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head size), the acetabular cup orientation (using the TAL 19 , 46 ) and the need for spinal surgery to correct a severe sagittal imbalance ( Table 1 ). The more stiff a lumbopelvic complex is, the more it seems sensible firstly to use a large
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vigorously act and counteract in response. If this imbalance continues over time, the muscles of the spine and pelvis will eventually require more energy, leading to fatigue, discomfort and pain. 4 Then, spinal surgery may be necessary to restore a more
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patient suffering from coxarthritis with a clinical history of spinal disorders (instability, spondylolisthesis, spondylolysis, and previous spinal surgery) ( 26 ) or positive on clinical examination for hyper/hypomobility of the spine (iatrogenic or
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radiographic evaluation. Relevant points in the history should include but not be limited to the presence of previous spinal surgery (arthrodesis or not), back pain, history of inflammatory arthropathies, previous spinal/pelvic trauma (including