European Spine Journal

, Volume 23, Issue 3, pp 576–583 | Cite as

Spinopelvic balance: new biomechanical insights with clinical implications for Parkinson’s disease

  • Luciano BissolottiEmail author
  • Massimiliano Gobbo
  • Jorge Hugo Villafañe
  • Stefano Negrini
Original Article



The aim of this study was to describe the disease-related sagittal balance changes in relation to the sacropelvic morphology of PD patients with different durations of disease.


Thirty-one consecutive Parkinson’s disease patients (26 males, 5 females; age 55–83 years) participated in the cross-sectional study. The clinical assessment included: Hoehn Yahr score; plumb line distance from the spinous process of C7, kyphosis apex, spinous process of L3 and S1. Lumbar lordosis (LL), thoracic kyphosis (TK), spinosacral angle, spinopelvic angle, spinal tilt, pelvic incidence, sacral slope (SS) and pelvic tilt were radiographically assessed.


Radiographic spinopelvic angles appeared normal, but many patients presented variations from normality. In particular, pelvic tilt increased and SS decreased; spinosacral and spinopelvic angles were greatly reduced compared to healthy people, and spinal tilt increased. Unlike TK, LL was well correlated with most of the parameters.


Sagittal balance evaluation provides new valuable insights for biomechanical understanding of PD patients. Specific spinal parameters (spinosacral, spinopelvic and spinal tilt angles), and their clinical correlation, as well as pelvic parameters like pelvic tilt and sacral slope, appear particularly interesting for their clinical implications in terms of spinal deformities correction in PD population.


Sagittal Spinopelvic Parkinson’s disease Fall risk 



The study has been fully conducted in the Rehabilitation Service of Fondazione Teresa Camplani-Domus Salutis Rehabilitation Hospital, Brescia, Italy.

Conflict of interest

The authors of the paper have not received specific funding to perform the research. The authors declare no conflict of interest. Luciano Bissolotti: employed at the Fondazione Teresa Camplani-Domus Salutis Rehabilitation Hospital, Brescia. Massimiliano Gobbo: employed at the Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy. Jorge Hugo Villafañe: employed at the IRCCS Fondazione Don Gnocchi ONLUS, Milan, Italy. Stefano Negrini: Professor of Physical and Rehabilitation Medicine, University of Brescia, Italy; IRCCS Fondazione Don Gnocchi ONLUS, Milan, Italy.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Luciano Bissolotti
    • 1
    • 2
    Email author
  • Massimiliano Gobbo
    • 2
    • 3
  • Jorge Hugo Villafañe
    • 5
  • Stefano Negrini
    • 4
    • 5
  1. 1.Rehabilitation ServiceFondazione Teresa Camplani-Casa di Cura Domus SalutisBresciaItaly
  2. 2.LARIN, Neuromuscular and Adapted Physical Activity LaboratoryBresciaItaly
  3. 3.Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
  4. 4.Physical and Rehabilitation MedicineUniversity of BresciaBresciaItaly
  5. 5.IRCCS Fondazione Don Gnocchi ONLUSMilanItaly

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