The sagittal pelvic thickness: a determining parameter for the regulation of the sagittal spinopelvic balance

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.