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Chris Hales - One of the best experts on this subject based on the ideXlab platform.
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pelvic Lordosis and alignment in spondylolisthesis
Spine, 2003Co-Authors: Roger P Jackson, Timothy Phipps, Chris Hales, Jim SurberAbstract:Study Design and Objectives. Pelvic morphology and lumbopeivic Lordosis were measured on standing radiographs of 75 patients with greater than 10% L5-S1 spondylolytic spondylolisthesis. The findings were compared with those of 75 volunteers to determine significant differences between the two groups. Summary of Background Data. Etiology of isthmic (lytic) spondylolisthesis remains uncertain. Causation appears to be multifactorial. The relationship between pelvic'morphology and spondylolisthesis deserves additional study, Methods. Both groups had a standing lateral radiograph of the thoracolumbar spine and pelvis taken that included both hips. Three radiographic angles for pelvic morphology (pelvisacral, pelvic incidence, and pelvic fordosis) were measured by two observers. Each offered similar reliability. Measurement of the pelvic fordosis angle by the pelvic radius technique required fewer steps. It also allowed calculation of the combined angles comprising both the pelvic morphology component for Lordosis (the constant pelvic Lordosis angle) and tne Lordosis in the lumbar spine (the variable lumbar Lordosis from T12-S1) that should complement the fixed pelvic Lordosis (the complementary lumbopelvic Lordosis). Mean values and statistical correlations were then computed for each group and compared. Results. The mean slippage for patients was 30% (range, 11-85%), with 34 patients (45%) having Grade I slips, 32 (43%) having Grade II slips, and nine (12%) having Grade III and IV slips. The mean measurements be tween patients and volunteers were significantly different (P < 0.01) for lumbar Lordosis, pelvic Lordosis, and lumbopeivic Lordosis. Subgrouns of patients with increasingly larger slips (Grade I-III) bad significantly smaller means angles for pelvic Lordosis. Conclusions. The pelvic and lumbopelvic parameters studied were different in patients compared with controls. The contribution of the pelvis to Lordosis was significantly smaller in the subgroups of patients with increasingly larger grades of spondylolishesis. Pelvic morphology may play a role in the development of spondylolisthesis. Measurement of the combined lumbar and pelvic (lumbopelvic) iordosis on standing radiographs is important.
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lumbopelvic Lordosis and pelvic balance on repeated standing lateral radiographs of adult volunteers and untreated patients with constant low back pain
Spine, 2000Co-Authors: Roger P Jackson, Tokumi Kanemura, Noriaki Kawakami, Chris HalesAbstract:Study design Twenty volunteers and 20 patients with no prior spine surgery had two standing lateral radiographs taken, on the average, 66 months apart and 2 weeks apart, respectively. Objectives To first determine the reliability of the measurement techniques used, and then the longitudinal variation between radiographs for the sagittal spinopelvic alignments measured in two stable populations, the one manifesting no back symptoms (volunteers) and the other showing no changes in symptoms (patients). Pelvic morphology also was assessed quantitatively, and significant correlations for the measurements were studied. Summary of background data There are no published studies on longitudinal variation for measurements of sagittal spinal alignments in asymptomatic control subjects or untreated patients with stable back problems. It may be helpful to know not only how much variation in alignments can be expected between radiographs of the same individual, but also which measurements and measurement techniques offer the greatest clinical reliability and application. Methods Each patient in this study reported mechanical type low back pain that was constant in location and character as well as clinically consistent with symptomatic degenerative lumbar disc disease. Each patient and volunteer had 36-inch-long lateral radiographs taken of the entire thoracic and lumbar spine, which included the pelvis. After intervening periods of 1 to 4 weeks (patients) and 5 to 6 years (volunteers), a second radiograph was taken for comparison. Two observers made 24 different measurements on the radiographs including determinations for lumbopelvic Lordosis, pelvic balance, and pelvic morphology using the pelvic radius technique. Reliabilities, longitudinal variations, and correlations for the measurements were compared. Results The most reliable measurements were for pelvic morphology, pelvic balance, and regional lumbopelvic Lordosis by the pelvic radius technique. Pelvic morphology was the most constant measurement between individual radiographs. Pelvic morphology and total lumbosacral Lordosis were dependent measurements that were complementary in determining total lumbopelvic Lordosis. Lumbopelvic Lordosis and pelvic balance also had strong correlation, whereas lumbosacral Lordosis and pelvic balance were independent measurements. Conclusions The pelvic radius technique is recommended for evaluating Lordosis to the pelvis because this approach provided not only good measurement reliability on standing radiographs for lumbopelvic Lordosis, but also determination of pelvic balance over the hips and the option to assess pelvic morphology quantitatively. Lumbopelvic Lordosis and pelvic balance were strongly correlative. This finding, along with higher reliability and lower longitudinal variation on repeated radiographs, indicated greater clinical application for these specific measurements.
