Biomechanical Evidences
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1. The document discusses human standing balance and stability, which relies on aligning the center of mass and center of pressure. It maintains stability through sophisticated neural control systems and compensatory body motions. 2. The study examines 131 adults to analyze spinal and pelvic parameters related to sagittal imbalance. It finds that with increasing sagittal imbalance, kyphosis increases while lordosis decreases. Pelvic tilt also increases to compensate. 3. The conclusions indicate that as the trunk inclines forward with age or deformity, the pelvis shifts posteriorly and pelvic tilt increases to maintain the gravity line within the foot imprint and keep balance. Further analysis of lower extremity and spino-pelvic relationships is still needed
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Ligament stress, strain on the back, annular and disc tears, degenerative changes and aging can lead to chronic back pain. Understanding disorders of the spine and how they are caused will help provide the right treatment option for individual patients.
Dr. Corenman is a Colorado spine expert and talented lecturer and researcher. He has written countless medical articles on spine injuries, spine conditions and the surgical options that are available today. He recently launched his own website (http://neckandback.com) to educate patients on spine disorders and to offer second opinions to physicians and colleagues who are seeking additional information on specific spine injuries and treatment options.
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Understanding disorders of the spine| anatomy of the spine | chronic back pain
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Biomechanical Evidences
- 1. Biomechanical Evidence: The complexity of human standing and its associated compensatory mechanisms Virginie Lafage PhD Frank Schwab MD Jean-Pierre Farcy MD NYU Hospital for Joint Diseases, New York, NY
- 2. Human Standing Position Balance state of equilibrium; equal distribution of weight Posture relative disposition of the body’s parts Stability state or quality of maintaining equilibrium, self-restoring http://pmgagey.club.fr/
- 12. Clinical Group (Prospective IRB) Inclusion criteria 131 Adults No Previous spine surgery Cobb angle < 20 C7 Frontal Imbalance < 5cm Subdivision by SVA [Jackson, Spine 1994] 8.2 ± 4.8 0 ± 1.6 -4.8 ± 1.4 Mean SVA (cm) > 2.5cm -2.5 => 2.5cm < -2.5cm Inclusion criteria (SVA) 37 51 43 Number 68 ± 17 51 ± 18 35 ± 16 Mean age (year) Sagittal Forward (Sf) Neutral (N) Sagittal Backward (Sb)
- 13. Measurements 1. Frontal & Sagittal XRays Free standing position 2. Load distribution Simultaneous assessment of X-Rays and load distribution
- 14. 3. Vertebrae and FH location on XRays SpineView® 4. Gravity Line (GL) and heel line projected on X-rays => Distance between GL, Heel line and anatomical points Measurements
- 15. Pelvic Parameters PI = PT + SS S acral S lope P elvic T ilt P elvic I ncidence
- 16. Results
- 17. Spinal parameters With increasing SVA Kyphosis increases ( Sf group vs. the 2 others) Lordosis decreases 80 ± 50 0 ± 13 -45 ± 17 SVA (mm) 50 ± 13 57 ± 11 63 ± 12 Lordo (deg) -51 ± 20 -42 ± 15 -41 ± 11 Kypho (deg) Sagittal Forward (Sf) Neutral (N) Sagittal Backward (Sb)
- 18. With increasing SVA No significant differences in Sacral Slope Pelvic Tilt increases Higher Pelvic Incidence ( Sf group vs. the 2 others) => Differences in pelvic morphology and orientation Pelvic parameters 35 ± 10 36 ± 10 38 ± 9 Sacral Slope 21 ± 8 16 ± 6 10 ± 7 Pelvic Tilt 56 ± 11 52 ± 9 48 ± 10 Incidence Sagittal Forward (Sf) Neutral (N) Sagittal Backward (Sb)
- 19. S. Backward Neutral S. Forward GL vs. Heels = constant Pelvis shifts posteriorly Forceplate parameters Gravity Line Heels Line
- 20. Young Adult Gravity Line vs. Heel = Constant Required to keep our standing position Age and spinal deformity do not affect this constraint By definition, the whole body mass is equally distributed around the gravity line Conclusions
- 21. How to maintain balance if the trunk inclines forward ? => Body mass distribution should compensate trunk inclination to keep the GL within foot imprint What do we know ? Pelvis shifts posteriorly Pelvic tilt increases Feet are fixed in standing position Adaptation of lower extremities Hip flexion ? Knee flexion ? Ankle regulation ? Conclusions Young Adult