Abstract/Text: On theoretic grounds it can be assumed that aberrations of posture may play a role in the generation of low-back pain by creating concentrations of stress. However, this assumption remains speculative because of the absence of criteria for normal posture. This study considers some of these criteria, especially as they are related to the lumbar spine and pelvis. The relations between the angle of declivity of the sacrum and radius and inclination of the lordotic curvature of the lumbar spine show good correlation. Mean values of postural parameters in the group of spondylolysis patients differ significantly from those in the group of healthy volunteers.

Abstract/Text: STUDY DESIGN: Current concepts review.
OBJECTIVE: Outline the basic principles in the evaluation and treatment of adult spinal deformity patients with a focus on goals to achieve during surgical realignment surgery.
SUMMARY OF BACKGROUND DATA: Proper global alignment of the spine is critical in maintaining standing posture and balance in an efficient and pain-free manner. Outcomes data demonstrate the clinical effect of spinopelvic malalignment and form a basis for realignment strategies.
METHODS: Correlation between certain radiographic parameters and patient self-reported pain and disability has been established. Using normative values for several important spinopelvic parameters (including sagittal vertical axis, pelvic tilt, and lumbar lordosis), spinopelvic radiographic realignment objectives were identified as a tool for clinical application. Because of the complex relationship between the spine and the pelvis in maintaining posture and the wide range of "normal" values for the associated parameters, a focus on global alignment, with proportionality of individual parameters to each other, was pursued to provide clinical relevance to planning realignment for deformity across a range of clinical cases.
CONCLUSION: Good clinical outcome requires achieving proper spinopelvic alignment in the treatment of adult spinal deformity. Although variations in pelvic morphology exist, a framework has been established to determine ideal values for regional and global parameter in an individualized patient approach. When planning realignment surgery for adult spinal deformity, restoring low sagittal vertical axis and pelvic tilt values are critical goals, and should be combined with proportional lumbar lordosis to pelvic incidence.