[Biomechanical aspects of preoperative planning: What is really important?] / Biomechanische Aspekte der präoperativen Planung: Was ist wirklich wichtig?

ABSTRACT

BACKGROUND: Sagittal balance is dependent on a complex interplay of the spinal curves, shape and setting of the pelvis, but also the position of the joints of the lower limb. Degenerative processes such as stiffening of the spine, aging of musculature, or reduction of the range of motion of the joints lead to imbalance of the spine after all compensatory mechanisms have been exhausted. OBJECTIVES: Based on standardized imaging, compensation mechanisms must be identified within a biomechanical analysis of the spine, the original sagittal spine profile anticipated and included in the planning of the corrective intervention. RESULTS: This review presents the most important global and spinopelvic parameters for the biomechanical analysis of the spine. In addition, normal variations of the sagittal alignment are discussed, compensation mechanisms are shown, and the planning of the rebalancing of the sagittal alignment is shown according to the full balance integrated model.