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lumbopelvic Lordosis and pelvic balance on repeated standing lateral radiographs of adult volunteers and untreated patients with constant low back pain
Spine, 2000Co-Authors: Roger P Jackson, Tokumi Kanemura, Noriaki Kawakami, Chris HalesAbstract:Study design Twenty volunteers and 20 patients with no prior spine surgery had two standing lateral radiographs taken, on the average, 66 months apart and 2 weeks apart, respectively. Objectives To first determine the reliability of the measurement techniques used, and then the longitudinal variation between radiographs for the sagittal spinopelvic alignments measured in two stable populations, the one manifesting no back symptoms (volunteers) and the other showing no changes in symptoms (patients). Pelvic morphology also was assessed quantitatively, and significant correlations for the measurements were studied. Summary of background data There are no published studies on longitudinal variation for measurements of sagittal spinal alignments in asymptomatic control subjects or untreated patients with stable back problems. It may be helpful to know not only how much variation in alignments can be expected between radiographs of the same individual, but also which measurements and measurement techniques offer the greatest clinical reliability and application. Methods Each patient in this study reported mechanical type low back pain that was constant in location and character as well as clinically consistent with symptomatic degenerative lumbar disc disease. Each patient and volunteer had 36-inch-long lateral radiographs taken of the entire thoracic and lumbar spine, which included the pelvis. After intervening periods of 1 to 4 weeks (patients) and 5 to 6 years (volunteers), a second radiograph was taken for comparison. Two observers made 24 different measurements on the radiographs including determinations for lumbopelvic Lordosis, pelvic balance, and pelvic morphology using the pelvic radius technique. Reliabilities, longitudinal variations, and correlations for the measurements were compared. Results The most reliable measurements were for pelvic morphology, pelvic balance, and regional lumbopelvic Lordosis by the pelvic radius technique. Pelvic morphology was the most constant measurement between individual radiographs. Pelvic morphology and total lumbosacral Lordosis were dependent measurements that were complementary in determining total lumbopelvic Lordosis. Lumbopelvic Lordosis and pelvic balance also had strong correlation, whereas lumbosacral Lordosis and pelvic balance were independent measurements. Conclusions The pelvic radius technique is recommended for evaluating Lordosis to the pelvis because this approach provided not only good measurement reliability on standing radiographs for lumbopelvic Lordosis, but also determination of pelvic balance over the hips and the option to assess pelvic morphology quantitatively. Lumbopelvic Lordosis and pelvic balance were strongly correlative. This finding, along with higher reliability and lower longitudinal variation on repeated radiographs, indicated greater clinical application for these specific measurements.
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compensatory spinopelvic balance over the hip axis and better reliability in measuring Lordosis to the pelvic radius on standing lateral radiographs of adult volunteers and patients
Spine, 1998Co-Authors: Roger P Jackson, Anne C Mcmanus, Chris HalesAbstract:STUDY DESIGN Sagittal alignments, including lumbar Lordosis and spinopelvic balance (measured from C7, S1, and hip axis reference points for the relative positions of the spine and sacropelvis over the hips), were studied on standing 36-in. lateral radiographs of adult volunteers (control subjects) and patients who had specific spinal disorders. OBJECTIVES To determine the most reliable methods for measuring lumbopelvic Lordosis and to define significant spinopelvic compensations for sagittal balance. SUMMARY OF BACKGROUND DATA Measurements for standing sagittal balance, obtained using a C7 plumb line, and segmental angulations of the spinal vertebrae, including Lordosis to the sacrum, have been reported. Absolute values, even for normative data, have had wide variation and limited clinical usefulness. Correlations of sagittal balance with the reported spinopelvic angulations (spinal vertebral and sacropelvic angulations) have not been well defined. In addition, determinates of balance (spinal and pelvic) have not been studied for reliability, and compensatory mechanisms for maintenance of balance have not been carefully evaluated. Better recognition of the correlations and more reliable methods to measure Lordosis and balance and the spinopelvic compensations for its maintenance may be beneficial in treating patients who have spinal disorders. METHODS Measurements