{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T04:32:40Z","timestamp":1789014760604,"version":"build-2803163510"},"reference-count":42,"publisher":"Elsevier BV","issue":"5","license":[{"start":{"date-parts":[[2017,5,1]],"date-time":"2017-05-01T00:00:00Z","timestamp":1493596800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["clinicalkey.jp","clinicalkey.com","clinicalkey.es","clinicalkey.com.au","clinicalkey.fr","thespinejournalonline.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Spine Journal"],"published-print":{"date-parts":[[2017,5]]},"DOI":"10.1016\/j.spinee.2016.11.016","type":"journal-article","created":{"date-parts":[[2016,12,1]],"date-time":"2016-12-01T05:31:30Z","timestamp":1480570290000},"page":"681-688","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":38,"title":["The impact of obesity on compensatory mechanisms in response to progressive sagittal malalignment"],"prefix":"10.1016","volume":"17","author":[{"given":"Cyrus M.","family":"Jalai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bassel G.","family":"Diebo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana L.","family":"Cruz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory W.","family":"Poorman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaleen","family":"Vira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0275-5020","authenticated-orcid":false,"given":"Aaron J.","family":"Buckland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4820-1835","authenticated-orcid":false,"given":"Renaud","family":"Lafage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shay","family":"Bess","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J.","family":"Errico","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0119-7111","authenticated-orcid":false,"given":"Virginie","family":"Lafage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter G.","family":"Passias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.spinee.2016.11.016_bib0010","doi-asserted-by":"publisher","first-page":"1082","DOI":"10.1097\/01.brs.0000160842.43482.cd","article-title":"Adult scoliosis: prevalence, SF-36, and nutritional parameters in an elderly volunteer population","volume":"30","author":"Schwab","year":"2005","journal-title":"Spine"},{"key":"10.1016\/j.spinee.2016.11.016_bib0015","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000248126.96737.0f","article-title":"Gravity line analysis in adult volunteers: age-related correlation with spinal parameters, pelvic parameters, and foot position","volume":"31","author":"Schwab","year":"2006","journal-title":"Spine"},{"key":"10.1016\/j.spinee.2016.11.016_bib0020","series-title":"The pediatric spine: principles and practices","first-page":"479","article-title":"Three-dimensional analysis of the scoliotic deformity","author":"Dubousset","year":"1994"},{"key":"10.1016\/j.spinee.2016.11.016_bib0025","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181aad219","article-title":"Pelvic tilt and truncal inclination: two key radiographic parameters in the setting of adults with spinal deformity","volume":"34","author":"Lafage","year":"2009","journal-title":"Spine"},{"key":"10.1016\/j.spinee.2016.11.016_bib0030","doi-asserted-by":"publisher","first-page":"436","DOI":"10.3171\/2015.5.SPINE14989","article-title":"Role of pelvic translation and lower-extremity compensation to maintain gravity line position in spinal deformity","volume":"24","author":"Ferrero","year":"2016","journal-title":"J Neurosurg Spine"},{"key":"10.1016\/j.spinee.2016.11.016_bib0035","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1016\/j.jspd.2015.08.004","article-title":"Is there a gender-specific full body sagittal profile for different spinopelvic relationships? A study on propensity-matched cohorts","volume":"4","author":"Vira","year":"2016","journal-title":"Spine Deform"},{"key":"10.1016\/j.spinee.2016.11.016_bib0040","doi-asserted-by":"publisher","first-page":"642","DOI":"10.1097\/BRS.0000000000000844","article-title":"Recruitment of compensatory mechanisms in sagittal spinal malalignment is age and regional deformity dependent: a full-standing axis analysis of key radiographical parameters","volume":"40","author":"Diebo","year":"2015","journal-title":"Spine"},{"issue":"Suppl. 