Sabarul A. Mokhtar MD, PhD
President of Malaysia Spine Society
Senior consultant Orthopaedic surgeon
Department of Orthopaedics & Traumatology
Faculty of Medicine
Universiti Kebangsaan Malaysia

 

Sagittal balance forms part of the radiographic assessment of spinal column based on full-spine postero-anterior and lateral plain x-rays images. Deformity including kyphotic or lordotic and even scoliotic deformities may cause imbalance of the spinal column which frequently results in back pain, as patients have to expend more energy for compensation. The sagittal balance is primarily described by different angles that can be measured by its curvatures (lordosis and kyphosis) relative to the position of the pelvis. Sagittal vertical axis(SVA) is the simplest way to assess the “global spinal sagittal balance” on a

standing lateral full length plain radiographic images. Pelvic parameters are associated with sagittal balance of the spine. Herein the parameters related to spinal sagittal balance are pelvic incidence(PI), sacral slope(SS) and pelvic tilt(PT) and spino-sacral angle (SSA). Pelvic incidence(PI) equals the sum of the angle that identifies the status of the pelvis, which is called pelvic tilt(PT) and the sacral slope(SS) angles.