on standing 36-in. lateral radiographs were made for sagittal alignments in adult volunteers (n = 50) and in adult patients who had symptomatic degenerative lumbar disc disease (n = 50), low grade L5-S1 isthmic (lytic) spondylolisthesis (n = 30), and idiopathic or degenerative scoliosis (n = 30). All participants exhibited clinical compensation for balance. Data were analyzed for significant correlations within each group to determine compensatory correlations of spinopelvic balance with the other sagittal alignments. Intraobserver and interobserver reliability for the parameters evaluated were calculated. This included two methods for determining Lordosis (S1 end-plate and pelvic radius techniques). RESULTS Plumb line measurements for balance from the S1 and hip axis reference points, as defined, were similar in all four groups. However, the groups appeared to adjust for balance by using common and distinctive spinopelvic compensations that resulted in significantly and characteristically different angular alignments among the four groups. Lordosis and balance measurements were closely correlated, and the correlation was characterized by pelvic rotation and translation around the hip axis. The subjects with less Lordosis typically stood with the C7 plumb line anterior to and at a longer distance from the sacral reference point. This was primarily because of posterior sacropelvic translation around the hip axis and not because the sagittal plumb line initially moved anteriorly away from the sacrum. This was true in all four groups and gave the appearance that the sacropelvis was less well balanced over the hips in the subjects with less Lordosis. Even small differences in Lordosis appeared to be associated with considerable adjustments in the other spinopelvic alignments. Therefore, it was important to determine that Lordosis was lumbopelvic more reliably measured by the pelvic radius technique. CONCLUSIONS Lower lumbar Lordosis, by the pelvic radius technique, and compensatory sacropelvic translation around a hip axis, in addition to measurements from this axis to the C7 plumb line, were the primary determinates and most reliable radiographic assessments for sagittal balance. Understanding the common and characteristically different compensations that occur with balance in these patients who had specific spinal disorders may help to improve their care.
Roger P Jackson - One of the best experts on this subject based on the ideXlab platform.
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pelvic Lordosis and alignment in spondylolisthesis
Spine, 2003Co-Authors: Roger P Jackson, Timothy Phipps, Chris Hales, Jim SurberAbstract:Study Design and Objectives. Pelvic morphology and lumbopeivic Lordosis were measured on standing radiographs of 75 patients with greater than 10% L5-S1 spondylolytic spondylolisthesis. The findings were compared with those of 75 volunteers to determine significant differences between the two groups. Summary of Background Data. Etiology of isthmic (lytic) spondylolisthesis remains uncertain. Causation appears to be multifactorial. The relationship between pelvic'morphology and spondylolisthesis deserves additional study, Methods. Both groups had a standing lateral radiograph of the thoracolumbar spine and pelvis taken that included both hips. Three radiographic angles for pelvic morphology (pelvisacral, pelvic incidence, and pelvic fordosis) were measured by two observers. Each offered similar reliability. Measurement of the pelvic fordosis angle by the pelvic radius technique required fewer steps. It also allowed calculation of the combined angles comprising both the pelvic morphology component for Lordosis (the constant pelvic Lordosis angle) and tne Lordosis in the lumbar spine (the variable lumbar Lordosis from T12-S1) that should complement the fixed pelvic Lordosis (the complementary lumbopelvic Lordosis). Mean values and statistical correlations were then computed for each group and compared. Results. The mean slippage for patients was 30% (range, 11-85%), with 34 patients (45%) having Grade I slips, 32 (43%) having Grade II slips, and nine (12%) having Grade III and IV slips. The mean measurements be tween patients and volunteers were significantly different (P < 0.01) for lumbar Lordosis, pelvic Lordosis, and lumbopeivic Lordosis. Subgrouns of patients with increasingly larger slips (Grade I-III) bad significantly smaller means angles for pelvic Lordosis. Conclusions. The pelvic and lumbopelvic parameters studied were different in patients compared with controls. The contribution of the pelvis to Lordosis was significantly smaller in the subgroups of patients with increasingly larger grades of spondylolishesis. Pelvic morphology may play a role in the development of spondylolisthesis. Measurement of the combined lumbar and pelvic (lumbopelvic) iordosis on standing radiographs is important.
