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Chiropractic Research Review

Measuring Pelvic Lordosis: The Pelvic Radius Technique

Posture and spinopelvic balance are specific to the individual, with each person having a particular sagittal alignment. Measurement techniques for spinopelvic alignment, including sagittal vertebral angulations for lordosis and sagittal plumblines for spinal balance, vary considerably and remain inconsistent in the literature.



Forty adult subjects with mechanical low back pain and without prior spine surgery or symptomatic hip disease participated in a study designed to compare the reliability of measurement techniques for spinopelvic alignment. The study sought to determine longitudinal variation between radiographs for sagittal spinopelvic alignments. Subjects were recruited from two different groups (20 volunteers with no back symptoms and 20 patients with no changes in symptoms). Standing radiographs were taken an average of two weeks apart.

Two observers made 24 different measurements on the radiographs to determine lumbopelvic lordosis, pelvic balance and pelvic morphology, using a pelvic radius technique called the "hip axis," described by Jackson (Spine 1998:23, pp1750-67). This technique generates angles based on measurements from the pelvic radius, a line determined from the midpoint for the pelvic hip axis to the posterior superior corner of the S1 spinal level.

Conclusions: Lumbopelvic alignments and a morphologic angle for the sacropelvic could be measured reliably using the pelvic radius technique. Specifically, the authors note that:

* The lordosis measurement appeared dependent on individual pelvic morphology.

* Pelvic morphology and lumbosacral lordosis were strongly correlated with lumbopelvic lordosis.

* The pelvic radius technique demonstrated high reliability in assessing sagittal spinopelvic alignment, including lumbopelvic lordosis, pelvic balance and pelvic morphology.

Jackson RP, Kanemura T, Kawakami N, et al. Lumbopelvic lordosis and pelvic balance on repeated standing lateral radiographs of adult volunteers and untreated patients with constant low back pain. Spine, March 1, 2000:25(5), pp575-586.

Chiropractic Research Review

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