[Sagittal Balance of the Spine--Clinical Importance and Radiographic Assessment]

Area of Science:

• Orthopedics and Spinal Surgery
• Radiology and Diagnostic Imaging
• Biomechanical Engineering

Background:

• Sagittal spinal deformities are a common cause of chronic back pain.
• These deformities disrupt the spine's natural curvatures (lordosis and kyphosis) relative to pelvic positioning.
• Effective management requires accurate assessment of spinal alignment and balance.

Purpose of the Study:

• To outline the diagnostic assessment of spinal sagittal deformities.
• To describe key parameters for evaluating sagittal spinal balance.
• To introduce classification systems for surgical decision-making.

Main Methods:

• Utilizing full spine anteroposterior and lateral X-rays for diagnostic assessment.
• Measuring key angular parameters including lumbar lordosis, pelvic incidence, pelvic tilt, and thoracic kyphosis.
• Employing the sagittal vertical axis for initial evaluation and severity assessment.

Main Results:

• Sagittal balance is defined by specific measurable angles.
• Quality of life correlates with the difference between pelvic incidence and lumbar lordosis.
• The sagittal vertical axis and pelvic tilt quantify imbalance severity.

Conclusions:

• Accurate measurement of spinal alignment parameters is crucial for diagnosing sagittal deformities.
• The SRS-Schwab classification provides a framework for surgical treatment planning.
• Comprehensive analysis of sagittal balance is essential for effective patient management.