5","key":"10.1016\/j.spinee.2016.11.016_bib0045","doi-asserted-by":"publisher","first-page":"626","DOI":"10.1007\/s00586-011-1930-3","article-title":"Sagittal balance disorders in severe degenerative spine. Can we identify the compensatory mechanisms?","volume":"20","author":"Barrey","year":"2011","journal-title":"Eur Spine J"},{"key":"10.1016\/j.spinee.2016.11.016_bib0050","doi-asserted-by":"publisher","first-page":"1572","DOI":"10.1097\/BRS.0b013e31817886a2","article-title":"Standing balance and sagittal plane spinal deformity: analysis of spinopelvic and gravity line parameters","volume":"33","author":"Lafage","year":"2008","journal-title":"Spine"},{"key":"10.1016\/j.spinee.2016.11.016_bib0055","doi-asserted-by":"publisher","first-page":"656","DOI":"10.3171\/2015.3.SPINE14743","article-title":"Impact of obesity on complications, infection, and patient-reported outcomes in adult spinal deformity surgery","volume":"23","author":"Soroceanu","year":"2015","journal-title":"J Neurosurg Spine"},{"key":"10.1016\/j.spinee.2016.11.016_bib0060","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1097\/BRS.0b013e318270b243","article-title":"Obesity is associated with inferior results after surgery for lumbar spinal stenosis: a study of 2633 patients from the Swedish spine register","volume":"38","author":"Knutsson","year":"2013","journal-title":"Spine"},{"key":"10.1016\/j.spinee.2016.11.016_bib0065","doi-asserted-by":"publisher","first-page":"968","DOI":"10.1007\/s11999-013-3346-3","article-title":"Does obesity affect the surgical outcome and complication rates of spinal surgery? A meta-analysis","volume":"472","author":"Jiang","year":"2014","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.spinee.2016.11.016_bib0070","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1186\/1743-0003-7-3","article-title":"Effect of obesity and low back pain on spinal mobility: a cross sectional study in women","volume":"7","author":"Vismara","year":"2010","journal-title":"J Neuroeng Rehabil"},{"key":"10.1016\/j.spinee.2016.11.016_bib0075","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1097\/00007632-200202010-00021","article-title":"Association between obesity and functional status in patients with spine disease","volume":"27","author":"Fanuele","year":"2002","journal-title":"Spine"},{"key":"10.1016\/j.spinee.2016.11.016_bib0080","doi-asserted-by":"publisher","first-page":"878","DOI":"10.1007\/s00586-012-2560-0","article-title":"The impact of body mass index and central obesity on the spino-pelvic parameters: a correlation study","volume":"22","author":"Romero-Vargas","year":"2013","journal-title":"Eur Spine J"},{"key":"10.1016\/j.spinee.2016.11.016_bib0085","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/j.wneu.2015.12.024","article-title":"Comparison of complications and clinical and radiographic outcomes between non-obese and obese patients with adult spinal deformity undergoing minimally invasive surgery","volume":"87","author":"Park","year":"2016","journal-title":"World Neurosurg"},{"key":"10.1016\/j.spinee.2016.11.016_bib0090","doi-asserted-by":"publisher","first-page":"1947","DOI":"10.1097\/BRS.0b013e31825fab16","article-title":"Intervertebral disc height changes after weight reduction in morbidly obese patients and its effect on quality of life and radicular and low back pain","volume":"37","author":"Lidar","year":"2012","journal-title":"Spine"},{"issue":"Suppl. 5","key":"10.1016\/j.spinee.2016.11.016_bib0095","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1007\/s00586-011-1936-x","article-title":"Global analysis of sagittal spinal alignment in major deformities: correlation between lack of lumbar lordosis and flexion of the knee","volume":"20","author":"Obeid","year":"2011","journal-title":"Eur Spine J"},{"key":"10.1016\/j.spinee.2016.11.016_bib0100","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1097\/BRS.0b013e3181bdcaa4","article-title":"Diagnostic imaging of spinal deformities: reducing patients radiation dose with a new slot-scanning X-ray