{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T02:07:05Z","timestamp":1789092425033,"version":"build-2803163510"},"reference-count":54,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T00:00:00Z","timestamp":1745452800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Sagittal spinal alignment goals for adult spinal deformity (ASD) surgery are predominantly derived from standing radiographs, despite the biomechanical relevance of sitting posture. Existing studies on sitting alignment involve young, healthy cohorts, which poorly represent ASD patients. This study assessed posture-dependent changes in spinopelvic parameters, including pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and lumbar lordosis (LL), and examined how age, BMI, and gender influence these changes. Methods: In this retrospective cohort study, sitting and standing lateral radiographs of 1447 patients were evaluated. Spinopelvic parameters were measured, and changes (\u0394PI, \u0394PT, \u0394SS, and \u0394LL) were calculated. Multiple regression analysis was used to determine associations between these changes and age, BMI, and gender. Results: All parameters differed significantly between positions (p &lt; 0.001); PT and PI increased in sitting (\u0394PT = \u221219.20\u00b0; \u0394PI = \u22124.52\u00b0), while SS and LL increased in standing (\u0394SS = 14.67\u00b0; \u0394LL = 18.44\u00b0). Older age correlated with increased \u0394PT (p &lt; 0.001) and \u0394PI (p = 0.049) but reduced \u0394LL and \u0394SS (p &lt; 0.001). Higher BMI was associated with decreased \u0394PI, \u0394PT, and \u0394LL (p &lt; 0.001, 0.003, and 0.025). Females showed greater \u0394PT (p = 0.013) but smaller \u0394PI, \u0394SS, and \u0394LL (p = 0.043, &lt;0.001, and 0.001). Conclusions: Spinopelvic parameters vary significantly between sitting and standing positions, affected by age, BMI, and gender. The observed PI change suggests SIJ involvement, highlighting the need for posture-specific and demographic-adjusted alignment goals in ASD surgery to optimize outcomes.<\/jats:p>","DOI":"10.3390\/jcm14092952","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T10:17:16Z","timestamp":1745489836000},"page":"2952","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Evaluating Variations in Spinopelvic Parameters from Sitting to Standing: A Comparative Analysis of 1447 Older Adults Across Age, BMI, and Gender Subgroups"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5236-2212","authenticated-orcid":false,"given":"Atahan","family":"Durbas","sequence":"first","affiliation":[{"name":"Department of Spine Surgery, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0323-6716","authenticated-orcid":false,"given":"Tejas","family":"Subramanian","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021, USA"},{"name":"Weill Cornell Medical College, 1300 York Ave, New York, NY 10021, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chad","family":"Simon","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myles R. J.","family":"Allen","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6170-5220","authenticated-orcid":false,"given":"Justin","family":"Samuel","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Felipe","family":"Col\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8443-7936","authenticated-orcid":false,"given":"Michael R.","family":"Mazzucco","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021, USA"},{"name":"Weill Cornell Medical College, 1300 York Ave, New York, NY 10021, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cale","family":"Pagan","sequence":"additional","affiliation":[{"name":"Department of Hip and Knee Replacement Surgery, Hospital for Special Surgery, 535 E 71st St, New York, NY 10021, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theofilos","family":"Karasavvidis","sequence":"additional","affiliation":[{"name":"Department of Hip and Knee Replacement Surgery, Hospital for Special Surgery, 535 E 71st St, New York, NY 10021, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Vigdorchik","sequence":"additional","affiliation":[{"name":"Department of Hip and Knee Replacement Surgery, Hospital for Special Surgery, 535 E 71st St, New York, NY 10021, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3723-062X","authenticated-orcid":false,"given":"Matthew E.","family":"Cunningham","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7482-6994","authenticated-orcid":false,"given":"Han Jo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis C.","family":"Lovecchio","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2024","DOI":"10.1097\/01.brs.0000179086.30449.96","article-title":"The Impact of Positive Sagittal Balance in Adult Spinal Deformity","volume":"30","author":"Glassman","year":"2005","journal-title":"Spine"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1828","DOI":"10.1097\/BRS.0b013e3181a13c08","article-title":"Sagittal Plane Considerations and the Pelvis in the Adult Patient","volume":"34","author":"Schwab","year":"2009","journal-title":"Spine"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1611","DOI":"10.1097\/00007632-199407001-00010","article-title":"Radiographic Analysis of Sagittal Plane Alignment and Balance in Standing Volunteers and Patients with Low Back Pain Matched for Age, Sex, and Size. 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