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Sagittal Balance of the Spine

Sagittal Balance of the Spine

From Normal to Pathology: A Key for Treatment Strategy


Format: Hardback
ISBN: 9781626237322
Publication Date: August 2019

Please note that payment will be taken immediately. The book will be delivered to you when it is in stock, as per the publication date.

Unique resource from internationally renowned experts details the key role of sagittal spine balance

Through evolution, human verticality became associated with a wide range of normal pelvic shapes and associated pelvic incidence angles (PIs). While all types of sagittal alignment generally provide adequate support to young adults, age, stress, and related degeneration can progressively lead to sagittal imbalance and contribute to various spinal pathologies.

Sagittal Balance of the Spine by Pierre Roussouly, João Luiz Pinheiro-Franco, Hubert Labelle, Martin Gehrchen, and a cadre of esteemed international contributors focuses on the importance of sagittal alignment and spino-pelvic shape identification in clinical practice. Offering the most comprehensive text on sagittal balance to date, this state-of-the-art, richly illustrated book fills a void in the literature, offering clinical pearls throughout seven sections and 24 chapters.

Key Highlights

  • The biomechanics of sagittal balance including spine modeling, primary parameters, spinal curves segmentation, and lumbar lordosis classification
  • The role of sagittal balance in low back pain and degeneration, with discussion of spinal orientation and the contact forces theory, spinal degeneration associated with spinopelvic morphotypes, and compensatory mechanisms
  • Comprehensive analysis of the relationship between sagittal imbalance and isthmic lysis spondylolisthesis, degenerative spondylolisthesis, Scheuermann's kyphosis, adolescent idiopathic scoliosis, and adult scoliosis
  • Posterior and anterior treatment approaches – from spinal fixation and spinal fusion – to spinal osteotomy techniques and management of surgical failure

This text is essential reading for every neurosurgical and orthopaedic resident, as well as veteran surgeons who evaluate and treat patients with spine conditions. Clinicians will learn why incorporating sagittal balance evaluations into spinal exams is integral to devising more effective treatment strategies and achieving improved outcomes.

This book includes complimentary access to a digital copy on

Section 1 – Introduction to Sagittal Balance
Chapter 01: Historical Background of Spinal Sagittal Balance
Chapter 02: The Acquisition of Human Verticality
Section 2 – Biomechanics of Sagittal Balance
Chapter 03: From the Head to the Feet: Anatomy of the Upright Position
Chapter 04: Modeling of the Spine
Chapter 05: Sagittal Balance: The Main Parameters
Chapter 06 : Spinal Curves Segmentation and Lumbar Lordosis Classification
Section 3 – Normative values following age and populations
Chapter 07: Normative Values of Sagittal Balance in Children and Adults
Chapter 08: Sagittal Balance in the Elderly
Section 4 – The Sagittal Balance of the Spine in Pathology
Chapter 09: Local Stresses: Segmental Mechanism of Low Back Pain and Degeneration. Stresses According to Spinal Orientation - Contact Forces Theory
Chapter 10: Mechanisms of Spinal Degeneration According to Spinopelvic Morphotypes
Chapter 11: Sagittal Imbalance Compensatory Mechanisms
Section 5 – The Non Scoliotic Spine
Chapter 12: Isthmic Lytic Spondylolisthesis–The Physiopathology, Classification, and Treatment Better Explained by the Sagittal Balance
Chapter 13: Degenerative Spondylolisthesis: Does the Sagittal Balance Matter?
Chapter 14: Degenerative (Aging) Spine: A Challenge for Contemporaneous Societies
Chapter 15: Scheuermann's Kyphosis
Chapter 16: Cervical Sagittal Alignment and Cervicarthrosis
Chapter 17: Advantages and Limitations of the SRS-Schwab Classification for Adult Spinal Deformity
Section 6 – Adolescent Idiopathic Scoliosis (AIS)
Chapter 18: Specificities in Growing Spine
Chapter 19: Sagittal Balance Incidence on Treatment Strategy in AIS
Section 7 – Adult Scoliosis (AS)
Chapter 20: From Pathological to Normal Shapes in Adult Scoliosis
Chapter 21: Sagittal Balance Treatment Strategy in a Posterior Approach
Chapter 22: Adult Scoliosis Treatment with an Anterior Approach
Chapter 23: Techniques for Spine Osteotomies and Clinical Applications
Chapter 24: Surgical Failures Mechanisms and Their Treatment

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