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Thread: sagital imbalance?

  1. #1
    Join Date
    May 2008
    Location
    long island, ny
    Posts
    233

    sagital imbalance?

    Have not posted in a while (always look in though to see how everyone is doing), all is fine except my posture, it seems to me that my hips are pushing forward when I stand, making my belly look pregnant, I'm about 5'51/2" tall and weigh about 132lbs. I look like a skinny (old) preganant woman. Also my neck with I am experiencing pain is also jutting forward. I tried to understand what sagital imbalance is from the posts on this forum and on line.
    I have an appointment with a recommended physical therapist on Tuesday coming, this therapist I'm told is all about posture. When I see him I will ask his opinion also. So I guess my question is, could my changing posture have anything to do with sagittal imbalance? thanks, hope everyone is doing well!
    Dolores A
    June 4, 2009 Anterior L3 - S1
    June 8, 2009 Posterior T4 - Pelvis
    Mark Agulnick, MD FAAOS
    NY Spine & Scoliosis Center

  2. #2
    Join Date
    Sep 2004
    Location
    New York City
    Posts
    18

    Sagittal imbalance

    Hi -- I had surgery last December, and also notice, now, that my head juts forward. It was probably that way before but I am very conscious of it now. I try to consciously push my head back, but it seems very unnatural. When I sleep on my back, I sleep without a pillow, thinking that might help, but really don't know. If you find your therapist helpful with the posture issue, I would appreciate his information, as I am in the NYC area (I assume you are also). Thanks very much.

  3. #3
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    May 2008
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    long island, ny
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    Hi Susan, thanks for your input, I will post after my appt. with therapist what comes of the consult, not sure yet if I should notify my surgeon of what is happening. What levels are you fused?
    Dolores A
    June 4, 2009 Anterior L3 - S1
    June 8, 2009 Posterior T4 - Pelvis
    Mark Agulnick, MD FAAOS
    NY Spine & Scoliosis Center

  4. #4
    Join Date
    Sep 2004
    Location
    New York City
    Posts
    18

    Sagittal imbalance

    Hi Dolores -- I am fused from T3 down to the sacrum, with pelvic anchors. Had a really severe curve (double major, both over 90 degrees) but never had any pain or problems associated with the curves, just I was getting shorter and the curves were increasing; so I was corrected to approximately 60/50 degrees, so still crooked but much better than before. I next see my surgeon (Dr. Boachie) in November, but when I asked previously about the posture issue, he said just to make an effort to hold my head high, but nothing about seeing a therapist. I will ask him next visit, but in meantime, if I could find a posture therapist, I think that would be of tremendous help. So if you find yours to be helpful, I would appreciate your input about him. Thanks so much! Hope your visit goes well.

  5. #5
    Join Date
    May 2012
    Location
    Columbia, SC
    Posts
    75
    I am fused from T4 to sacrum and had my surgery by Dr. Lenke about 10 weeks ago. I have had a very good recovery so far. I saw him in St. Louis on Sept. 19 and told him that my neck was jutting forward somewhat and that I couldn't tilt my head back at all to put drops in my eyes. (I have to lie down in bed now to do this.) He looked at my before and after surgery x-rays and said that my neck looked the same. It is not. I also can't tilt my head back to drink the last part of water, etc. in a glass. All of this is small stuff since I am now free of lumbar pain and have a straight spine but it does bother me somewhat as he did not seem to have an answer for it or a remedy.
    Jane

  6. #6
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    Sep 2003
    Location
    Northern California
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    Sagittal imbalance simply means that your spine is not balanced in the front/back plane. THIS article explains it in fairly simple language.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

  7. #7
    Join Date
    Oct 2008
    Location
    Sunshine Coast, Queensland, Australia
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    3,263
    Sagittal imbalance was one of the problems I was most concerned about, that and infection. Dolores, do you know if you had osteotomies? I had some but never found out how many and have a decent curve in my lower back, similar to what I had as a teenager. So far no problems. How does your lower back look - is there plenty of lordosis? I might be on the wrong track but think s.i. has to do with your lordosis? Someone more knowledgeable maybe able to correct me on that.

    Hoping the therapist can help you Dolores. Please let us know.
    Surgery March 3, 2009 at almost 58, now 63.
    Dr. Askin, Brisbane, Australia
    T4-Pelvis, Posterior only
    Osteotomies and Laminectomies
    Was 68 degrees, now 22 and pain free

  8. #8
    Join Date
    May 2010
    Location
    Indianapolis area
    Posts
    966
    Jane,

    My neck was pretty stiff at first, but it has gotten much better as the months have gone by. I used to be unable to tolerate a pillow, for instance. But now I can use one if I want. I think you will see an improvement in your range of motion over time, as long as you're not fused too high up.

