Spino-pelvic postural changes between the standing and sitting human position: Proposal of a method for its systematic analysis

This study presents numerical tools, based on biplanar radiography, allowing to analyze the 3D changes in position and length of the various spinal segments with respect to the pelvis which occur between the standing and sitting positions. Three asymptomatic adult subjects and twelve adult patients with low back pain or scoliosis had biplanar calibrated radiographs in the erect posture and sitting position. The 3D points of the spinal curve were then reconstructed from their plane projections using a standard photogrammetric technique. A technical data form has been formulated to present and summarize the complex 3D spino-pelvic changes occurring between both postures. The spine and pelvis are displayed as a chain of linear articulated segments, in their plane of maximum curvature, allowing users to compare both postures and to assess the global and local spinal mobility between the two fixed postures. Examples of asymptomatic volunteers and of subjects with low back pain or scoliosis demonstrate that different strategies can be adopted to perform this simple task and are presented to illustrate these new techniques and their clinical potential to discriminate between and within normal and pathological conditions.