PMID: 9161545Jan 1, 1997Paper

Sagittal balance of the spine

Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
P Mangione, J Sénégas

Abstract

The authors examined the modifications of sagittal shape and muscular functions in different vertebral diseases in order to investigate their correlations and to specify the role of hip extension in standing posture. We included 57 patients presenting various diseases, among which lumbar kyphosis, spondylosis and spondylolisthesis, backache and lumbar stenosis. We measured joint mobility (hip extension, lumbar flexion), muscular retractions (ilio-psoas, hamstrings, rectus femoris), and muscular strength (spine flexors and extensors, hamstrings, quadriceps femoris). On standing lateral x-rays, measurements were made of various spinal and pelvic parameters, among which the "pelvi-femoral angle", proposed by the authors for hip extension evaluation. There was a significant correlation between pelvi-femoral angle and pelvic backward tilting (r = 0.8037 p < 0.01). This angle can therefore be considered as fundamental for evaluation of sagittal posture. Characteristic abnormalities were found for each pathogenic group, notably for lumbar kyphosis and spondylolisthesis. Upright posture is secondary to hip extension and lumbar lordosis, and an optimal and economic standing posture is obtained when balance between these two phenomena is...Continue Reading

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