Introduction: Alignment of the lumbosacral spine has an important impact on the dynamics of many spine and hip pathologies. The aim of our study was to assess the normal sacropelvic parameters and their correlation in asymptomatic Indian adults in relation to variations in sex and age.

Material and Methods: A group of 250 Volunteers were selected from general population with age ranging from 20-45 years. Radiography work was performed by a single radiographer to avoid bias. Left lateral radiograph was taken exposing C7 to S1 and both the hips while the volunteer was made to stand with a long 30x90 cm cassette placed at 230 cm from the X-ray tube

Results: The average PI, PT, LL, SVA, and SS values were average 48.14±10.40, 10.10±6.10, 55.36±10.08, 16.98±9.54, and 37.38±8.98 respectively. No statistically significant difference was observed in statistical values with regards to sex. Our study showed that PI has significant positive correlations with SS, LL and PT, and also affects LL. SS have significant positive correlation with LL.

Conclusion: The current results broaden our understanding of normal sagittal spino-pelvic alignment and also serve as a basis for realignment strategies in adult population of Jammu region.

Keywords: Pelvic Incidence (PI), Lumbosacral Parameters, Lumbar Lordosis (LL), Thoracic Kyphosis (TK) Pelvic Tilt (PT), Sagittal Vertical Axis (SVA).

1. Okcu G, Yercan Y, Yorulmaz I et al. Radiographical analysis of the lumbar spine in the sagittal plan. Journal of Arthroplasty Arthroscopic Surgery 2000; 11: 145-50.
2. Cil A, Yazici M, Uzumcugil A et al. The evolution of sagittal segmental alignment of the spine during childhood. Spine 2005; 30: 93-100.
3. Kobayashi T, Atsuta Y, Matsuno T et al. A longitudinal study of congruent sagittal spinal alignment in an adult cohort. Spine 2004; 29: 671-6.
4. Kim JS, Oh SH, Kim SB et al. Wedge shape cage in posterior lumbar interbody fusion: Focusing on changes of lordotic curve. J Korean Neurosurg 2005; 38: 255258.
5. Wiggins GC, Ondra SL, Shaffrey CI. Management of iatrogenic flat-back syndrome. Neurosurg Focus 2003; 15: E8.
6. Tuzun C, Yorulmaz I, Cindas A et al. Low back pain and posture. ClinRheumatol 1999; 18: 308-12.
7. Evcik D, Yucel A. Lumbar lordosis in acute and chronic low back pain patients. RheumatolInt 2003; 23: 163165.
8. Marty C, Boisaubert B, Descamps H et al. The sagittal anatomy of the sacrum among young adults, infants, and spondylolis-thesis patients. European Spine J 2002; 11: 119– 25.
9. Kanemura T. Sagittal spino-pelvic alignment in an asymptomatic Japanese population. J Spine Res 2011; 2: 52-8.
10. Kim WJ, Kang JW, Yeom JS, et al. A comparative analysis of sagittal spinal balance in 100 asymptomatic young and old ages volunteers. J Korean Soc Spine Surg 2003; 10: 327-34.
11. Lee CS, Chung SS, Kang KC et al. Normal patterns of sagittal alignment of the spine in young adults radiological analysis in a Korean population. Spine (Phila pa 1976) 2011; 36: E1648-54.
12. Schwab F, Patel A, Ungar B et al. Adult spinal deformitypostoperative standing imbalance: how much can you tolerate? An overview of key parameters in assessing alignment and planning corrective surgery. Spine (Phila  Pa 1976) 2010;35:2224-31.
13. Takemitsu Y, Harada Y, Iwahara T et al. Lumbar degenerative kyphosis. Clinical, radiological and epidemiological studies. Spine (Phila Pa 1976) 1988; 13:1317-26.
14. Barrey C, Jund J, Noseda O. Sagittal bal ance of the pelvis-spine complex and lumbar degenerative diseases. A comparative study about 85 cases. Eur Spine J 2007; 16:1459-67.
15. Endo K, Suzuki H, Tanaka H et al. Sagittal spinal alignment in patients with lumbar disc herniation. Eur Spine J 2010; 19: 435-8.
16. Vialle R, Ilharreborde B, Dauzac C et al. Is there a sagittal imbalance of the spine in isthmic spondylolisthesis? A correlation study. Eur Spine J 2007; 16:1641-9.
17. Offierski CM, MacNab I. Hip-spine syndrome. Spine (Phila Pa 1976) 1983; 8:316-21.
18. Yoshimoto H, Sato S, Masuda T, et al. Spino-pelvic alignment in patients with osteoarthrosis of the hip: a radiographic comparison to patients with low back pain. Spine (Phila Pa 1976) 2005; 30:1650-7.
19. Roussouly P, Nnadi C. Sagittal plane deformity: an overview of interpretation and management. Eur Spine J 2010; 19:1824-36.
20. Lafage V, Ames C, Schwab F, et al; International Spine Study Group.Changes in thoracic kyphosis negatively impact sagittal alignment after lumbar pedicle subtraction osteotomy: a comprehensive radiographic analysis. Spine (Phila Pa 1976) 2012;37:E180–E7
21. Glattes RC, Bridwell KH, Lenke LG et al. Proximal junctional kyphosis in adult spinal deformity following long instrumented posterior spinal fusion: incidence, outcomes, and risk factor analysis. Spine (Phila Pa 1976) 2005;30:1643–9
22. Schwab F, Ungar B, Blondel B, et al. Scoliosis Research Society-Schwab adult spinal deformity classification: a validation study. Spine (Phila Pa 1976). 2012; 37:107782.

Dr Tanveer Ahmed Bhat

Post graduate III yr, Deptt of Orthopedics GMC Jammu, India