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lumbopelvic Lordosis and pelvic balance on repeated standing lateral radiographs of adult volunteers and untreated patients with constant low back pain
Spine, 2000Co-Authors: Roger P Jackson, Tokumi Kanemura, Noriaki Kawakami, Chris HalesAbstract:Study design Twenty volunteers and 20 patients with no prior spine surgery had two standing lateral radiographs taken, on the average, 66 months apart and 2 weeks apart, respectively. Objectives To first determine the reliability of the measurement techniques used, and then the longitudinal variation between radiographs for the sagittal spinopelvic alignments measured in two stable populations, the one manifesting no back symptoms (volunteers) and the other showing no changes in symptoms (patients). Pelvic morphology also was assessed quantitatively, and significant correlations for the measurements were studied. Summary of background data There are no published studies on longitudinal variation for measurements of sagittal spinal alignments in asymptomatic control subjects or untreated patients with stable back problems. It may be helpful to know not only how much variation in alignments can be expected between radiographs of the same individual, but also which measurements and measurement techniques offer the greatest clinical reliability and application. Methods Each patient in this study reported mechanical type low back pain that was constant in location and character as well as clinically consistent with symptomatic degenerative lumbar disc disease. Each patient and volunteer had 36-inch-long lateral radiographs taken of the entire thoracic and lumbar spine, which included the pelvis. After intervening periods of 1 to 4 weeks (patients) and 5 to 6 years (volunteers), a second radiograph was taken for comparison. Two observers made 24 different measurements on the radiographs including determinations for lumbopelvic Lordosis, pelvic balance, and pelvic morphology using the pelvic radius technique. Reliabilities, longitudinal variations, and correlations for the measurements were compared. Results The most reliable measurements were for pelvic morphology, pelvic balance, and regional lumbopelvic Lordosis by the pelvic radius technique. Pelvic morphology was the most constant measurement between individual radiographs. Pelvic morphology and total lumbosacral Lordosis were dependent measurements that were complementary in determining total lumbopelvic Lordosis. Lumbopelvic Lordosis and pelvic balance also had strong correlation, whereas lumbosacral Lordosis and pelvic balance were independent measurements. Conclusions The pelvic radius technique is recommended for evaluating Lordosis to the pelvis because this approach provided not only good measurement reliability on standing radiographs for lumbopelvic Lordosis, but also determination of pelvic balance over the hips and the option to assess pelvic morphology quantitatively. Lumbopelvic Lordosis and pelvic balance were strongly correlative. This finding, along with higher reliability and lower longitudinal variation on repeated radiographs, indicated greater clinical application for these specific measurements.
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lumbopelvic Lordosis and pelvic balance on repeated standing lateral radiographs of adult volunteers and untreated patients with constant low back pain
Spine, 2000Co-Authors: Roger P Jackson, Tokumi Kanemura, Noriaki Kawakami, Chris HalesAbstract:Study design Twenty volunteers and 20 patients with no prior spine surgery had two standing lateral radiographs taken, on the average, 66 months apart and 2 weeks apart, respectively. Objectives To first determine the reliability of the measurement techniques used, and then the longitudinal variation between radiographs for the sagittal spinopelvic alignments measured in two stable populations, the one manifesting no back symptoms (volunteers) and the other showing no changes in symptoms (patients). Pelvic morphology also was assessed quantitatively, and significant correlations for the measurements were studied. Summary of background data There are no published studies on longitudinal variation for measurements of sagittal spinal alignments in asymptomatic control subjects or untreated patients with stable back problems. It may be helpful to know not only how much variation in alignments can be expected between radiographs of the same individual, but also which measurements and measurement techniques offer the greatest clinical reliability and application. Methods Each patient in this study reported mechanical type low back pain that was constant in location and character as well as clinically consistent with symptomatic degenerative lumbar disc disease. Each patient and volunteer had 36-inch-long lateral radiographs taken of the entire thoracic and lumbar spine, which included the pelvis. After intervening periods of 1 to 4 weeks (patients) and 5 to 6 years (volunteers), a second radiograph was taken for comparison. Two observers made 24 different measurements on the radiographs including determinations for lumbopelvic Lordosis, pelvic balance, and pelvic morphology using the pelvic radius technique. Reliabilities, longitudinal variations, and correlations for the measurements were compared. Results The most reliable measurements were for pelvic morphology, pelvic balance, and regional lumbopelvic Lordosis by the pelvic radius technique. Pelvic morphology was the most constant measurement between individual radiographs. Pelvic morphology and total lumbosacral Lordosis were dependent measurements that were complementary in determining total lumbopelvic Lordosis. Lumbopelvic Lordosis and pelvic balance also had strong correlation, whereas lumbosacral Lordosis and pelvic balance were independent measurements. Conclusions The pelvic radius technique is recommended for evaluating Lordosis to the pelvis because this approach provided not only good measurement reliability on standing radiographs for lumbopelvic Lordosis, but also determination of pelvic balance over the hips and the option to assess pelvic morphology quantitatively. Lumbopelvic Lordosis and pelvic balance were strongly correlative. This finding, along with higher reliability and lower longitudinal variation on repeated radiographs, indicated greater clinical application for these specific measurements.
