nach oben

European Spine Journal

Erschienen in:

01.09.2011 | Original Article

Age- and sex-related variations in sagittal sacropelvic morphology and balance in asymptomatic adults

verfasst von: Jean-Marc Mac-Thiong, P. Roussouly, É. Berthonnaud, P. Guigui

Erschienen in: European Spine Journal | Sonderheft 5/2011

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Many studies suggest the importance of the sagittal sacropelvic balance and morphology in spinal and hip disorders. This study describes the normal age- and sex-related changes in sacropelvic morphology and balance in a prospective cohort of asymptomatic adults without spinal disorder.

Materials and methods

A prospective cohort of 709 asymptomatic adults without spinal pathology was recruited. There were 354 males and 355 females aged 37.9 ± 14.7 and 35.7 ± 13.9 years, respectively. For each subjects, pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS) were measured from standing lateral radiographs. Ratios of SS to PI (SS/PI), PT to PI (PT/PI), and PT to SS (PT/SS) were also calculated.

Results

There was no significant difference in PI (pelvic incidence), SS (sacral slope), PT (pelvic tilt), PT/PI, SS/PI, or PT/SS between males and females. The mean ± 2 standard deviations (SD) range was 32°–74°, 0°–27°, and 24°–55° for PI, PT and SS, respectively. The mean ± 2 SD range was greater than 0.5 for SS/PI and less than 0.5 for PT/PI. PI was not related to age in either sex group. PT, SS, PT/PI, SS/PI, and PT/SS presented only weak correlation coefficients (r ≤ 0.21) with respect to age.

Conclusion

The current study presents the largest cohort of asymptomatic adults in the literature dedicated to the evaluation of sagittal sacropelvic morphology and balance. The range of values corresponding to the mean ± 2 SD can provide invaluable information to clinicians about the normal range of values expected in 95% of the normal population.

Hresko MT, Labelle H, Roussouly P et al (2007) Classification of high-grade spondylolisthesis based on pelvic version and spine balance: possible rationale for reduction. Spine 32:2208–2213PubMedCrossRef

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

Labelle H, Roussouly P, Berthonnaud É et al (2004) Spondylolisthesis, pelvic incidence, and spinopelvic balance. A correlation study. Spine 29:2049–2954PubMedCrossRef

Labelle H, Roussouly P, Chopin D et al (2008) Spino-pelvic alignment after surgical correction for developmental spondylolisthesis. Eur Spine J 17:1170–1176PubMedCrossRef

Mac-Thiong J-M, Wang Z, de Guise JA et al (2008) Postural model of sagittal spino-pelvic balance and its relevance for lumbosacral developmental spondylolisthesis. Spine 33:2316–2325PubMedCrossRef

Mac-Thiong J-M, Labelle H, Parent S et al (2008) Reliability and development of a new classification of lumbosacral spondylolisthesis. Scoliosis 3:19PubMedCrossRef

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 11:119–125PubMedCrossRef

Rajnics P, Templier A, Skalli W et al (2002) The association of sagittal spinal and pelvic parameters in asymptomatic persons and patients with isthmic spondylolisthesis. J Spinal Disord 15:24–30CrossRef

Roussouly P, Gollogly S, Berthonnaud É et al (2006) Sagittal alignment of the spine and pelvis in the presence of L5–S1 isthmic lysis and low-grade spondylolisthesis. Spine 31:2484–2490PubMedCrossRef

10.

Vialle R, Ilharreborde B, Dauzac C et al (2007) Is there a sagittal imbalance of the spine in isthmic spondylolisthesis? A correlation study. Eur Spine J 16:1641–1649PubMedCrossRef

11.

Wang Z, Parent S, Mac-Thiong J-M et al (2008) Influence of sacropelvic morphology in developmental spondylolisthesis. Spine 33:2185–2191PubMedCrossRef

12.

Whitesides TE Jr, Horton WC, Hutton WC et al (2005) Spondylotic spondylolisthesis. A study of pelvic and lumbosacral parameters of possible etiologic effect in two genetically and geographically distinct groups with high occurrence. Spine 30(6S):S12–S21PubMedCrossRef

13.

Barrey C, Jund J, Perrin G et al (2007) Spinopelvic alignment of patients with degenerative spondylolisthesis. Neurosurgery 61:981–986PubMedCrossRef

14.

Morel E, Ilharreborde B, Lenoir T et al (2005) Sagittal balance of the spine and degenerative spondylolisthesis [French]. Rev Chir Orthop Reparatrice Appar Mot 91:615–626PubMed

15.

Mac-Thiong J-M, Labelle H, Charlebois M et al (2003) Sagittal plane analysis of the spine and pelvis in adolescent idiopathic scoliosis according to the coronal curve type. Spine 28:1404–1409PubMed

16.

Tanguay F, Mac-Thiong J-M, de Guise JA et al (2007) Relation between the sagittal pelvic and lumbar spine geometries following surgical correction of adolescent idiopathic scoliosis. Eur Spine J 16:531–536PubMedCrossRef

17.

