Spine Anatomy
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Overview of Spinopelvic Alignment
The two overarching concepts in this section are scoliosis and sagittal balance. A number of specific terms and measurements are shown for reference. Depending on the purpose and practice, radiology reports may remain descriptive.
Reference
Savarse LG et al. Spinopelvic sagittal balance: what does the radiologist need to know? Radiol Brasil 2020;53(3):175-184
Davis DK et al. Spine sagittal balance. StatPearls
Key anatomic points for assessment of spinopelvic alignment include: the C7 vertebral body, S1 superior surface, and femoral head geometric midpoint.
Spinal Alignment-Scoliosis Terms
Apex
End Vertebral body
Cobb Angle
Primary Curve
Secondary Curve
Hemi-vertebrae, Butterfly vertebrae
Acute Upper Thoracic Scoliosis
Lumbar Lordosis
Thoracic Kyphosis
Coronal balance
Sagittal Balance
More important than coronal balance
Associated with pain and disability
Compensatory mechanisms for positive sagittal balance include reduction of thoracic kyphosis and pelvic rotation
Examinations in standing position are useful.
Spinopelvic Alignment-Key Terms
Plumb line. A line from the midportion of the C7 vertebral body extending straight caudally.
Sagittal Vertical Axis
Pelvic Tilt
Sacral Slope. The slope of the superior surface of S1 defined by an angle between a line along the surface and a line perpendicular to the posterior edge of the S1 superior endplate.
Pelvic Incidence
Spinopelvic Angle. An angle formed by a line extending from the C7 vertebral body midpoint to the S1 superior endplate midpoint and a line from the S1 superior endplate midpoint to the femoral head geometric midpoint.
Pelvic Incidence = Sacral Slope + Pelvic Tilt
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