Reviewer’s comment concerning “Classification of normal sagittal spine alignment: refounding the Roussouly classification” by F. Laouissat et al. (2017). doi:10.1007/s00586-017-5111-x (Epub ahead of print)
Twelve years after the publication of the original Roussouly’s classification  of sagittal alignment types in the normal spine, the concepts originally defined by Pierre Roussouly are not widely utilized by surgeons in the diagnosis and treatment of patients with spinal pathology.
Increasing pelvic incidence causes increasing sacral slope values in normal individuals. Thus, his original classification was based primarily on the magnitude of sacral slope.
Within a given range of sacral slope (and thus of pelvic incidence), the architecture of the spine can be defined, regarding the number of vertebrae included in the lumbar lordosis, the position of the apex of the lumbar lordosis and the position of the inflection point (change from lordosis to kyphosis), which defines the number of vertebrae included in the kyphosis (that can be thoracic or also include some of the upper...
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The author declares that he has no competing interests.
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