Analysis of pelvic compensation for dynamic sagittal imbalance using motion analysis

  • Ho-Joong Kim
  • Heoung-Jae Chun
  • Feng Shen
  • Kyoung-Tak Kang
  • Bong-Soon Chang
  • Choon-Ki Lee
  • Jin S. YeomEmail author
Original Article



To analyze pelvic compensation during walking in patients with severe sagittal plane deformity by using motion analysis.


A total of 44 patients with sagittal plane deformity who were scheduled to undergo surgery were included. Motion analysis was performed 3 consecutive times during walking to estimate the anterior pelvic tilt (Ant-PT) angle, trunk kyphosis (TK) angle, and distance of the center of gravity (CoG) from the center of mass (CoM) of the pelvic segment, and hip and knee joint angles during gait. The patients were classified into Ant-PT+/Ant-PT−, TK+/TK−, and CoG+/CoG− groups according to the changes in Ant-PT angle, TK angle, and distance of the CoG from the CoM of the pelvic segment. Increases and decreases in the values of the variables from the first trial to the third trial were indicated with “+” and “−” signs, respectively.


The mean Ant-PT angle, TK angle, and distance of the CoG from the CoM of the pelvic segment increased progressively, and the differences in the values of these variables from the first to the third trials were statistically significant (P = 0.046, P = 0.004, and P = 0.007 for the Ant-PT angle, TK angle, and distance of the CoG from the CoM of pelvic segment, respectively). Among the 44 patients, 27 and 34 were classified into the Ant-PT+ and CoG+ groups, respectively. Older age and higher body mass index (BMI) were significantly associated with the Ant-PT+ group. The CoG+ group demonstrated a significantly higher height and weight than the CoG− group.


Higher BMI, height, and weight are risk factors for progressive worsening of dynamic sagittal imbalance.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.


Dynamic sagittal imbalance Motion analysis Pelvic compensation Center of gravity Anterior pelvic tilt angle 



This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2016R1A2B3012850) and by Grant Number 14-2018-005 from the SNUBH Research Fund.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

586_2019_6267_MOESM1_ESM.pptx (141 kb)
Supplementary material 1 (PPTX 140 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2020

Authors and Affiliations

  1. 1.Spine Center and Department of Orthopaedic SurgerySeoul National University College of Medicine and Seoul National University Bundang HospitalSungnamRepublic of Korea
  2. 2.Department of Mechanical EngineeringYonsei UniversitySeoulRepublic of Korea
  3. 3.Department of Orthopaedic SurgerySeoul National University College of Medicine and Seoul National University HospitalSeoulRepublic of Korea

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