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Javier Pizones Spine Unit, Department of Orthopaedic Surgery, Hospital Universitario La Paz, Madrid, Spain

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Eduardo García-Rey Hip Unit, Department of Orthopaedic Surgery, Hospital Universitario La Paz, Madrid, Spain

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assessed by the pelvic incidence (PI) angle, a concept that originated from Duval-Beaupère’s studies, 16 which can be measured in a sagittal standing radiograph. PI is defined as the angle created by the intersection of the line drawn from the centre

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Juan I. Cirillo Totera Clínica Universidad de los Andes, Santiago, Chile
Hospital del Trabajador, Santiago, Chile

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José G. Fleiderman Valenzuela Clínica Universidad de los Andes, Santiago, Chile
Hospital del Trabajador, Santiago, Chile

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Jorge A. Garrido Arancibia Clínica Universidad de los Andes, Santiago, Chile

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Samuel T. Pantoja Contreras Clínica Universidad de los Andes, Santiago, Chile
Hospital Roberto del Río, Santiago, Chile

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Lyonel Beaulieu Lalanne Clínica Universidad de los Andes, Santiago, Chile

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Facundo L. Alvarez-Lemos Clínica Universidad de los Andes, Santiago, Chile

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”, “sagittal balance”, “sagittal imbalance”, “pelvic incidence” and “lumbar lordosis”. The inclusion criteria were articles, clinical guidelines, systematic reviews and randomized controlled trials (RCTs) published in indexed journals, with full

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Luigi Zagra Hip Department, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy

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Francesco Benazzo Chirurgia Protesica ad Indirizzo Robotico, Fondazione Poliambulanza, Brescia, Italy

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Dante Dallari Reconstructive Orthopaedic Surgery and Innovative Techniques – Musculoskeletal Tissue Bank, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy

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Francesco Falez Department of Orthopaedics and Traumatology, ASL Roma 1, S. Filippo Neri Hospital, Rome, Italy

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Giuseppe Solarino Department of Basic Medical Sciences, Neuroscience and Sense Organs, Orthopaedic & Trauma Unit, School of Medicine, University of Bari Aldo Moro, AOU Consorziale ‘Policlinico’, Bari, Italy

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Rocco D’Apolito Hip Department, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy

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Claudio Carlo Castelli FROM, Research Foundation Papa Giovanni XXIII Hospital, Bergamo, Italy

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aspect of the femur ( 7 ). Spinopelvic parameters such as sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI) aid in classifying such positional changes ( Figs 1 and 2 ). Figure 1 Reduction of sacral slope (SS, blue lines) between the

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Emmanuelle Ferrero Service de chirurgie orthopédique, Hôpital européen Georges Pompidou, France, APHP, Université Paris V

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Pierre Guigui Service de chirurgie orthopédique, Hôpital européen Georges Pompidou, France, APHP, Université Paris V

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, sagittal facets). More recently, the role of sagittal alignment was highlighted: DS patients had on average higher pelvic incidence than asymptomatic subjects. 38 Based on these findings, one explanation of the physiopathology of DS might be that high

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George Grammatopoulos The Ottawa Hospital, Ottawa, Ontario, Canada

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Moritz Innmann Heidelberg University Hospital, Heidelberg, Germany

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Philippe Phan The Ottawa Hospital, Ottawa, Ontario, Canada

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Russell Bodner Midwest Orthopedic Institute, Sycamore, United States of America

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Geert Meermans Bravis Hospital, Roosendaal, The Netherlands

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bicoxofemoral axis to the midpoint of the sacral plate and the vertical ( 47 ). Pelvic incidence (PI) Pelvic incidence is defined as the angle between a line perpendicular to the sacral plate at its midpoint and a line connecting the same point to the

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Charles Rivière MSK Lab, Imperial College London, UK; South West London Elective Orthopaedic Center, UK

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Stefan Lazic South West London Elective Orthopaedic Center, UK

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Loïc Villet Centre de l’arthrose, Merignac, France

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Yann Wiart Unfallchirurgie, Theresienkrankenhauss Mannheim, Germany

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Sarah Muirhead Allwood London Hip Unit, UK

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Justin Cobb MSK Lab, Imperial College London, UK

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Comparison between a ‘hip’ and ‘spine’ user’s pelvic kinematics in standing (solid line) and sitting (dashed line). Note the differences in pelvic incidence (blue), sacral slope (green) and the sacro-femoral angle (orange). Fig. 4 Type 1 spine

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Charles Rivière MSK Lab, Imperial College London, UK
South West London Elective Orthopaedic Centre, UK

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Stefan Lazic South West London Elective Orthopaedic Centre, UK

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Louis Dagneaux CHU de Montpellier, France

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Catherine Van Der Straeten London Hip Unit, UK

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Justin Cobb MSK Lab, Imperial College London, UK

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Sarah Muirhead-Allwood London Hip Unit, UK

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spino-pelvic parameters: sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), lumbar lordosis (LL) and the C7 plumb line (C7pl) ( Fig. 1 ). 4 , 5 SS, PT and LL are ‘functional parameters’, as their value varies with body position; PI is a

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Alessandro Colombi Department of Orthopaedic Surgery, ASST Papa Giovanni XXIII, Bergamo, Italy

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Daniele Schena Department of Orthopaedic Surgery, ASST Papa Giovanni XXIII, Bergamo, Italy

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Claudio Carlo Castelli Department of Orthopaedic Surgery, ASST Papa Giovanni XXIII, Bergamo, Italy

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lumbo-pelvic complex and the hip joint. The main spino-pelvic parameters important to know are: sacral slope, pelvic tilt and pelvic incidence. Pelvic incidence is a morphological parameter (constant for an individual), sacral slope and pelvic tilt are

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Charles Court Department of Orthopedic Surgery and Traumatology, Spine and tumor Unit, Bicetre University Hospital, Assistance Publique Hôpitaux de Paris, Paris Saclay University, Le Kremlin-Bicêtre, France

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Leonard Chatelain Department of Orthopedic Surgery and Traumatology, Spine and tumor Unit, Bicetre University Hospital, Assistance Publique Hôpitaux de Paris, Paris Saclay University, Le Kremlin-Bicêtre, France

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Barthelemy Valteau Department of Orthopedic Surgery and Traumatology, Spine and tumor Unit, Bicetre University Hospital, Assistance Publique Hôpitaux de Paris, Paris Saclay University, Le Kremlin-Bicêtre, France

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Charlie Bouthors Department of Orthopedic Surgery and Traumatology, Spine and tumor Unit, Bicetre University Hospital, Assistance Publique Hôpitaux de Paris, Paris Saclay University, Le Kremlin-Bicêtre, France

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type 2. Conversely, an extension of the spine will lead to type 3. The SPD can change the shape of the sacrum and acetabulum, thereby altering the position of the acetabula within the pelvis and changing the pelvic incidence (cf. Fig. 3 ). Pelvic

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Kashif Ansari Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA

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Manjot Singh Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA

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Jake R McDermott Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
SUNY Downstate Medical School, New York City, New York, USA

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Jerzy A Gregorczyk Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA

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Mariah Balmaceno-Criss Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA

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Mohammad Daher Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA

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Christopher L McDonald Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA

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Bassel G Diebo Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA

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Alan H Daniels Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA

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changes in key sagittal parameters, including sagittal vertical axis, lumbar lordosis, pelvic incidence, pelvic tilt, and sacral slope. Table 1 Severity and treatment recommendations for AIS based on Cobb angle. Cobb angle magnitude

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