title: Sagittal spino-pelvic alignment in chronic low back pain.
abstract: BACKGROUND
  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.
  
  
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Médecine Physique et Réadaptation, Hôpital de Jour, Centre médico-chirurgical de réadaptation des Massues, 92 Rue Edmond Locard, 69322, Lyon cedex 05, France. chaleat-valayer.e@cmcr-massues.com
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Chaléat-Valayer
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Mac-Thiong
authors.forename: Jérôme
authors.initials: J
authors.lastname: Paquet
authors.forename: Eric
authors.initials: E
authors.lastname: Berthonnaud
authors.forename: Fabienne
authors.initials: F
authors.lastname: Siani
authors.forename: Pierre
authors.initials: P
authors.lastname: Roussouly
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000209:etiology / Q000503:physiopathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000473:pathology / Q000503:physiopathology*; D004856:Postural Balance / Q000502:physiology; D011446:Prospective Studies; D013121:Spinal Curvatures / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D013131:Spine / Q000473:pathology / Q000503:physiopathology*; D055815:Young Adult