Upasani V, Tis J, Bastrom T et al (2007) Analysis of sagittal alignment in thoracic and thoracolumbar curves in adolescent idiopathic scoliosis. How do these two curve types differ? Spine 32:1355–1359PubMedCrossRef

18.

Gottfried ON, Daubs MD, Patel AA et al (2009) Spinopelvic parameters in postfusion flatback deformity patients. Spine J 9:639–647

19.

Kim YJ, Bridwell KH, Lenke LG et al (2006) An analysis of sagittal spinal alignment following long adult lumbar instrumentation and fusion to L5 or S1: can we predict ideal lumbar lordosis? Spine 31:2343–2352PubMedCrossRef

20.

Rose PS, Bridwell KH, Lenke LG et al (2009) Role of pelvic incidence, thoracic kyphosis, and patient factors on sagittal plane correction following pedicle substraction osteotomy. Spine 34:785–791PubMedCrossRef

21.

De Thomasson E, Guingand O, Terracher R et al (2004) Role of sagittal spinal curvature in early dislocation after revision total hip arthroplasty: prospective analysis of 49 revision procedures [French]. Rev Chir Orthop Reparatrice Appar Mot 90:226–231PubMed

22.

Lazennec JY, Riwan A, Gravez F et al (2007) Hip spine relationships: application to total hip arthroplasty. Hip Int 17:91–104

23.

Tardieu C, Hecquet J, Boulay C et al (2008) Two key describers of the sacro-acetabular relationships: the angles of sacral and acetabular incidence (French). Rev Chir Orthop Reparatrice Appar Mot 94:327–335PubMed

24.

Yoshimoto H, Sato S, Masuda T et al (2005) Spinopelvic alignement in patients with osteoarthrosis of the hip. A radiographic comparison to patients with low back pain. Spine 30:1650–1657PubMedCrossRef

25.

Mac-Thiong J-M, Labelle H, Berthonnaud É et al (2007) Sagittal spinopelvic balance in normal children and adolescents. Eur Spine J 16:227–234PubMedCrossRef

26.

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 15:415–422PubMedCrossRef

27.

Berthonnaud É, Dimnet J, Roussouly P et al (2005) Analysis of the sagittal balance of the spine and pelvis using shape and orientation parameters. J Spinal Disord Tech 18:40–47PubMedCrossRef

28.

Janssen MMA, Drevelle X, Humbert L et al (2009) Differences in male and female spino-pelvic alignment in asymptomatic young adults. Spine 34:E826–E832PubMedCrossRef

29.

Kuntz C, Levin LS, Ondra SL et al (2007) Neutral upright sagittal spinal alignment from the occiput to the pelvis in asymptomatic adults: a review and resynthesis of the literature. J Neurosurg Spine 6:104–112PubMedCrossRef

30.

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 87:260–267PubMedCrossRef

31.

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

32.

Berthonaud E, Labelle H, Roussouly P et al (2005) A variability study of computerized sagittal spinopelvic radiologic measurements of trunk balance. J Spinal Disord Tech 18:66–71CrossRef

33.

Vaz G, Roussouly P, Berthonnaud E et al (2002) Sagittal morphology and equilibrium of pelvis and spine. Eur Spine J 11:80–88PubMedCrossRef

34.

Cohen J ((1988)) Statistical power analysis for the behavioural sciences, 2nd edn. Lawrence Erlbaum Associates, Hillsdale, New Jersey, pp 100–110

35.

Albanese J (2003) A metric method for sex determination using the hipbone and the femur. J Forensic Sci 48:263–273PubMed

36.

Bruzek J (2002) A method for visual determination of sex, using the human hip bone. Am J Phys Anthropol 117:157–168PubMedCrossRef

37.

Igbigbi P, Nanono-Igbigbi AM (2003) Determination of sex and race from the subpubic angle in Ugandan subjects. Am J Forensic Med Pathol 24:168–172PubMed

38.

McBride DG, Dietz MJ, Vennemeyer MT et al (2001) Bootstrap methods for sex determination from the os coxae using the ID3 algorithm. J Forensic Sci 46:427–431PubMed

39.

Patriquin ML, Steyn M, Loth SR (2005) Metric analysis of sex differences in South African black and white pelves. Forensic Sci Int 147:119–127PubMedCrossRef

40.

Gelb D, 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

Titel: Age- and sex-related variations in sagittal sacropelvic morphology and balance in asymptomatic adults
verfasst von: Jean-Marc Mac-Thiong
P. Roussouly
É. Berthonnaud
P. Guigui
Publikationsdatum: 01.09.2011
Verlag: Springer-Verlag
Erschienen in: European Spine Journal / Ausgabe Sonderheft 5/2011
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-011-1923-2

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Introduction

Materials and methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Sonderheft 5/2011

Thoracolumbar imbalance analysis for osteotomy planification using a new method: FBI technique

Hip–spine relations and sagittal balance clinical consequences

Standardized way for imaging of the sagittal spinal balance

Correlation of clinical outcome and spinopelvic sagittal alignment after surgical treatment of low-grade isthmic spondylolisthesis

Pelvic parameters: origin and significance

Lumbo-pelvic lordosis and the pelvic radius technique in the assessment of spinal sagittal balance: strengths and caveats