New possibilities of postural spine radiography

Digital radiography has solved the central problem of patient’s radiation exposure. In addition, due to the high sensitivity of digital detector, the quality of the images obtained has significantly increased. The combination of the characteristics made it possible to obtain a single image of the entire spine as routine task. Spine radiographs are made with the patient in an upright position, so this investigation has called “postural radiography”. The value of these images lies in the fact that, in addition to morphological features, they display the position of each vertebra, spine part, and a spine as a whole. It is widely used for the purpose of prognosis of orthopedic surgical interventions. The method of spine radiograph system analysis allows to register the data on a single examination protocol.

The purpose of this work was to demonstrate the possibilities of postural radiography and system analysis of spinal radiographs to study the morphological features and vertebra positions of all spine parts simultaneously.

1. Schmorl Ch.G., Junghanns H. Die gesunde und kranke Wirbelsäule im Röntgenbild. Leipzig, 1932.

2. Schmorl Ch.G., Junghans H. Die gesunde und die kranke Wirbelsäule im Röntgenbild und Klinik. Stuttgart, 1957.

3. Junghas H. Die Wirbelsaule unter den Einflussen des taglischen Lebens, der Freireit, des Sports. Sturtgart: Hippokrates, 1986. 503 S.

4. Kosinskaya N.S. Degenerative and dystrophic lesions of the osteoarticular apparatus. Leningrad: Medgiz, 1961. 196 p. (In Russian)

5. Roussouly P., Gollogly S., Berthonnaud E., Dimnet J. Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position. Spine (Phila Pa 1976). 2005; 30: 346–353. https://doi.org/10.1097/01.brs.0000152379.54463.65

6. O’Brien M.F., Kuklo T.R., Blanke K.M. et al. Radiographic Measurement Manual of Spinal Deformity Study Group. Medtronic Sofamor Danek USA, Inc., 2008. 110 p.

7. Mac-Thiong J.M., Roussouly P., Berthonnaud E., Guigui P. Sagittal parameters of global spinal balance: normative values from a prospective cohort of seven hundred nine Caucasian asymptomatic adults. Spine (Phila Pa 1976). 2010; 35 (22): E1193–1198. https://doi.org/10.1097/BRS.0b013e3181e50808

8. Clément J.L., Solla F., Amorese V. et al. Lumbopelvic parameters can be used to predict thoracic kyphosis in adolescents. Eur. Spine J. 2020; 29: 2281–2286. https://doi.org/10.1007/s00586-020-06373-z

9. Bayat A., Pace D.F., Sekuboyina A. et al. Anatomy-Aware Inference of the 3D Standing Spine Posture from 2D Radiographs. Tomography. 2022; 8: 479–496. https://doi.org/10.3390/ tomography8010039

10. Charles Y.P., Bauduin E., Pesenti S. et al. Variation of Global Sagittal Alignment Parameters According to Gender, Pelvic Incidence, and Age. Clin. Spine Surg. 2022; 35: E610–E620. https://doi.org/10.1097/BSD.0000000000001321

11. Solla F., Ilharreborde B., Blondel B. et al.; French Spine Surgery Society (SFCR). Can Lumbopelvic Parameters Be Used to Predict Thoracic Kyphosis at all Ages? A National Cross-Sectional Study. Global Spine J. 2024; 14 (4): 1116–1124. https://doi.org/10.1177/21925682221134039

12. Orel A.M. System analysis of spine radiographs in the practice of manual medicine. Moscow: Vidar-M Publishing House, 2018. 432 p. (In Russian)

13. Frolov V.A., Nechaev V.I., Nechaev E.V., Ivanov V.V. Short leg syndrome in clinical practice. Russian Osteopathic Journal. 2024; 2: 113–130. https://doi.org/10.32885/2220-0975-2024-2-113-130 (In Russian)