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compensatory spinopelvic balance over the hip axis and better reliability in measuring Lordosis to the pelvic radius on standing lateral radiographs of adult volunteers and patients
Spine, 1998Co-Authors: Roger P Jackson, Anne C Mcmanus, Chris HalesAbstract:STUDY DESIGN Sagittal alignments, including lumbar Lordosis and spinopelvic balance (measured from C7, S1, and hip axis reference points for the relative positions of the spine and sacropelvis over the hips), were studied on standing 36-in. lateral radiographs of adult volunteers (control subjects) and patients who had specific spinal disorders. OBJECTIVES To determine the most reliable methods for measuring lumbopelvic Lordosis and to define significant spinopelvic compensations for sagittal balance. SUMMARY OF BACKGROUND DATA Measurements for standing sagittal balance, obtained using a C7 plumb line, and segmental angulations of the spinal vertebrae, including Lordosis to the sacrum, have been reported. Absolute values, even for normative data, have had wide variation and limited clinical usefulness. Correlations of sagittal balance with the reported spinopelvic angulations (spinal vertebral and sacropelvic angulations) have not been well defined. In addition, determinates of balance (spinal and pelvic) have not been studied for reliability, and compensatory mechanisms for maintenance of balance have not been carefully evaluated. Better recognition of the correlations and more reliable methods to measure Lordosis and balance and the spinopelvic compensations for its maintenance may be beneficial in treating patients who have spinal disorders. METHODS Measurements on standing 36-in. lateral radiographs were made for sagittal alignments in adult volunteers (n = 50) and in adult patients who had symptomatic degenerative lumbar disc disease (n = 50), low grade L5-S1 isthmic (lytic) spondylolisthesis (n = 30), and idiopathic or degenerative scoliosis (n = 30). All participants exhibited clinical compensation for balance. Data were analyzed for significant correlations within each group to determine compensatory correlations of spinopelvic balance with the other sagittal alignments. Intraobserver and interobserver reliability for the parameters evaluated were calculated. This included two methods for determining Lordosis (S1 end-plate and pelvic radius techniques). RESULTS Plumb line measurements for balance from the S1 and hip axis reference points, as defined, were similar in all four groups. However, the groups appeared to adjust for balance by using common and distinctive spinopelvic compensations that resulted in significantly and characteristically different angular alignments among the four groups. Lordosis and balance measurements were closely correlated, and the correlation was characterized by pelvic rotation and translation around the hip axis. The subjects with less Lordosis typically stood with the C7 plumb line anterior to and at a longer distance from the sacral reference point. This was primarily because of posterior sacropelvic translation around the hip axis and not because the sagittal plumb line initially moved anteriorly away from the sacrum. This was true in all four groups and gave the appearance that the sacropelvis was less well balanced over the hips in the subjects with less Lordosis. Even small differences in Lordosis appeared to be associated with considerable adjustments in the other spinopelvic alignments. Therefore, it was important to determine that Lordosis was lumbopelvic more reliably measured by the pelvic radius technique. CONCLUSIONS Lower lumbar Lordosis, by the pelvic radius technique, and compensatory sacropelvic translation around a hip axis, in addition to measurements from this axis to the C7 plumb line, were the primary determinates and most reliable radiographic assessments for sagittal balance. Understanding the common and characteristically different compensations that occur with balance in these patients who had specific spinal disorders may help to improve their care.
Ella Been - One of the best experts on this subject based on the ideXlab platform.
