Sagittal balance: from theory to clinical practice

Area of Science:

• Orthopedics
• Spinal Surgery
• Biomechanical Engineering

Background:

• Adequate sagittal balance (SB) is critical for maintaining an upright posture and overall quality of life.
• Sagittal profile alterations significantly impact patient well-being, comparable to chronic diseases.
• The evaluation of SB is increasingly important in assessing spinal pathology.

Purpose of the Study:

• To provide a practical and understandable guide to evaluating a patient's sagittal profile.
• To summarize the fundamental principles of sagittal balance assessment.
• To differentiate between balanced, compensated, and decompensated sagittal imbalance.

Main Methods:

• This review synthesizes existing knowledge on sagittal balance.
• It focuses on practical and simple methods for evaluating the sagittal profile.
• The dynamic nature of SB and its energy expenditure are considered.

Main Results:

• Sagittal balance is a dynamic process influenced by energy expenditure.
• Identifying the type of sagittal imbalance (balanced, compensated, or decompensated) is key.
• Accurate assessment aids in diagnosis and therapeutic decision-making.

Conclusions:

• A clear understanding of sagittal balance principles is essential for clinical practice.
• Practical evaluation methods enhance the assessment of spinal alignment.
• Distinguishing between different states of sagittal balance informs patient management.