Influence of age and sagittal balance of the spine on the value of the pelvic incidence

Eur Spine J. 2014 Jul;23(7):1394-9. doi: 10.1007/s00586-014-3207-0. Epub 2014 Feb 9.

Abstract

Background data: The pelvic incidence (PI) was recognized as the key factor of the sagittal balance of the spine. Its value was described own for each individual and unchanged during adulthood.

Purpose: To bring out the effect of the age and of a sagittal imbalance in the variability of the value of PI.

Materials and methods: 200 subjects with chronic low back pain due to sagittal imbalance were compared to 89 normal subjects. For each groups, the cases were divided according to the age (19-40, 6-40 years, over 60 years). The PI and the sagittal positional parameters were measured on large radiographs in standardized standing position.

Results: The correlation between age and PI was observed significant only for the >60 years cases. The mean values of PI were significantly greater for these cases.

Discussion: An increase of the value of PI was attributable to a twisting mobilization within the sacroiliac joint. It results from a forward projection of the gravity due to a sagittal disturbance and a pelvic compensatory backward rotation. This twisting into the sacroiliac joint was incriminated in the origin of chronic low back pain.

Conclusion: The sagittal pelvi-spinal imbalance may be incriminated in the increasing of the value of PI by a painful destabilization sacro-iliac, with leads to an increasing of the value of PI.

MeSH terms

  • Adult
  • Aged
  • Aging / physiology*
  • Case-Control Studies
  • Female
  • Humans
  • Lordosis / diagnostic imaging
  • Lordosis / physiopathology
  • Low Back Pain / physiopathology
  • Lumbar Vertebrae / diagnostic imaging*
  • Lumbar Vertebrae / physiopathology
  • Male
  • Middle Aged
  • Pelvis / diagnostic imaging*
  • Radiography
  • Sacroiliac Joint / diagnostic imaging
  • Sacroiliac Joint / physiopathology
  • Sacrum / diagnostic imaging*
  • Sacrum / physiopathology
  • Spine / diagnostic imaging*
  • Spine / physiopathology
  • Young Adult