European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Significant progression of spinal deformity could occur during the peak of pubertal growth in adolescent idiopathic scoliosis (AIS). Gender differences in spinal and vertebral inclination have been reported in asymptomatic young adults and are thought to affect the risk of curve progression in male and female AIS. The present study aimed to investigate whether there were gender differences in the sagittal spinal-pelvic profile and whether any differences occurred before or developed during the normal pubertal growth spurt. ⋯ Although a trend toward a more backward inclination of the spine and individual vertebrae might pre-exist during the ascending phase or peak of pubertal growth, the differences become more significant during the late stage of puberty. The observation could be related to relatively active anterior vertebral overgrowth that occurs in females during pubertal growth.
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Lumbo-pelvic indexes appeared recently in the literature taking advantage from the relationship between pelvic incidence (PI) and lumbar lordosis (LL). Schwab proposed to subtract LL from PI (PI-LL) as Boissière proposed the lumbar lordosis index (LLI), which is the ratio between LL and PI (LL/PI). Both indexes have been described to weight LL by a constant parameter not affected by degenerative processes, the PI. The aim of this study is to evaluate these parameters in adult spinal deformity (ASD) by analyzing their relationship with spinal malalignment and vertebral osteotomies. ⋯ This study highlights the necessity to considerer spinal malalignment with lumbo-pelvic indexes as they appear to be highly correlated with lack of LL. They can be used as mathematical tools to detect spinal malalignment in ASD and guide the surgeon's decision of realizing a vertebral osteotomy for ASD sagittal correction. They can be used as well for the interpretation of clinical series in ASD.
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Women wearing high-heeled shoes have been considered to be more characterizing beauty, self-assurance and elegance. However, while maintaining the body on this type of support base, women with increased heel height often complain that wearing high-heeled shoes causes them to experience low back pain. The aim of the present study was to morphologically assess the effect of high-heel use on the static sagittal profile of the spino-pelvic structure. ⋯ The present study revealed that wearing high-heeled shoes can lead to increased LL and an uneconomic body position. This finding may help explain why some women complain that wearing high-heeled shoes causes them to experience low back pain.