Clinical issues of the sagittal balance in adults

Literature data were used to present the parameters of integral sagittal balance assessment. It is shown that the assessment of the sagittal balance should be performed taking into account the spatial position of the body and the use of the “cone of economy” concept and gravity line. Cervical spine and the pelvis are the key compensatory mechanisms in correction of the sagittal balance changes. The ratio of PI (pelvic incidence) and LL (lumbar lordosis) is the most significant as far as it correlates with the changes in the quality of life. Clinical interpretation of the changes in the sagittal balance should be conducted on the basis of their integration with a mandatory consideration of clinical manifestations and changes in the quality of life.