Abstract
To examine whether the association between spinal alignment and sacral anatomical orientation (SAO) can be detected in skeletal populations, by comparing SAO values in individuals with a typical SD to individuals with normal spinal alignment. 2025 skeletons were screened for Scheuermann’s disease. Scheuermann’s kyphosis was established by the presence of apophyseal abnormalities associated with more than 5° of anterior wedging in each of three adjacent vertebrae. SAO was measured as the angle created between the intersection of a line running parallel to the superior surface of the sacrum and a line running between the anterior superior iliac spine and the anterior–superior edge of the symphysis pubis (PUBIS). SAO was measured on 185 individuals with normal spines and 183 individuals with Scheuermann’s kyphosis. Out of 2025 skeletons, 183 (9 %) were diagnosed with Scheuermann’s kyphosis. The sacrum was significantly more horizontally oriented in individuals with Scheuermann’s kyphosis compared with the control (SAO: 44.44 ± 9.7° vs. 50 ± 9.9°, p < 0.001). Alteration in spinal biomechanics due to a horizontally orientated sacrum may be an important contributing factor for the development of Scheuermann’s kyphosis.
Highlights
Scheuermann’s disease (SD) is identified as a structural hyperkyphosis (Lowe 1990; Lowe and Line 2007; Scheuermann 1977, 1920)
Until the end of the previous century there were already more than 12 theories [summarized and criticized by Alexander (1977)], and the number continues to grow in the twenty-first century
The aim of the current study is to examine whether the association between spinal alignment and sacral anatomical orientation (SAO) can be detected in skeletal populations as well, by comparing SAO values in individuals with a typical SD to individuals with normal spinal alignment
Summary
Scheuermann’s disease (SD) is identified as a structural hyperkyphosis (Lowe 1990; Lowe and Line 2007; Scheuermann 1977, 1920). Until the end of the previous century there were already more than 12 theories [summarized and criticized by Alexander (1977)], and the number continues to grow in the twenty-first century Acquiring a vertically oriented spine to almost its full length (sacrum excluded) is a prerequisite for erect posture; tilted pelvis, dorsally oriented sacrum and profound structural modifications of the muscles supporting the spine are mandatory for efficient (economic) bipedal locomotion and the bearing of large-headed babies (Abitbol 1987; Le Huec et al 2011a, b; Mitchell 1934; Tague 1992). The different alignment requirements of the structures expose the lumbosacral region to extreme shearing forces, the pathological consequences of which (e.g., spondylolysis, spondylolysthesis) have been widely studied (e.g., Hanson et al 2007; Inoue et al 2002; Labelle et al 2005; Le Huec et al 2011a; Peleg et al SpringerPlus (2016) 5:141
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