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Neutral upright sagittal spinal alignment from the occiput to the pelvis in asymptomatic adults: a review and resynthesis of the literature.

Publication ,  Journal Article
Kuntz, C; Levin, LS; Ondra, SL; Shaffrey, CI; Morgan, CJ
Published in: J Neurosurg Spine
February 2007

OBJECT: An increasing emphasis is being placed on the preservation or restoration of neutral upright sagittal spinal alignment in both deformity surgery and routine spinal operations. Sagittal spinal alignment is becoming recognized as an important predictor of a patient's outcome after spinal surgery. In this literature review, the authors analyze data obtained from previously published studies conducted to evaluate neutral upright sagittal spinal alignment from the occiput to the pelvis in asymptomatic adults. METHODS: A review of the English-language literature was conducted to identify studies conducted to evaluate neutral upright sagittal spinal (occiput-pelvis) alignment in asymptomatic adult volunteers with no spinal disease. The authors identified 12 articles that met the strict primary inclusion criteria of the current study. From these articles, 23 angles and displacements were selected to depict neutral upright sagittal occiput-pelvis alignment. Pooled estimates of the mean and variance were calculated for angles and displacements that met secondary inclusion criteria. The greatest variation in the regional spinal curves occurred in the cervical spine from C-2 to C-7, whereas the greatest focal angulation in the spine occurred from L-4 to S-1. Sagittal spinal balance was maintained in a narrow range for alignment of the spine over the pelvis and femoral heads. CONCLUSIONS: Neutral upright sagittal occiput-pelvis alignment in asymptomatic adults has been well studied regionally. Despite a wide variation in the undulating lordotic and kyphotic regional curves from the occiput to the pelvis, sagittal spinal balance is maintained in a narrower range for alignment of the spine over the pelvis and femoral heads.

Duke Scholars

Published In

J Neurosurg Spine

DOI

ISSN

1547-5654

Publication Date

February 2007

Volume

6

Issue

2

Start / End Page

104 / 112

Location

United States

Related Subject Headings

  • Spinal Curvatures
  • Sacrum
  • Postural Balance
  • Orthopedics
  • Lumbar Vertebrae
  • Humans
  • Cervical Vertebrae
  • 1109 Neurosciences
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Kuntz, C., Levin, L. S., Ondra, S. L., Shaffrey, C. I., & Morgan, C. J. (2007). Neutral upright sagittal spinal alignment from the occiput to the pelvis in asymptomatic adults: a review and resynthesis of the literature. J Neurosurg Spine, 6(2), 104–112. https://doi.org/10.3171/spi.2007.6.2.104
Kuntz, Charles, Linda S. Levin, Stephen L. Ondra, Christopher I. Shaffrey, and Chad J. Morgan. “Neutral upright sagittal spinal alignment from the occiput to the pelvis in asymptomatic adults: a review and resynthesis of the literature.J Neurosurg Spine 6, no. 2 (February 2007): 104–12. https://doi.org/10.3171/spi.2007.6.2.104.
Kuntz C, Levin LS, Ondra SL, Shaffrey CI, Morgan CJ. Neutral upright sagittal spinal alignment from the occiput to the pelvis in asymptomatic adults: a review and resynthesis of the literature. J Neurosurg Spine. 2007 Feb;6(2):104–12.
Kuntz, Charles, et al. “Neutral upright sagittal spinal alignment from the occiput to the pelvis in asymptomatic adults: a review and resynthesis of the literature.J Neurosurg Spine, vol. 6, no. 2, Feb. 2007, pp. 104–12. Pubmed, doi:10.3171/spi.2007.6.2.104.
Kuntz C, Levin LS, Ondra SL, Shaffrey CI, Morgan CJ. Neutral upright sagittal spinal alignment from the occiput to the pelvis in asymptomatic adults: a review and resynthesis of the literature. J Neurosurg Spine. 2007 Feb;6(2):104–112.

Published In

J Neurosurg Spine

DOI

ISSN

1547-5654

Publication Date

February 2007

Volume

6

Issue

2

Start / End Page

104 / 112

Location

United States

Related Subject Headings

  • Spinal Curvatures
  • Sacrum
  • Postural Balance
  • Orthopedics
  • Lumbar Vertebrae
  • Humans
  • Cervical Vertebrae
  • 1109 Neurosciences
  • 1103 Clinical Sciences