Adjustment of pelvispinal parameters preserves the constant gravity line position

There is a high variance in sagittal morphology and complaints between different subjects suffering from spinal disorders. Sagittal spinal alignment and clinical presentation are not closely related. Different parameters have been used to describe the pelvispinal morphology based on standing lateral radiographs. We conducted a study using radiography of the lumbar spine combined with force platform data to examine the correlation between pelvispinal parameters and the gravity line position. Fifty consecutive patients with a mean age of 55 years (18-84 years) were compared to normal controls. Among patients we found a statistically significant correlation between the following spinal parameters: lumbar lordosis and sacral slope (r=0.77; P < 0.001), sacral slope and pelvic incidence (r=0.72; P < 0.001) and pelvic tilt and overhang (r=-0.93; P < 0.001). In patients and controls, the gravity line position was found to be located at 60 and 61%, respectively, of the foot length measured from the great toe, ranging from 53 to 69%, when corrected for the individual foot length. The results indicate that subjects with and without spinal disorders have their gravity line position localised within a very small range despite the high variability for lumbar lordosis and pelvic tilt.