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Anterior approach for determination of sagittal spinopelvic parameters using anterior pelvic plane and sternum plane: a case study on symptom-free subjects

Radło Paweł, Danioł Mateusz, Boehler Lukas, Kozak Josef

Medical Robotics Reports

2019/2020

vol. 8/9

20-26

Sagittal imbalance causes low back pain, hip impingement, and influences the whole skeleton and muscular system of our body. It is documented in the literature on spinal deformities that good long-term surgical results can only be achieved by restoring sagittal balance and spinopelvic harmony as part of surgical treatment. Currently, the state of the art in sagittal balance determination is based on conventional radiology or an EOS system both using X-ray radiation. These procedures are associated with radiation exposure for the patients. Therefore, a new anterior approach is shown in this work to measure sagittal balance with a navigated ultrasound system without any radiation exposure. The anterior pelvic plane and a newly defined sternum plane are considered to provide an assessment of the sagittal balance. This new approach was tested in a trial on 10 symptom-free subjects by using a smartphone navigated ultrasound system. The relationship between the rotation of the pelvis and the upper body inclination in young healthy people is examined in a standing position. The study with new determined landmarks (incisura jugularis, superior iliac spinas, and symphysis pubis) gives us significant different results between male and female test persons. A proposal for a classification of sagittal balance is achieved which defines a reasonable range for the Sternum Tilt of -0.1 ± 1.5° / 3.7 ± 2.5°. The significant advantage of this method is to evaluate the sagittal balance with a cost effective, smart system without any radiation exposure to the patient.