{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T07:24:39Z","timestamp":1791617079165,"version":"4.3.4"},"reference-count":56,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The relation of the pelvis to the spine has previously been overlooked as a contributor to sagittal balance. However, it is now recognized that spinopelvic alignment is important to maintain an energy-efficient posture in normal and disease states. The pelvis is characterized by an important anatomic landmark, the pelvic incidence (PI). The PI does not change after adolescence, and it directly influences pelvic alignment, including the parameters of pelvic tilt (PT) and sacral slope (SS) (PI = PT 1 SS), overall sagittal spinal balance, and lumbar lordosis. In the setting of an elevated PI, the spineadapts with increased lumbar lordosis. To prevent or limit sagittal imbalance, the spine may also compensate with increased PT or pelvic retroversion to attempt to maintain anupright posture. Abnormal spinopelvic parameters contribute to multiple spinal conditions including isthmic spondylolysis, degenerative spondylolisthesis, deformity, and impact outcome after spinal fusion. Sagittal balance, pelvic incidence, and all spinopelvic parameters are easily and reliably measured on standing, full-spine (lateral) radiographs, and it is essential to accurately assess and measure these sagittal values to understand their potential role in the disease process, and to promote spinopelvic balance at surgery. In this article, we provide a comprehensive review of the literature regarding the implications of abnormal spinopelvic parameters and discuss surgical strategies for correction of sagittal balance. Additionally, the authors rate and critique the quality of the literature cited in a systematic review approach to give the reader an estimate of the veracity of the conclusions reached from these reports.<\/jats:p>","DOI":"10.1227\/neu.0b013e31823262ea","type":"journal-article","created":{"date-parts":[[2011,10,4]],"date-time":"2011-10-04T18:04:07Z","timestamp":1317751447000},"page":"707-721","source":"Crossref","is-referenced-by-count":85,"title":["Implications of Spinopelvic Alignment for the Spine Surgeon"],"prefix":"10.1227","volume":"70","author":[{"given":"Vivek A.","family":"Mehta","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Southern California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anubhav","family":"Amin","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, The Johns Hopkins Hospital, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Omeis","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, The Johns Hopkins Hospital, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziya L.","family":"Gokaslan","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, The Johns Hopkins Hospital, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oren N.","family":"Gottfried","sequence":"first","affiliation":[{"name":"Division of Neurosurgery, Duke University School of Medicine, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2011,9,20]]},"reference":[{"issue":"6","key":"2020022604305578500_b1","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1097\/01.brs.0000155425.04536.f7","article-title":"Correlation of radiographic parameters and clinical symptoms 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alignment of the spine and pelvis in the presence of L5-s1 isthmic lysis and low-grade spondylolisthesis","volume":"31","author":"Roussouly","year":"2006","journal-title":"Spine (Phila Pa 1976)."},{"issue":"8","key":"2020022604305578500_b8","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1097\/BRS.0b013e31819d0c86","article-title":"Role of pelvic incidence, thoracic kyphosis, and patient factors on sagittal plane correction following pedicle subtraction osteotomy","volume":"34","author":"Rose","year":"2009","journal-title":"Spine (Phila Pa 1976)."},{"issue":"4","key":"2020022604305578500_b9","doi-asserted-by":"crossref","first-page":"387","DOI":"10.3171\/SPI-07\/10\/387","article-title":"Changes in sagittal alignment after restoration of lower lumbar lordosis in patients with degenerative flat back syndrome","volume":"7","author":"Jang","year":"2007","journal-title":"J Neurosurg 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Zhi."},{"issue":"4","key":"2020022604305578500_b52","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1007\/s00586-006-0238-1","article-title":"Relation between the sagittal pelvic and lumbar spine geometries following surgical correction of adolescent idiopathic scoliosis","volume":"16","author":"Tanguay","year":"2007","journal-title":"Eur Spine J."},{"issue":"2","key":"2020022604305578500_b53","doi-asserted-by":"crossref","first-page":"139","DOI":"10.3171\/SPI-07\/08\/139","article-title":"New prognostic factors for adjacent-segment degeneration after one-stage 360 degrees fixation for spondylolytic spondylolisthesis: special reference to the usefulness of pelvic incidence angle","volume":"7","author":"Park","year":"2007","journal-title":"J Neurosurg Spine."},{"issue":"13","key":"2020022604305578500_b54","doi-asserted-by":"crossref","first-page":"1617","DOI":"10.1097\/00007632-200007010-00004","article-title":"The biomechanical effect of postoperative hypolordosis in 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