imager","volume":"35","author":"Desch\u00eanes","year":"2010","journal-title":"Spine"},{"key":"10.1016\/j.spinee.2016.11.016_bib0105","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1097\/01.brs.0000153698.94091.f8","article-title":"Is there an optimal patient stance for obtaining a lateral 36\u2033 radiograph? A critical comparison of three techniques","volume":"30","author":"Horton","year":"2005","journal-title":"Spine"},{"key":"10.1016\/j.spinee.2016.11.016_bib0110","doi-asserted-by":"publisher","first-page":"760","DOI":"10.1007\/s00586-009-1249-5","article-title":"3D postural balance with regard to gravity line: an evaluation in the transversal plane on 93 patients and 23 asymptomatic volunteers","volume":"19","author":"Steffen","year":"2010","journal-title":"Eur Spine J"},{"key":"10.1016\/j.spinee.2016.11.016_bib0115","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3182293548","article-title":"Angle measurement reproducibility using EOS three-dimensional reconstructions in adolescent idiopathic scoliosis treated by posterior instrumentation","volume":"36","author":"Ilharreborde","year":"2011","journal-title":"Spine"},{"key":"10.1016\/j.spinee.2016.11.016_bib0120","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1016\/j.nec.2012.12.007","article-title":"Use of Surgimap Spine in sagittal plane analysis, osteotomy planning, and correction calculation","volume":"24","author":"Akbar","year":"2013","journal-title":"Neurosurg Clin N Am"},{"key":"10.1016\/j.spinee.2016.11.016_bib0125","first-page":"22","article-title":"[Sagittal balance of the spine]","volume":"83","author":"Mangione","year":"1997","journal-title":"Rev Chir Orthop Reparatrice Appar Mot"},{"key":"10.1016\/j.spinee.2016.11.016_bib0130","series-title":"Global Sagittal Angle (GSA): a novel parameter to address sagittal alignment and compensatory mechanisms in the body","author":"Diebo","year":"2015"},{"key":"10.1016\/j.spinee.2016.11.016_bib0135","doi-asserted-by":"publisher","first-page":"2265","DOI":"10.1002\/(SICI)1097-0258(19981015)17:19<2265::AID-SIM918>3.0.CO;2-B","article-title":"Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group","volume":"17","author":"D'Agostino","year":"1998","journal-title":"Stat Med"},{"key":"10.1016\/j.spinee.2016.11.016_bib0140","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v042.i07","article-title":"Multivariate and propensity score matching software with automated balance optimization: the matching package for R","volume":"42","author":"Sekhon","year":"2011","journal-title":"J Stat Softw"},{"key":"10.1016\/j.spinee.2016.11.016_bib0145","doi-asserted-by":"publisher","first-page":"2224","DOI":"10.1097\/BRS.0b013e3181ee6bd4","article-title":"Adult spinal deformity-postoperative standing imbalance: how much can you tolerate? An overview of key parameters in assessing alignment and planning corrective surgery","volume":"35","author":"Schwab","year":"2010","journal-title":"Spine"},{"key":"10.1016\/j.spinee.2016.11.016_bib0150","first-page":"213","article-title":"Sagittal plane alignment of the spine and gravity: a radiological and clinical evaluation","volume":"71","author":"Legaye","year":"2005","journal-title":"Acta Orthop Belg"},{"key":"10.1016\/j.spinee.2016.11.016_bib0155","doi-asserted-by":"publisher","first-page":"1351","DOI":"10.1097\/00007632-199520120-00005","article-title":"An analysis of sagittal spinal alignment in 100 asymptomatic middle and older aged volunteers","volume":"20","author":"Gelb","year":"1995","journal-title":"Spine"},{"key":"10.1016\/j.spinee.2016.11.016_bib0160","doi-asserted-by":"publisher","first-page":"2452","DOI":"10.1097\/00007632-199710150-00025","article-title":"Management of flatback and related kyphotic decompensation syndromes","volume":"22","author":"Farcy","year":"1997","journal-title":"Spine"},{"key":"10.1016\/j.spinee.2016.11.016_bib0165","doi-asserted-by":"publisher","first-page":"E8","DOI":"10.3171\/foc.2003.15.3.8","article-title":"Management of iatrogenic flat-back syndrome","volume":"15","author":"Wiggins","year":"2003","journal-title":"Neurosurg Focus"},{"key":"10.1016\/j.spinee.2016.11.016_bib0170","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1097\/00002517-199203000-00011","article-title":"Lumbar disc and back muscle degeneration on MRI: correlation to age and body mass","volume":"5","author":"Parkkola","year":"1992","journal-title":"J Spinal Disord"},{"key":"10.1016\/j.spinee.2016.11.016_bib0175","doi-asserted-by":"publisher","first-page":"97","DOI":"10.3109\/17453678909150103","article-title":"Hip motion related to age and sex","volume":"60","author":"Svenningsen","year":"1989","journal-title":"Acta Orthop Scand"},{"issue":"Suppl. 