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21
Whole Body Sagittal Alignment
Figure legends
Vertical line
ODUpper TK
(T1-4)
Cr-
Global TK
(T1-12)
O-C2 angle
Lower TK
(T4-12)
Global LL (L1-S1)
SVA
C2-7 lordotic angle
Lower LL (L4-S1)
SSA
T1-slope
CAM-HA
TPA
SS
PI
KF
PT
Pelvic thickness
Figure 1. Spinopelvic parameters and whole body sagittal alignment parameters
22
Whole Body Sagittal Alignment
Table 1. Baseline characteristics of healthy subjects from the three cohorts
Total Sample
Mean
SD
317
Characteristics
No. of subjects
Race
Age (years)
Female, n (%)
ODI score
Cohort 1
Mean
SD
106
Mongoloid
52.6
12.3
76 (71.7)
8.0
7.4
43.8
14.7
192 (60.6)
4.3
6.2
Cohort 2
Mean
SD
100
Mongoloid
39.4
12.1
63 (63.0)
4.3
5.4
Cohort 3
Mean
SD
111
Caucasian
39.2
15.2
53 (47.7)
0.7
2.2
Table 2. The mean and standard deviation of all measured parameters according to age group
Total
Mean
15.9
1.3
22.7
11.1
33.6
40.5
11.3
35.2
54.1
38.2
12.6
50.8
10.8
-0.8
-0.2
-9.9
-1.7
-2.1
8.0
129.1
2.1
4.3
O-C2 angle (°)
C2-7 lordotic angle (°)
T1-slope (°)
Upper (T1-4) TK (°)
Lower (T4-12) TK (°)
Global (T1-12) TK (°)
Upper (L1-3) LL (°)
Lower (L4-S1) LL (°)
Global(L1-S1) LL (°)
SS (°)
PT (°)
PI (°)
Pelvic thickness (cm)
Knee flexion (°)
SVA (cm)
OD-HA (°)
Cr-HA (cm)
CAM-HA (cm)
TPA (°)
SSA (°)
CrSVA (cm)
ODI score
Male
SD
8.1
12.6
8.4
6.3
10.5
10.8
10.5
7.1
11.5
8.4
7.6
10.9
0.9
5.5
2.6
20.6
2.9
3.0
7.6
17.2
2.6
6.2
Total (n=125)
Mean
SD
15.6
7.6
3.8
12.0
24.9
8.4
13.0
6.6
35.2
10.4
43.5
11.4
11.8
10.5
36.4
6.1
55.1
11.8
38.1
8.9
11.4
6.8
49.6
10.4
10.6
1.0
0.5
4.8
-0.5
2.4
-10.1
20.4
-1.7
2.8
-2.2
3.0
6.7
6.2
130.5
8.0
1.8
2.4
2.8
4.5
20s-30s (n=62)
Mean
SD
15.3
6.6
1.2
10.1
23.8
7.1
12.6
6.1
35.2
9.1
43.1
9.1
13.3
10.4
37.4
5.4
56.6
10.3
38.9
8.4
10.2
6.2
49.1
10.4
10.6
0.8
-1.7
4.5
-1.0
2.1
-12.7
23.3
-2.2
2.4
-2.6
2.7
5.7
6.0
131.6
7.7
1.6
1.8
1.7
3.8
40s-50s (n=45)
Mean
SD
16.3
8.1
4.0
12.6
24.7
9.5
12.5
7.1
34.5
11.7
42.2
13.4
11.1
10.1
35.1
6.9
54.5
12.3
37.9
9.6
13.0
7.6
50.8
10.7
10.6
0.8
2.1
4.1
-0.3
2.2
-8.5
17.1
-1.5
2.7
-2.2
2.6
7.8
6.7
130.4
8.4
1.8
2.5
3.6
4.7
≥60s (n=18)
Mean
SD
14.8
9.8
12.1
13.5
29.4
8.8
15.4
6.9
37.1
11.4
48.0
12.4
8.1
11.0
36.4
6.4
51.4
14.7
36.4
9.1
11.9
6.6
48.1
9.5
10.9
1.9
3.8
4.2
0.7
3.1
-5.0
16.2
-0.7
4.1
-0.8
4.6
7.7
5.0
127.2
7.7
2.5
3.9
4.4
5.3
Total (n=192)
Mean
SD
16.1
8.4
-0.4
12.8
21.3
8.1
9.8
5.8
32.5
10.5
38.6
10.0
11.0
10.6
34.4
7.6
53.4
11.3
38.2
8.1
13.4
8.0
51.6
11.2
10.8
0.7
-1.6
5.7
-0.1
2.8
-9.9
20.8
-1.7
2.9
-2.1
3.0
8.8
8.2
128.1
21.1
2.2
2.7
5.3
6.9
Female
20s-30s (n=74)
40s-50s (n=84)
Mean
SD
Mean
SD
17.1
9.9
15.6
7.3
-3.7
12.7
-1.2
10.8
19.5
6.8
20.9
7.9
10.7
4.8
9.7
5.9
31.3
9.1
30.3
9.6
38.5
8.7
36.5
10.3
11.9
9.6
10.6
10.8
36.0
7.1
32.7
7.3
55.5
10.1
52.1
12.2
38.2
8.0
38.3
8.4
10.4
6.8
14.8
7.8
48.7
10.1
53.1
12.0
11.1
0.7
10.8
0.7
-4.5
5.5
-0.5
4.3
-1.5
1.9
0.3
2.3
-15.2
23.6
-6.2
16.5
-2.5
2.7
-1.5
2.4
-2.9
2.8
-1.9
2.6
5.1
6.3
10.2
7.9
131.5
8.5
129.4
8.1
1.4
1.8
2.3
2.4
2.2
4.3
6.9
7.2
≥60s (n=34)
Mean
SD
15.2
7.8
8.8
13.7
25.9
9.8
8.1
7.1
40.5
12.0
43.9
10.2
9.9
12.1
35.1
8.9
52.1
11.2
37.6
7.6
16.4
9.2
54.0
10.3
10.5
0.7
1.8
6.3
2.2
3.6
-7.2
22.0
-0.1
3.7
-0.6
3.6
13.2
9.6
117.5
45.9
4.0
3.8
8.1
8.3
Table 3. Correlation between age and whole body sagittal alignment parameters
Male
Female
Male
