From the Guidelines
Spino-pelvic balance in the context of lumbar spondylolisthesis refers to the critical relationship between the spine and pelvis that maintains proper alignment and posture, and its assessment is essential for diagnosis and treatment planning. In the context of lumbar spondylolisthesis, spino-pelvic balance is assessed through specific radiographic parameters, including pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), and lumbar lordosis (LL) 1. These parameters determine whether a patient has balanced or unbalanced spondylolisthesis.
Key Parameters
- Pelvic incidence (PI)
- Sacral slope (SS)
- Pelvic tilt (PT)
- Lumbar lordosis (LL) When spondylolisthesis disrupts this balance, it can lead to compensatory mechanisms that cause pain, disability, and progressive deformity.
Importance of Spino-Pelvic Balance
Treatment approaches for lumbar spondylolisthesis must consider restoring proper spino-pelvic balance, particularly in surgical planning where the goal is to achieve appropriate alignment between the lumbar lordosis and pelvic incidence 1.
Consequences of Imbalance
Failure to address spino-pelvic imbalance during treatment can result in persistent symptoms, adjacent segment disease, and poor clinical outcomes. Understanding a patient's specific spino-pelvic parameters helps surgeons determine the appropriate degree of correction needed during fusion procedures to optimize long-term results and prevent future complications.
Diagnostic Imaging
Imaging modalities such as MRI, CT myelography, and upright radiographs can provide useful information about spino-pelvic balance and help guide treatment decisions 1.