Fundamentals of Spinal Alignment and Balance

Summary of Key Points

• The pelvis is the foundation of the spinal column and has a primary role in determining the alignment of the spinal column.

• Pelvic version is important as a compensatory mechanism between mobile lower extremities and the mobile spine.

• Alignment is a static radiographic measurement. Balance is distinct from alignment and captures the dynamic interplay between alignment and the functional harmony of the three-dimensional motion of the body in space.

• The chain of correlation between the pelvis and spinal regions is important to understand in surgical planning for procedures that realign regions of the spine.

• A three-dimensional representation of the spine using a view from the top can be useful in representing spinal alignment and setting realignment goals.