Implications of Spinopelvic Alignment

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Implications of Spinopelvic Alignment

The Study: Implications of spinopelvic alignment for the spine surgeon.

The Facts:
a. Proper alignment of the spine and pelvis is necessary to have an energy efficient upright posture.

b. In order to understand this paper you must understand Pelvic Incidence (PI).

c. The definition of PI is somewhat lengthy and complex, so for a working definition we will call the PI the angle at which the base of the sacrum sits relative to the femurs in the lateral view.

d. The angle of the PI affects the lumbar lordosis. As the angle of PI increases, the lumbar lordosis increases.

e. Overall sagittal spinal balance is measured on a standing lateral full spine radiograph.

f. The body may alter the tilt of the pelvis in an effort to help balance spinal alignment.

g. Spinopelvic misalignment in the sagittal plane may cause a number of problems including: “low back pain (LBP), lumbar degenerative disease, and hip osteoarthritis.”

h. Spinopelvic misalignment also appears related to degenerative spondylolisthesis and poorer surgical outcomes.


Take Home:
Spinopelvic alignment in the sagittal plane is important to the well being of patients .


Reviewer’s Comments:
This is a complex paper with which comes to the simple conclusion that misalignment of the spine and pelvis can have adverse affects on the health of patents. 
The lead author is from the Department of Neurosurgery at the University of Southern California in Los Angeles. 

It also describes how to look at the balance of the spine on the lateral radiograph. All these things are good and it is another example of how the medical profession is writing about the importance of spinal alignment. I’ve been reading the literature for many years and I am wondering when the medical profession is going to say that they have discovered the importance of spinal alignment to patient health and that only qualified medical doctors should be allowed to treat these important problems. 

Meanwhile a significant portion of chiropractors are downplaying the importance of spinal alignment.

Reviewer: Roger Coleman DC

Reference: Mehta VA, Amin A, Omeis I, Gokaslan ZL, Gotfried ON. Implications of spinopelvic alignment for the spine surgeon. Neurosurgery 2012;70:707-21.

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