0
Review Article

Spinal Balance/Alignment - Clinical Relevance and Biomechanics

[+] Author and Article Information
Anoli A. Shah

Engineering Center for Orthopaedic Research Excellence (E-CORE), Departments of Bioengineering and Orthopaedic Surgery, Colleges of Engineering and Medicine, University of Toledo, Toledo, OH
anoli.shah@rockets.utoledo.edu

Justin VC Lemans

University Medical Center Utrecht, Utrecht, Netherlands
J.V.C.Lemans-3@umcutrecht.nl

Joseph Zavatsky

Spine and Scoliosis Specialists, Tampa, Florida
josephzavatsky@yahoo.com

Aakash Agarwal

Engineering Center for Orthopaedic Research Excellence (E-CORE), Departments of Bioengineering and Orthopaedic Surgery, Colleges of Engineering and Medicine, University of Toledo, Toledo, OH
aakash.agarwal@utoledo.edu

Moyo C. Kruyt

University Medical Center Utrecht, Utrecht, Netherlands
M.c.kruyt@umcutrecht.nl

Koji Matsumoto

Department of Orthopaedic Surgery, Nihon University School of Medicine, Tokyo, Japan
monsq8@yahoo.co.jp

Hassan Serhan

Depuy Synthes Spine Inc., Raynham, Massachusetts
hserhan@dpyus.jnj.com

Anand K. Agarwal

Engineering Center for Orthopaedic Research Excellence (E-CORE), Departments of Bioengineering and Orthopaedic Surgery, Colleges of Engineering and Medicine, University of Toledo, Toledo, OH
Anand.Agarwal@utoledo.edu

Vijay Goel

Engineering Center for Orthopaedic Research Excellence (E-CORE), Departments of Bioengineering and Orthopaedic Surgery, Colleges of Engineering and Medicine, University of Toledo, Toledo, OH
vijay.goel@utoledo.edu

1Corresponding author.

ASME doi:10.1115/1.4043650 History: Received October 15, 2018; Revised April 20, 2019

Abstract

In the normal spine due to its curvature in various regions, C7 plumb line (C7PL) passes through the sacrum so that the head is centered over the pelvis-ball and socket hip joints and ankle joints. This configuration leads to the least muscular activities to maintain the spinal balance. For any reason like deformity, scoliosis, kyphosis, trauma, and/or surgery this optimal configuration gets disturbed requiring higher muscular activity to maintain the posture and balance. Several parameters like the thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), sacral slope (SS), Hip- and leg position influence the sagittal balance and thus the optimal configuration of spinal alignment. Global sagittal imbalance is energy consuming and often painful compensatory mechanisms are developed, that in turn negatively influence the quality of life. This review looks at the clinical aspects of spinal imbalance, and the biomechanics of spinal balance as dictated by the deformities- ankylosing spondylitis, scoliosis and kyphosis; surgical corrections- pedicle subtraction osteotomies and long segment stabilizations and consequent postural complications like the proximal and distal junctional kyphosis. This review suggests several potential research topics as well.

Copyright (c) 2019 by ASME
Your Session has timed out. Please sign back in to continue.

References

Figures

Tables

Errata

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging and repositioning the boxes below.

Related Journal Articles
Related eBook Content
Topic Collections

Sorry! You do not have access to this content. For assistance or to subscribe, please contact us:

  • TELEPHONE: 1-800-843-2763 (Toll-free in the USA)
  • EMAIL: asmedigitalcollection@asme.org
Sign In