Normative values for the spine shape parameters using 3D standing analysis from a database of 268 asymptomatic Caucasian and Japanese subjects

Eur Spine J. 2016 Nov;25(11):3630-3637. doi: 10.1007/s00586-016-4485-5. Epub 2016 Mar 7.


Purpose: Sagittal balance analysis has gained importance and the measure of the radiographic spinopelvic parameters is now a routine part of many interventions of spine surgery. Indeed, surgical correction of lumbar lordosis must be proportional to the pelvic incidence (PI). The compensatory mechanisms [pelvic retroversion with increased pelvic tilt (PT) and decreased thoracic kyphosis] spontaneously reverse after successful surgery.

Materials and methods: This study is the first to provide 3D standing spinopelvic reference values from a large database of Caucasian (n = 137) and Japanese (n = 131) asymptomatic subjects.

Results: The key spinopelvic parameters [e.g., PI, PT, sacral slope (SS)] were comparable in Japanese and Caucasian populations. Three equations, namely lumbar lordosis based on PI, PT based on PI and SS based on PI, were calculated after linear regression modeling and were comparable in both populations: lumbar lordosis (L1-S1) = 0.54*PI + 27.6, PT = 0.44*PI - 11.4 and SS = 0.54*PI + 11.90.

Conclusion: We showed that the key spinopelvic parameters obtained from a large database of healthy subjects were comparable for Causasian and Japanese populations. The normative values provided in this study and the equations obtained after linear regression modeling could help to estimate pre-operatively the lumbar lordosis restoration and could be also used as guidelines for spinopelvic sagittal balance.

Keywords: Lumbar lordosis; Pelvic incidence; Sagittal balance; Spine surgery; Spinopelvic parameters formula.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Asian People*
  • Databases, Factual
  • Female
  • Healthy Volunteers
  • Humans
  • Imaging, Three-Dimensional*
  • Japan
  • Linear Models
  • Lordosis / diagnostic imaging
  • Lordosis / ethnology
  • Lumbar Vertebrae / anatomy & histology
  • Lumbar Vertebrae / diagnostic imaging*
  • Male
  • Middle Aged
  • Pelvic Bones / anatomy & histology
  • Pelvic Bones / diagnostic imaging*
  • Postural Balance
  • Posture*
  • Radiography
  • Reference Values
  • Sacrum / anatomy & histology
  • Sacrum / diagnostic imaging*
  • White People*
  • Young Adult