Female
O-C2 angle
C2-7 lordotic angle
T1-slope
Upper TK (T1-4)
.020
.326
.242
.152
.055
.147
.822
.000
.007
.091
.543
.103
.065
.105
-.108
.355
.279
-.163
.244
.137
-.062
-.061
.137
.000
.000
.024
.001
.058
.396
.401
PI
Pelvic thickness
KneeFlex
SVA
OD-HA
Cr-HA
CAM-HA
-.020
.062
.427
.234
.120
.163
.149
.824
.491
.000
.009
.182
.072
.236
-.316
.429
.507
.161
.001
.000
.000
.000
.026
Lower TK (T4-12) Global TK (T1-12)
Upper LL (L1-3)
SS
PT
-.155
.176
.043
.084
.050
-.139
-.031
.357
.054
.672
.000
TPA
SSA
CrSVA
ODI score
.169
-.233
.117
.241
.098
.060
.009
.198
.007
.275
.262
.442
-.173
.349
.302
.000
.000
.000
.016
.000
.000
-.166
Lower LL (L4-S1) Global LL (L1-S1)
-.146
-.181
10
23
Whole Body Sagittal Alignment
Table 4. Correlation among whole body sagittal alignment parameters
O-C2
angle
C2-7 lordotic angle
T1-slope
Upper TK (T1-4)
Lower TK (T4-12)
Global TK (T1-12)
Upper LL (L1-3)
Lower LL (L4-S1)
Global LL (L1-S1)
SS
PT
PI
Pelvic thickness
Knee flexion
SVA
OD-HA
Cr-HA
CAM-HA
TPA
SSA
CrSVA
C2-7
lordotic
angle
T1-slope
Global
Upper TK Lower TK
TK (T1(T1-4)
(T4-12)
12)
Upper LL Lower LL Global LL
(L1-3)
(L4-S1)
(L1-S1)
-.470
.000
-.061
.280
.008
.658
.000
.241
.513
.881
-.107
.057
.000
.493
.000
.000
.627
.000
-.042
.457
-.100
.075
-.137
.015
-.072
.198
.582
.000
.136
.016
.126
.024
.800
.000
-.092
.103
.073
.193
.392
.000
-.103
.068
-.051
.363
.833
.000
.284
.000
.305
.000
.242
.000
.277
.000
.038
.505
SS
PT
PI
Pelvic
thickness
Average
Knee
flexion
very weak 0.00-0.19
weak
0.20-0.39
moderate 0.40-0.59
strong 0.60-0.79
very strong
0.80-
-.099
.045
.000
-.016
.431
.407
.649
.538
.080
-.024
.664
-.052
.429
-.064
.257
.162
.996
-.071
.210
.059
.770
.012
.832
-.093
.000
.126
.025
-.051
.000
.116
.040
-.070
.000
.444
.000
.049
.000
.426
.000
-.244
.817
.000
-.153
-.082
.355
-.056
.004
.066
.292
-.012
.097
-.057
.366
.063
.211
.041
.381
.378
.000
.158
.006
.525
.144
.714
.638
.319
.102
.069
.242
-.162
.004
.831
-.024
.670
.309
.110
.051
.261
-.120
.032
.463
-.068
.225
.000
-.227
.000
.005
-.205
.000
.000
-.306
.000
.000
-.319
.000
.000
-.213
.000
-.399
.000
-.048
.398
.177
.002
.228
.000
.057
.313
.064
.254
.075
.180
-.140
.012
-.116
.039
-.155
.006
-.068
.225
.198
.000
.087
.124
-.080
.156
-.037
.517
.131
.019
.347
.000
-.092
.103
.433
.000
.270
.000
-.091
.107
.149
.008
.189
.001
.016
.773
.078
.163
.040
.476
-.074
.187
-.414
.000
-.286
.000
-.209
.000
-.230
.000
-.183
.001
.018
.749
-.005
.924
.342
.000
-.077
.172
.255
.000
-.058
.301
-.136
.015
.056
.320
.327
.000
.247
.000
.136
.016
.091
.109
.411
.000
.016
.778
.191
.001
.141
.012
-.188
.001
-.101
.074
-.136
.016
.048
.396
-.156
.006
-.073
.199
-.058
.307
.306
.000
.170
.002
-.052
.074
.192
.221
.438
.000
.166
.037
.515
-.128
.217
.000
.014
.168
.003
-.053
-.187
.001
.068
-.108
.054
-.293
-.114
.042
-.162
.096
.088
-.008
-.158
.005
.914
-.037
.516
.636
-.046
.415
-.254
.285
.000
.251
.352
.028
.000
-.119
.003
-.070
.022
.024
.800
.058
.351
.067
.227
.153
.000
.286
.004
.401
.888
.399
.000
-.177
.000
.184
.000
-.136
.000
-.106
.622
.019
.742
.034
.107
.057
.212
.368
.000
.673
-.044
.433
.301
.186
.001
.232
.125
.026
.007
-.121
.032
.000
-.147
.009
.000
-.230
.000
.000
-.093
.098
.002
.190
.001
.001
.062
.274
.016
-.047
.402
.060
.328
.000
24
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