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development of pelvic incidence and lumbar Lordosis in children and adolescents
Anatomical Record-advances in Integrative Anatomy and Evolutionary Biology, 2019Co-Authors: Jeannie F Bailey, Sara Shefi, Michalle Soudack, Ella Been, Patricia A KramerAbstract:: Pelvic incidence (PI) is a measure of the sagittal orientation of the sacrum relative to the acetabula and is not dependent on posture. In asymptomatic adults, PI correlates with lumbar Lordosis. Lumbar Lordosis is shown to increase with age following the onset of unassisted bipedal locomotion in children, but to what extent PI changes in relation to lumbar Lordosis during skeletal maturation is unclear. The purpose of this study is to understand how PI, lumbar Lordosis, and age are related in children and adolescents. PI, supine lumbar Lordosis (SLL), and individual wedging angles of the lumbar vertebral bodies were measured on mid-sagittal reformatted images from 144 abdominal computed tomographic scans of individuals aged 2-20 years old, divided into three separate age categories representing pre-growth spurt (ages 2-9), growth spurt (10-15), and post-growth spurt (16-20). Our results showed that, while SLL significantly increased with age during development, PI did not. Despite the fact that PI hardly changed with age, the difference between PI and SLL decreased nonlinearly with age. SLL did not correlate with PI in the youngest age category, but positively correlated with PI in the middle and oldest age categories. The relationship between lumbar Lordosis and PI, which is correlated in adults, was significant in our older age categories and not in our youngest age category. Our results indicate that PI in children and adolescents may have some predictive value for adult lumbar Lordosis. Anat Rec, 302:2132-2139, 2019. © 2019 American Association for Anatomy.
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cervical Lordosis the effect of age and gender
The Spine Journal, 2017Co-Authors: Sara Shefi, Ella Been, Michalle SoudackAbstract:Abstract Background Context Cervical Lordosis is of great importance to posture and function. Neck pain and disability is often associated with cervical Lordosis malalignment. Surgical procedures involving cervical Lordosis stabilization or restoration must take into account age and gender differences in cervical Lordosis architecture to avoid further complications. Purpose Therefore, the purpose of the present study was to evaluate differences in cervical Lordosis between males and females from childhood to adulthood. Study Design This is a retrospective descriptive study. Patient Sample A total of 197 lateral cervical radiographs of patients aged 6–50 years were examined. These were divided into two age groups: the younger group (76 children aged 6–19; 48 boys and 28 girls) and the adult group (121 adults aged 20–50; 61 males and 60 females). The retrospective review of the radiographs was approved by the institutional review board. Methods On each radiograph, six Lordosis angles were measured including total cervical Lordosis (FM–C7), upper (FM–C3; C1–C3) and lower (C3–C7) cervical Lordosis, C1–C7 Lordosis, and the angle between foramen magnum and the atlas (FM–C1). Wedging angles of each vertebral body (C3–C7) and intervertebral discs (C2–C3 to C6–C7) were also measured. Vertebral body wedging and intervertebral disc wedging were defined as the sum of the individual body or disc wedging of C3 to C7, respectively. Each cervical radiograph was classified according to four postural categories: A-lordotic, B-straight, C-double curve, and D-kyphotic. Results The total cervical Lordosis of males and females was similar. Males had smaller upper cervical Lordosis (FM–C3) and higher lower cervical Lordosis (C3–C7) than females. The sum of vertebral body wedging of males and females is kyphotic (anterior height smaller than posterior height). Males had more lordotic intervertebral discs than females. Half of the adults (51%) had lordotic cervical spine, 41% had straight spine, and less than 10% had double curve or kyphotic spine. Children had similar total cervical Lordosis (FM–C7) to adults. The sum of vertebral body wedging for children was more kyphotic—by 7°—than that of adults, whereas the sum of intervertebral disc wedging in children was more lordotic—by11°—than that of adults. Seventy-one percent of the children had lordotic cervical spine, 23% had straight spine, and less than 6% had double curve spine. Gender differences are already apparent in children as girls had higher upper cervical Lordosis (FM–C3; C1–C3) than boys do. Conclusions Although the total cervical Lordosis (FM–C7) did not change between age groups, and between males and females, the internal architecture of the cervical Lordosis changed significantly. Practitioners before neck stabilization procedures or correction and restoration should therefore take into account the gender and age differences in cervical Lordosis.