5","key":"10.1016\/j.spinee.2016.11.016_bib0180","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1007\/s00586-011-1928-x","article-title":"Biomechanical analysis of the spino-pelvic organization and adaptation in pathology","volume":"20","author":"Roussouly","year":"2011","journal-title":"Eur Spine J"},{"key":"10.1016\/j.spinee.2016.11.016_bib0185","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1097\/00007632-198501000-00013","article-title":"Toward standards for posture. Postural characteristics of the lower back system in normal and pathologic conditions","volume":"10","author":"During","year":"1985","journal-title":"Spine"},{"key":"10.1016\/j.spinee.2016.11.016_bib0190","doi-asserted-by":"publisher","first-page":"2029","DOI":"10.1097\/00007632-200109150-00017","article-title":"Dynamic sagittal imbalance of the spine in degenerative flat back: significance of pelvic tilt in surgical treatment","volume":"26","author":"Lee","year":"2001","journal-title":"Spine"},{"key":"10.1016\/j.spinee.2016.11.016_bib0195","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/j.gaitpost.2013.05.030","article-title":"The correlation between movement of the center of mass and the kinematics of the spine, pelvis, and hip joints during body rotation","volume":"39","author":"Wada","year":"2014","journal-title":"Gait Posture"},{"key":"10.1016\/j.spinee.2016.11.016_bib0200","doi-asserted-by":"publisher","first-page":"615","DOI":"10.3171\/2015.7.SPINE141306","article-title":"The role of obesity in the biomechanics and radiological changes of the spine: an in vitro study","volume":"24","author":"Rodriguez-Martinez","year":"2016","journal-title":"J Neurosurg Spine"},{"key":"10.1016\/j.spinee.2016.11.016_bib0205","doi-asserted-by":"publisher","first-page":"1071","DOI":"10.1111\/j.1467-789X.2011.00916.x","article-title":"A systematic review on changed biomechanics of lower extremities in obese individuals: a possible role in development of osteoarthritis","volume":"12","author":"Runhaar","year":"2011","journal-title":"Obes Rev"},{"key":"10.1016\/j.spinee.2016.11.016_bib0210","doi-asserted-by":"publisher","first-page":"1632","DOI":"10.1249\/mss.0b013e318076b54b","article-title":"Effects of obesity on the biomechanics of walking at different speeds","volume":"39","author":"Browning","year":"2007","journal-title":"Med Sci Sports Exerc"},{"issue":"Suppl. 1","key":"10.1016\/j.spinee.2016.11.016_bib0215","article-title":"Three-dimensional gait analysis of obese adults","volume":"23","author":"Lai","year":"2008","journal-title":"Clin Biomech (Bristol, Avon)"}],"container-title":["The Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S152994301631110X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S152994301631110X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2018,9,6]],"date-time":"2018-09-06T03:56:33Z","timestamp":1536206193000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S152994301631110X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5]]},"references-count":42,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2017,5]]}},"alternative-id":["S152994301631110X"],"URL":"https:\/\/doi.org\/10.1016\/j.spinee.2016.11.016","relation":{},"ISSN":["1529-9430"],"issn-type":[{"value":"1529-9430","type":"print"}],"subject":[],"published":{"date-parts":[[2017,5]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"The impact of obesity on compensatory mechanisms in response to progressive sagittal malalignment","name":"articletitle","label":"Article Title"},{"value":"The Spine Journal","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.spinee.2016.11.016","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2016 Published by Elsevier Inc.","name":"copyright","label":"Copyright"}]}}