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Review
. 2022 Mar 2:9:100108.
doi: 10.1016/j.xnsj.2022.100108. eCollection 2022 Mar.

The sitting vs standing spine

Christos Tsagkaris  1   2 , Jonas Widmer  1   2 , Florian Wanivenhaus  1 , Andrea Redaelli  3 , Claudio Lamartina  3 , Mazda Farshad  1
Affiliations
Review

The sitting vs standing spine

Christos Tsagkaris et al. N Am Spine Soc J. .

Abstract

Background: Planning of surgical procedures for spinal fusion is performed on standing radiographs, neglecting the fact that patients are mostly in the sitting position during daily life. The awareness about the differences in the standing and sitting configuration of the spine has increased during the last years. The purpose was to provide an overview of studies related to seated imaging for spinal fusion surgery, identify knowledge gaps and evaluate future research questions.

Methods: A literature search according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) extension for Scoping Reviews (PRISMASc) was performed to identify reports related to seated imaging for spinal deformity surgery. A summary of the finding is presented for healthy individuals as well as patients with a spinal disorder and/or surgery.

Results: The systematic search identified 30 original studies reporting on 1) the pre- and postoperative use of seated imaging of the spine (n=12), 2) seated imaging of the spine for non - surgical evaluation (n=7) and 3) seated imaging of the spine among healthy individuals (12). The summarized evidence illuminates that sitting leads to a straightening of the spine decreasing thoracic kyphosis (TK), lumbar lordosis (LL), the sacral slope (SS). Further, the postural change between standing and sitting is more significant on the lower segments of the spine. Also, the adjacent segment compensates the needed postural change of the lumbar spine while sitting with hyperkyphosis.

Conclusions: The spine has a different configuration in standing and sitting. This systematic review summarizes the current knowledge about such differences and reveals that there is minimal evidence about their consideration for surgical planning of spinal fusion surgery. Further, it identifies gaps in knowledge and areas of further research.

Keywords: EOS imaging; Seated imaging; Sitting radiographs; Spine surgery; Spine, spinal fusion; sedentary lifestyle.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper

Figures

Fig 1
Fig. 1
Literature search flow diagram.
Fig 2
Fig. 2
Graphical overview of spinal alignment in sitting and standing position.
Fig 3
Fig. 3
Graphical overview of spinal alignment in sitting and standing posture in patients undergone spinal fusion.
See this image and copyright information in PMC

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