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the neandertal vertebral column 2 the lumbar spine
Journal of Human Evolution, 2017Co-Authors: Asier Gomezolivencia, Mikel Arlegi, Alon Barash, Jay T Stock, Ella BeenAbstract:Abstract Here we provide the most extensive metric and morphological analysis performed to date on the Neandertal lumbar spine. Neandertal lumbar vertebrae show differences from modern humans in both the vertebral body and in the neural arch, although not all Neandertal lumbar vertebrae differ from modern humans in the same way. Differences in the vertebral foramen are restricted to the lowermost lumbar vertebrae (L4 and L5), differences in the orientation of the upper articular facets appear in the uppermost lumbar vertebrae (probably in L1 and L2–L3), and differences in the horizontal angle of the transverse process appear in L2–L4. Neandertals, when compared to modern humans, show a smaller degree of lumbar Lordosis. Based on a still limited fossil sample, early hominins (australopiths and Homo erectus) had a lumbar Lordosis that was similar to but below the mean of modern humans. Here, we hypothesize that from this ancestral degree of lumbar Lordosis, the Neandertal lineage decreased their lumbar Lordosis and Homo sapiens slightly increased theirs. From a postural point of view, the lower degree of Lordosis is related to a more vertical position of the sacrum, which is also positioned more ventrally with respect to the dorsal end of the pelvis. This results in a spino-pelvic alignment that, though different from modern humans, maintained an economic postural equilibrium. Some features, such as a lower degree of lumbar Lordosis, were already present in the middle Pleistocene populations ancestral to Neandertals. However, these middle Pleistocene populations do not show the full suite of Neandertal lumbar morphologies, which probably means that the characteristic features of the Neandertal lumbar spine did not arise all at once.
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brief communication lumbar Lordosis in extinct hominins implications of the pelvic incidence
American Journal of Physical Anthropology, 2014Co-Authors: Asier Gomezolivencia, Ella Been, Patricia A KramerAbstract:Recently, interest has peaked regarding the posture of extinct hominins. Here, we present a new method of reconstructing Lordosis angles of extinct hominin specimens based on pelvic morphology, more specifically the orientation of the sacrum in relation to the acetabulum (pelvic incidence). Two regression models based on the correlation between pelvic incidence and Lordosis angle in living hominoids have been developed. The mean values of the calculated Lordosis angles based on these models are 36°−45° for australopithecines, 45°−47° for Homo erectus, 27°−34° for the Neandertals and the Sima de los Huesos hominins, and 49°−51° for fossil H. sapiens. The newly calculated Lordosis values are consistent with previously published values of extinct hominins (Been et al.: Am J Phys Anthropol 147 (2012) 64–77). If the mean values of the present nonhuman hominoids are representative of the pelvic and lumbar morphology of the last common ancestor between humans and nonhuman hominoids, then both pelvic incidence and Lordosis angle dramatically increased during hominin evolution from 27° ± 5 to 22° ± 3 (respectively) in nonhuman hominoids to 54° ± 10 and 51° ± 11 in modern humans. This change to a more human-like configuration appeared early in the hominin evolution as the pelvis and spines of both australopithecines and H. erectus show a higher pelvic incidence and Lordosis angle than nonhuman hominoids. The Sima de los Huesos hominins and Neandertals show a derived configuration with a low pelvic incidence and Lordosis angle. Am J Phys Anthropol 154:307–314, 2014. © 2014 Wiley Periodicals, Inc.
Robert G Watkins - One of the best experts on this subject based on the ideXlab platform.
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lumbar Lordosis effects of sitting and standing
Spine, 1997Co-Authors: Michael J Lord, John Small, Jocylane M Dinsay, Robert G WatkinsAbstract:Study design The effect of sitting versus standing posture on lumbar Lordosis was studied retrospectively by radiographic analysis of 109 patients with low back pain. Objective To document changes in segmental and total lumbar Lordosis between sitting and standing radiographs. Summary of background data Preservation of physiologic lumbar Lordosis is an important consideration when performing fusion of the lumbar spine. The appropriate degree of lumbar Lordosis has not been defined. Methods Total and segmental lumbar Lordosis from L1 to S1 was assessed by an independent observer using the Cobb angle measurements of the lateral radiographs of the lumbar spine obtained with the patient in the sitting and standing positions. Results Lumbar Lordosis averaged 49 degrees standing and 34 degrees sitting from L1 to S1, 47 degrees standing and 33 degrees sitting from L2 to S1, 31 degrees standing and 22 degrees sitting from L4 to S1, and 18 degrees standing and 15 degrees sitting from L5 to S1. Conclusion Lumbar Lordosis while standing was nearly 50% greater on average than sitting lumbar Lordosis. The clinical significance of this data may pertain to: 1) the known correlation of increased intradiscal pressure with sitting, which may be caused by this decrease in Lordosis; 2) the benefit of a sitting lumbar support that increases Lordosis; and 3) the consideration of an appropriate degree of Lordosis in fusion of the lumbar spine.
Jinping Liu - One of the best experts on this subject based on the ideXlab platform.
