec JY, Ramaré S, Arafati N et al (2000) Sagittal alignment in lumbosacral fusion: relations between radiological parameters and pain. Eur Spine J 9(1):47–55PubMedCentralPubMedCrossRef
42.
43.
Bourghli A, Aunoble S, Reebye O et al (2011) Correlation of clinical outcome and spinopelvic sagittal alignment after surgical treatment of low-grade isthmic spondylolisthesis. Eur Spine J 20(Suppl 5):663–668PubMedCentralPubMedCrossRef
Metadata
Title
Influence of age and sagittal balance of the spine on the value of the pelvic incidence
Author
Legaye Jean
Publication date
01-07-2014
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 7/2014
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-014-3207-0

Other articles of this Issue 7/2014

European Spine Journal 7/2014 Go to the issue

Letter to the Editor

Letter to the Editor concerning “Range of motion of thoracic spine in sagittal plane”

Original Article

Dynamic cervical myelopathy in young adults

Letter to the Editor

A comparison of spinal anesthesia characteristics following intrathecal bupivacaine or levobupivacaine in lumbar disc surgery

Original Article

A novel technique for reduction of unreducible lumbar fractures in ankylosing spondylitis

Announcements

Announcements

Erratum

Erratum to: The growth and increase of the number of journals focusing on Spine: a scientific blessing?