(iii) Sagittal spinal alignment and its clinical implications

Much is known about spinal deformity in the coronal plane, and the three dimensional deformities that are associated with coronal plane deformities. Much less attention is paid to sagittal plane deformities and this is partly because they are much less widely distributed, being much more common in the Orient, particularly in those who spend long periods of time working in a stooped posture close to the ground. This article describes normal sagittal alignment of the spine and the abnormalities that can develop, including degenerative lumbar scoliosis and degenerative lumbar kyphosis. The surgical strategies for dealing with the latter are discussed in detail.