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does transforaminal lumbar interbody fusion induce Lordosis or kyphosis radiographic evaluation with a minimum 2 year follow up
Journal of Neurosurgery, 2021Co-Authors: Jinping Liu, Pingguo Duan, Praveen V Mummaneni, Rong Xie, Yinhui Dong, Sigurd Berven, Dean ChouAbstract:OBJECTIVE Conflicting reports exist about whether transforaminal lumbar interbody fusion (TLIF) induces Lordosis or kyphosis, ranging from decreasing Lordosis by 3.71° to increasing it by 18.8°. In this study, the authors' aim was to identify factors that result in kyphosis or Lordosis after TLIF. METHODS A single-center, retrospective study of open TLIF without osteotomy for spondylolisthesis with a minimum 2-year follow-up was undertaken. Preoperative and postoperative clinical and radiographic parameters and cage specifics were collected. TLIFs were considered to be "lordosing" if postoperative induction of Lordosis was > 0° and "kyphosing" if postoperative induction of Lordosis was ≤ 0°. RESULTS A total of 137 patients with an average follow-up of 52.5 months (range 24-130 months) were included. The overall postoperative disc angle (DA) and segmental Lordosis (SL) increased by 1.96° and 1.88° (p = 0.003 and p = 0.038), respectively, whereas overall lumbar Lordosis remained unchanged (p = 0.133). Seventy-nine patients had lordosing TLIFs with a mean SL increase of 5.72° ± 3.97°, and 58 patients had kyphosing TLIFs with a mean decrease of 3.02° ± 2.98°. Multivariate analysis showed that a lower preoperative DA, lower preoperative SL, and anterior cage placement were correlated with the greatest increase in postoperative SL (p = 0.040, p 0.05). Linear regression showed that the preoperative DA and SL correlated with SL after TLIF (R2 = 0.198, p < 0.001; and R2 = 0.2931, p < 0.001, respectively). CONCLUSIONS Whether a TLIF induces kyphosis or Lordosis depends on the preoperative DA, preoperative SL, and cage position. Less-lordotic segments became more lordotic postoperatively, and highly lordotic segments may lose Lordosis after TLIF. Cages placed more anteriorly were associated with more Lordosis.
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the effect of anterior cervical discectomy and fusion on cervical sagittal vertical axis and Lordosis with minimum 2 year follow up
World Neurosurgery, 2021Co-Authors: Jinping Liu, Praveen V Mummaneni, Rong Xie, Yinhui Dong, Minghao Wang, Dean ChouAbstract:Background Anterior cervical discectomy and fusion (ACDF) can induce Lordosis and improve cervical sagittal vertical axis (SVA), but multilevel ACDF may inadvertently increase cervical SVA because of insufficient Lordosis induction. Methods Patients who underwent 1-, 2-, or ≥3-level ACDF in the subaxial spine with minimum 2-year follow up were retrospectively studied. C2-C7 Cobb angle (Lordosis), cervical SVA, and T1 slope were measured preoperatively, immediately postoperatively, and at last follow-up. Results Inclusion criteria were met by 127 patients. There were no differences in baseline demographics among 1-, 2-, and ≥3-level ACDF groups. Mean follow-up was 43.7 months (range, 24–142 months). Increase of cervical SVA immediately postoperatively was 1.94 mm, −1.44 mm, and 7.25 mm for 1-, 2-, and ≥3-level ACDF (P = 0.041) and at last follow-up was 2.97 mm, 0.70 mm, and 9.32 mm for 1-, 2-, and ≥3-level ACDF (P = 0.026). At last follow-up, 2-level ACDF patients had the greatest decrease in T1 slope (−0.43°) compared with increase of 2.71° for 1-level and 2.84° for ≥3-level patients (P = 0.028). In all 3 groups, segmental (ACDF levels) Lordosis, cervical SVA, and T1 slope did not decrease from immediate postoperative to last follow-up. Only 2-level ACDF maintained C2-7 Lordosis (2.16°) compared with loss of Lordosis in 1-level (−0.84°) and ≥3-level (−2.00°) ACDF (P = 0.008) at last follow-up. Linear regression analysis showed that T1 slope had no relationship with correction of cervical SVA (P = 0.5310) but had a significant correlation with Cobb angle loss of C2-C7 Lordosis (P = 0.0016). Conclusions Compared with 1- and 2-level ACDF, ≥3-level ACDF resulted in significant increase of cervical SVA and loss of overall Lordosis. Compared with 1- and ≥3-level ACDF, 2-level ACDF had the greatest ability to maintain Lordosis. T1 slope had a significant correlation with loss of C2-C7 Lordosis after ACDF.
