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Impact of pelvic incidence on change in lumbo-pelvic sagittal alignment between sitting and standing positions



Lumbo-pelvic sagittal alignment is affected by pelvic incidence (PI), and the PI represents the compensatory capacity of lumbo-pelvic sagittal alignment. The purpose of this study was to analyze changes in lumbo-pelvic sagittal alignment between the standing and sitting positions and to analyze its association with PI.


This study included 253 subjects (160 men and 93 women; age 53.6 ± 7.4 years). The subjects were divided into three groups (younger age group (YG), from 20 to 49 years; middle age group, from 50 to 69 years, and older age group (OG), of 70 years and above). Lumbar lordotic angle (LL), sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), and the associations between the changes in LL (∆LL), SS (∆SS), PT (∆PT), and PI were analyzed.


In the YG, the amount of change in LL, SS, and PT was larger than in the OG. These parameters correlated with age in the standing position but not in the sitting position. On the other hand, in all groups, there were positive correlations between PI and changes between the standing and sitting positions. Multiple logistic regression analysis demonstrated that ∆LL = 3.81 − 0.72 × PT + 0.52 × PI, ∆SS = − 4.50 − 5.3 × PT + 0.34 × PI, and ∆PT = − 9.1 + 3.5 × PT − 0.21 × PI.


Change in lumbo-pelvic parameters between the sitting and standing positions correlated with PI.

Graphical abstract

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We are indebted to the Department of International Medical Communications of Tokyo Medical University for the editorial review of the English manuscript. The authors would also like to thank Ms. Yuri Amamizu of the Department of Orthopedic Surgery for assistance in preparing the initial English manuscript. No benefits in any form have been received or will be received from any commercial party associated directly or indirectly with this study.

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Correspondence to Kenji Endo.

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This study was approved by the institutional review board of our institution.

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All subjects provided written informed consent after explanation of the experimental protocol.

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Maekawa, A., Endo, K., Suzuki, H. et al. Impact of pelvic incidence on change in lumbo-pelvic sagittal alignment between sitting and standing positions. Eur Spine J 28, 1914–1919 (2019).

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  • Sagittal lumbar alignment
  • Pelvic incidence
  • Sitting position