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Research ArticleArticles

Quantitative evaluation of the lumbosacral sagittal alignment in degenerative lumbar spinal stenosis

Serik K. Makirov, Andrew A. Yuz, Mohammed T. Jahaf and Anastasia A. Nikulina
International Journal of Spine Surgery January 2015, 9 68; DOI: https://doi.org/10.14444/2068
Serik K. Makirov
1Traumatology, RMAPE, Moscow, Russia
MD
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Andrew A. Yuz
1Traumatology, RMAPE, Moscow, Russia
MD
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Mohammed T. Jahaf
1Traumatology, RMAPE, Moscow, Russia
MD
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Anastasia A. Nikulina
2Bauman Moscow State Technical University, Moscow, Russia
BS
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Article Figures & Data

Figures

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  • Fig. 1
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    Fig. 1

    Lumbosacral sagittal parameters. L – circle arc length; α – central angle; β – lordosis angle; c – chord length; r – circle radius; h – segment height. ST – sacral tilt; SD – sacral deviation.

  • Fig. 2
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    Fig. 2

    Geometrical construct of Lumbar Lordosis (LL) by two tangent arcs of circle. LL is limited proximally by the Inflexion Point (IP) and distally by the sacral plateau (S1P). C1 and C2 are two tangent circles on the apex (A) of LL. LL is divided in two arcs; the upper one from IP to A is located on C2, the lower between A and S1P is on C1. As complementary angles, lower arc equals SS.

  • Fig. 3
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    Fig. 3

    Geometry of the lumbar lordosis arc at patients with lumbar spinal stenosis. Sacral coefficient (Ks) = 0.78; Lumbar coefficient (Kl) = 0.77; Lumbosacral balance (LSB) = 0.01. L – circle arc length; α – central angle; β – lordosis angle; c – chord length; r – circle radius; h – segment height. ST – sacral tilt. SD – sacral deviation.

  • Fig. 4
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    Fig. 4

    Geometry of the lumbar lordosis arc in healthy volunteer. Sacral coefficient (Ks) = 0.98; Lumbar coefficient (Kl) = 1.21; Lumbosacral balance (LSB) = 0.23. L – circle arc length; α – central angle; β – lordosis angle; c – chord length; r – circle radius; h – segment height. ST – sacral tilt; SD – sacral deviation.

Tables

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    Table 1

    Descriptive statistics of all angular variables.

    Main GroupControl Group
    αβSTSDαβSTSD
    N5949
    Mean Std. Error2.541.761.271.022.291.461.02.93
    Median55.3949.9039.6043.8041.4147.8039.3050.90
    Std. Deviation19.5713.559.737.8216.0110.247.116.53
    Variance381.30182.6994.6161.10256.45104.8450.6142.61
    Percentile2541.2736.5033.0040.0032.0842.9535.2546.10
    7571.4258.0046.0050.1059.3759.2045.0053.40
    • α – central angle; β – lordosis angle; ST – sacral tilt; SD – sacral deviation.

    • View popup
    Table 2

    Correlation analysis of determined parameters.

    αβSSSD
    αPearson correlation1.738**.696**.320**
    Sig.(2-tailed).000.000.001
    βPearson correlation.738**1.842**.629**
    Sig.(2-tailed).000.000.000
    STPearson correlation.696**.842**1.620**
    Sig.(2-tailed).000.000.000
    SDPearson correlation.320**.629**.620**1
    Sig.(2-tailed).001.000.000
    N108
    • ↵** Correlation is significant at the 0.01 level (2-tailed).

    • α – central angle; β – lordosis angle; ST – sacral tilt; SD – sacral deviation.

    • View popup
    Table 3

    Ranks and statistics of Mann-Whitney U-criteria for main and control groups.

    GroupNMean RankSum of RanksMann-Whitney UWilcoxon WZAsymp.Sig.(2-tailed)
    α15961.773644.501016.502241.50-2.6470.008
    24945.742241.50
    β15951.803056.001286.003056.00-0.9840.325
    24957.762830.00
    ST15954.443212.001442.003212.00-0.0220.983
    24954.572674.00
    SD15944.622632.50862.502632.50-3.5980.000
    24966.403253.50
    Total108
    • α – central angle; β – lordosis angle; ST – sacral tilt; SD – sacral deviation.

    • View popup
    Table 4

    Descriptive statistics for Ks, Kl and LSB.

    GroupMainControl
    ParameterKsKlLSBKsKlLSB
    N5949
    Mean Std. Error0.0220.0260.0210.0170.0370.044
    Median0.900.860.180.771.110.34
    Std. Deviation0.1670.1990.1630.1180.2600.307
    Variance0.0280.0400.0260.0140.0680.094
    Percentile250.750.720.080.7350.980.19
    750.981.040.290.8851.300.55
    • Ks – Sacral Coefficient; Kl – Lumbar Coefficient; LSB – Lumbosacral Balance.

    • View popup
    Table 5

    Ranks and statistics of Mann-Whitney U-criteria for Ks, Kl, and LSB.

    GroupNMean RankSum of RanksMann-Whitney UWilcoxon WZAsymp. Sig. (2-tailed)
    Ks 15962.003658.001003.002228.00-2.7320.006
    24945.472228.00
    Kl 15939.462328.00558.002328.00-5.4790.0001
    24972.613558.00
    LSB15943.942592.50822.502592.50-3.8460.0001
    24967.213293.50
    Total108
    • Ks – Sacral Coefficient; Kl – Lumbar Coefficient; LSB – Lumbosacral Balance.

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1 Jan 2015
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Quantitative evaluation of the lumbosacral sagittal alignment in degenerative lumbar spinal stenosis
Serik K. Makirov, Andrew A. Yuz, Mohammed T. Jahaf, Anastasia A. Nikulina
International Journal of Spine Surgery Jan 2015, 9 68; DOI: 10.14444/2068

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Quantitative evaluation of the lumbosacral sagittal alignment in degenerative lumbar spinal stenosis
Serik K. Makirov, Andrew A. Yuz, Mohammed T. Jahaf, Anastasia A. Nikulina
International Journal of Spine Surgery Jan 2015, 9 68; DOI: 10.14444/2068
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Keywords

  • sagittal lumbosacral balance
  • lumbar lordosis
  • lordosis angle
  • lumbosacral sagittal alignment

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