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Abstract
Objective. To propose and validate a dimensional parameter, the sagittal pelvic thickness (SPT) (distance between the middle point of the upper sacral plate and the femoral heads axis, expressed as a ratio with the length of the upper plate of S1: (SPT/S1) for the analysis of the sagittal balance of the pelvispinal unit. Methods. The parameters were analysed on standing radiographic imaging and compared for normal, low back pain, children, and spondylolysis cases. Results. Values of SPT/S1 were observed significantly higher in high grade spondylolysis populations and in children (3,5 and 3,7) than in normal population (3,3). A geometrical connection with the classical angular parameters validated SPT/S1. Conclusion. SPT/S1 was considered reflecting the lever arm of action of spinopelvic muscles and ligaments and describing the ability of a subject to compensate a sagittal unbalance. It was proposed as an anatomical and functional pelvic parameter.
Highlights
A strict relation was described between the sagittal pelvic anatomy and the sagittal shape of the spine, the amount of lordosis needed for each individual
Into the painful group, the “pelvic incidence” was observed significantly lower for the cases with leg pain, as well for the sagittal pelvic thickness (SPT) expressed according to the length of the upper plate of S1
At the same time that the pelvic incidence was described as the key parameter for the analysis of the sagittal balance of the spinopelvic unit, the sagittal pelvic thickness was proposed by Duval-Beaupere and colleagues to define the sagittal anatomy of the pelvis [5]
Summary
A strict relation was described between the sagittal pelvic anatomy and the sagittal shape of the spine, the amount of lordosis needed for each individual. The distinction was established a long time ago by morphologists and paleontologists between the “pelvis in tension” of the quadrupeds and the “pelvis in pressure” characterizing the bipedalism [6]. They were distinguished according to their more or less lengthened form, defined by the distance between the upper sacral plate and the coxofemoral joints: the sagittal pelvic thickness (SPT). In spite of characterizing the sagittal pelvic anatomy as well as, angular parameters, SPT was poorly studied. We investigated here its significance on the spinopelvic sagittal balance and its clinical relevance
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