When the plumb line at C7 moves posterior to this point, there is a loss of sagittal balance[7,8]. In adults presenting with spinal deformity, recent research has shown that sagittal balance is the most important and reliable radiographic predictor of clinical health status.
What causes sagittal imbalance?
What Can Lead to Sagittal Disturbance? Experiencing a traumatic injury. Osteoporosis. Ankylosing spondylitis, or vertebral fusion due to arthritis. Prior spinal fusion surgery.
To what end is sagittal equilibrium necessary?
Sagittal equilibrium is of paramount importance in the treatment of adult spinal deformity. Man’s natural bipedalism is a secure and comfortable stance. When you adopt this stance, your pelvis plays a crucial role in maintaining stability and has an immediate effect on how your spine is positioned.
How do I fix my sagittal balance?
Sagittal imbalance surgeries typically consist of three distinct phases. Fix the twisted spine: Osteotomies are commonly used to achieve this result. The removal of a bone from the spine is done during this operation.
Is negative sagittal balance bad?
Patients are considered to have global sagittal imbalance if their SVA is greater than 5 cm. In light of the significant association between positive sagittal balance and worse patient symptoms and disability, it is possible that negative sagittal balance also affects these outcomes.
Put simply, what is sagittal alignment?
When talking about the ideal and “normal” alignment in the sagittal plane, which is caused by the interplay of various organic factors, we talk about sagittal alignment, which is often misunderstood as sagittal balance. The onset of sagittal malalignment and the activation of compensatory mechanisms follows any pathology that disrupts this balance.
When does positive and negative sagittal balance occur?
According to accepted norms, sagittal balance is positive when the C7 plumb line is positioned anterior to the posterior-superior corner of the S1 endplate. When the plumb line at C7 is located behind this point, there is a lack of sagittal balance[7,8].
When is the C7 plumb line considered positive sagittal balance?
For positive sagittal balance, the C7 plumb line needed to be more than 5 cm in front of the posterior superior corner of S1.
How can sagittal imbalance best be treated?
Sagittal balance patients are expected to adopt a variety of treatments due to the complexity of the condition’s etiology. Sagittal balance treatments aim to restore equilibrium along the spinal axis. The goals of surgical treatment for scoliosis are to increase lumbar lordosis, decrease thoracic kyphosis, or achieve a balance between the two.
How is the sagittal balance of S1 determined?
The C7 plumb line is the primary factor in establishing sagittal equilibrium. As can be seen in Figure 4, the average deviation of the C7 plumb line from the posterior-superior corner of S1 is 0.5 cm. It is abnormal for there to be an offset of more than 2.5 centimeters in either direction.