Lumbo-pelvino-azetabuläres Alignment – Grundlagen und klinische Konsequenzen

The spinal shape and the pelvic ante-/retroversion of an individual are determined by its innate, genetically fixed lumbosacral angulation. This can be measured with little effort in the lateral standing radiograph of the patient. In spinal surgery, there are a lot of original papers on the topic. In hip surgery, however, the individual pelvic version and its consequences for the acetabular orientation have not received the same attention so far. This review focuses on previous data on the relationship between lumbosacral angulation and pelvic ante-/retroversion. Four anatomically definable pelvic types can be distinguished; three of those have to be considered as facultatively pathogenetic. Clinical consequences arise for the clinical pictures of spondylolisthesis, non-specific lower back pain, acetabular retroversion and developmental dysplasia of the hip, as well as for acetabular cup positioning in total hip arthroplasty.