European Spine Journal

, 20:634 | Cite as

Sagittal spino-pelvic alignment in chronic low back pain

  • Emmanuelle Chaléat-Valayer
  • Jean-Marc Mac-Thiong
  • Jérôme Paquet
  • Eric Berthonnaud
  • Fabienne Siani
  • Pierre Roussouly
Original Article



The differences in sagittal spino-pelvic alignment between adults with chronic low back pain (LBP) and the normal population are still poorly understood. In particular, it is still unknown if particular patterns of sagittal spino-pelvic alignment are more prevalent in chronic LBP. The current study helps to better understand the relationship between sagittal alignment and low back pain.

Materials and methods

To compare the sagittal spino-pelvic alignment of patients with chronic LBP with a cohort of asymptomatic adults. Sagittal spino-pelvic alignment was evaluated in prospective cohorts of 198 patients with chronic LBP and 709 normal subjects. The two cohorts were compared with respect to the sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), lumbar lordosis (LL), lumbar tilt (LT), lordotic levels, thoracic kyphosis (TK), thoracic tilt (TT), kyphotic levels, and lumbosacral joint angle (LSA). Correlations between parameters were also assessed.


Sagittal spino-pelvic alignment is significantly different in chronic LBP with respect to SS, PI, LT, lordotic levels, TK, TT and LSA, but not PT, LL, and kyphotic levels. Correlations between parameters were similar for the two cohorts. As compared to normal adults, a greater proportion of patients with LBP presented low SS and LL associated with a small PI, while a greater proportion of normal subjects presented normal or high SS associated with normal or high PI.


Sagittal spino-pelvic alignment was different between patients with chronic LBP and controls. In particular, there was a greater proportion of chronic LBP patients with low SS, low LL and small PI, suggesting the relationship between this specific pattern and the presence of chronic LBP.


Low back pain Pelvic morphology Sagittal balance Spino-pelvic alignment 


Conflict of interest



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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Emmanuelle Chaléat-Valayer
    • 1
  • Jean-Marc Mac-Thiong
    • 2
  • Jérôme Paquet
    • 3
  • Eric Berthonnaud
    • 4
  • Fabienne Siani
    • 1
  • Pierre Roussouly
    • 5
  1. 1.Médecine Physique et Réadaptation, Hôpital de JourCentre médico-chirurgical de réadaptation des MassuesLyon cedex 05France
  2. 2.Department of Surgery, Faculty of MedicineUniversité de MontréalMontréalCanada
  3. 3.Department of NeurosurgeryHôpital de l’Enfant-JésusQuébecCanada
  4. 4.Laboratoire de physiologie de l’exercice St Etienne-Université de LyonCentre Hospitalier de VillefrancheVillefranche/SaoneFrance
  5. 5.Department of Orthopeadic SurgeryCentre médico-chirurgical de réadaptation des MassuesLyon cedex 05France

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