    Evelyn
    age 44
    80* thoracolumbar; 40* thoracic
    Reduced to ~16* thoracolumbar; ~0* thoracic
    Surgery 3/14/12 with Dr. Lenke, T4 to S1 with pelvic fixation
    Not "confused" anymore, but don't know how to change my username.

  9. #9
    Join Date
    Jan 2012
    Location
    Yacolt, WA
    Posts
    1,577

    Which way does a positiv or neg saggital or coronal imbalance lean?

    Thanks Linda for the great resources.

    Which way does a positive sagiital imbalance and a negative saggital imbalance lean? Same question for coronal imbalance?

    Does zero sagittal and coronal imbalance means "normal or non-scoliotic" [I would assume since the word IMBALANCE is used]?

    Thanks
    Susan
    Adult Onset Degenerative Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Severe disc degen T & L stenosis

    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal Spinal Cord Injury T4,5 sec to PJK
    2015: Revision Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
    2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone
    2018: Removal L4,5 screw

  10. #10
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    7,006
    Quote Originally Posted by susancook View Post
    Thanks Linda for the great resources.

    Which way does a positive sagiital imbalance and a negative saggital imbalance lean? Same question for coronal imbalance?

    Does zero sagittal and coronal imbalance means "normal or non-scoliotic" [I would assume since the word IMBALANCE is used]?

    Thanks
    Susan
    Positive sagittal balance is leaning forward. There's no difference in the designation for coronal balance; it can be either right or left. Zero coronal and sagittal balance is the norm.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

  11. #11
    Join Date
    Jan 2012
    Location
    Yacolt, WA
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    1,577
    Quote Originally Posted by LindaRacine View Post
    Positive sagittal balance is leaning forward. There's no difference in the designation for coronal balance; it can be either right or left. Zero coronal and sagittal balance is the norm.
    Thanks, Linda! You are such a wealth of knowledge! I am still learning the scoliosis language. Susan
    Adult Onset Degenerative Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Severe disc degen T & L stenosis

    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal Spinal Cord Injury T4,5 sec to PJK
    2015: Revision Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
    2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone
    2018: Removal L4,5 screw

  12. #12
    Join Date
    May 2008
    Location
    Central NJ
    Posts
    1,956
    I'm sorry you're having problem Dolores. Have you had this issue since your surgery or is it new? Are you having any pain with this problem? ((Hugs))
    __________________________________________
    Debbe - 50 yrs old

    Milwalkee Brace 1976 - 79
    Told by Dr. my curve would never progress

    Surgery 10/15/08 in NYC by Dr. Michael Neuwirth
    Pre-Surgury Thorasic: 66 degrees
    Pre-Surgery Lumbar: 66 degrees

    Post-Surgery Thorasic: 34 degrees
    Post-Surgery Lumbar: 22 degrees

  13. #13
    Join Date
    Dec 2008
    Location
    illinois
    Posts
    821

    Please help

    Hi to all,
    I have read the article on sagital imbalance--I feel I may have a problem with it. I have a 16 level spine fusion,done in last year and a half. and 3 level cervical.All summer I have had a harder time walking and have found myself leaning rt and shiffting my hips out and locking my knees. It is tiring to say the least. I fell several times now, and I am back at Pt. The Pt has found right leg shorter and is working on muscles to help that. Thus I am falling right. I do not see the Dr until Dec. I am beginning to think it is a balance issue,and I tried to explain to Pt. I know the people here understand much more about this then even he does. We do deal with things like this all of the time. My question is should I bring this to Dr before Dec, as I will lose my insurance in Feb. Very scary!Please let me know what you think.

  14. #14
    Join Date
    May 2009
    Posts
    3,745
    hi jackie
    i absolutely think you should get in to see your doctor
    before December...why wait...???? will your insurance
    cover it...? if so, again...why wait...??
    what if you need tx...and it cannot be completed by
    February...? why not get a jump on it now...

    hope you feel better....
    jess

  15. #15
    Join Date
    Oct 2008
    Location
    Sunshine Coast, Queensland, Australia
    Posts
    3,263
    I agree with Jess. It may not be what you're thinking, but it may. Ring today for an appt and get the ball rolling. The urgency is mainly because of your insurance situation. Good luck!
    Surgery March 3, 2009 at almost 58, now 63.
    Dr. Askin, Brisbane, Australia
    T4-Pelvis, Posterior only
    Osteotomies and Laminectomies
    Was 68 degrees, now 22 and pain free

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