• Kenji Endo, Hidekazu Suzuki, Hirosuke Nishimura, Hidetoshi Tanaka, Takaaki Shishido, and Kengo Yamamoto.
• Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan.
• Asian Spine J. 2014 Oct 1;8(5):599-604.

Study DesignRadiological analysis of normal patterns of sagittal alignment of the spine.PurposeThis study aimed to clarify the characteristics of normal sagittal spino-pelvic alignment in Asian people.Overview Of LiteratureIt is known that there are differences in these parameters based on age, gender, and race. In order to properly plan for surgical correction of the spine for Asian patients, it is necessary to understand the normal spino-pelvic alignment parameters for this population.MethodsThis study analyzed 86 Japanese healthy young adult volunteers (48 men and 38 women; age 35.9±11.1 (mean±standard deviation [SD]). The following parameters were measured on lateral standing radiographs of the entire spine: sagittal vertical axis (SVA), horizontal distance between the C7 plumb line and the posterior superior corner of the superior margin of S1, thoracic kyphotic angle (TK), lumbar lordotic angle (LLA), sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI).ResultsThe values (mean±SD) of SVA, TK, LLA, SS, PT, and PI were 8.45±25.7 mm, 27.5±9.6°, 43.4±14.6°, 34.6±7.8°, 13.2±8.2°, and 46.7±8.9°, respectively. The Japanese young adults evaluated in this study tended to have a smaller PI, LLA, TK, and SVA than most Caucasian people. Regarding gender differences, SVA was significantly longer and TK was significantly smaller in men; however, there was no statistically significant difference in LLA, SS, PA, and PI.ConclusionsJapanese young adults apparently have smaller PI and LLA values than Caucasian people. When making decisions for optimal sagittal spinal alignment, racial differences should be considered.

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