Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry · 2025
Sacral Slope as an Early Marker of Postural Change in Postmenopausal Women with Low Bone Mass.
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Ata Benil Nesli, Cinar Ece
Аннотация
OBJECTIVES: To assess the relationship between bone mineral density (BMD) and sagittal spinopelvic alignment in postmenopausal women with low bone mass.
METHODS: Ninety-two postmenopausal women diagnosed with osteopenia or osteoporosis based on DEXA T-scores were retrospectively analyzed. Spinopelvic parameters-sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), and lumbar lordosis (LL)-were measured using lateral radiographs. Clinical and demographic variables were compared between groups using appropriate statistical methods.
RESULTS: Among all parameters, only SS showed a statistically significant difference between osteoporotic and osteopenic women (p = 0.037). No significant correlations were found between BMD and parity, menopause age, or vitamin D levels. Osteoporotic women had lower SS values. Other spinopelvic and demographic parameters did not differ significantly between groups.
CONCLUSION: Alterations in SS may represent early postural and biomechanical adaptations to declining bone strength in postmenopausal women. As a determinant of sagittal alignment, SS influences pelvic orientation and lumbar curvature. Its reduction may signal a forward shift in the center of gravity, increasing fall risk. Incorporating SS evaluation into standard imaging may aid early identification of at-risk individuals. Prospective studies are needed to confirm its clinical relevance and predictive value for fractures and functional decline.
METHODS: Ninety-two postmenopausal women diagnosed with osteopenia or osteoporosis based on DEXA T-scores were retrospectively analyzed. Spinopelvic parameters-sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), and lumbar lordosis (LL)-were measured using lateral radiographs. Clinical and demographic variables were compared between groups using appropriate statistical methods.
RESULTS: Among all parameters, only SS showed a statistically significant difference between osteoporotic and osteopenic women (p = 0.037). No significant correlations were found between BMD and parity, menopause age, or vitamin D levels. Osteoporotic women had lower SS values. Other spinopelvic and demographic parameters did not differ significantly between groups.
CONCLUSION: Alterations in SS may represent early postural and biomechanical adaptations to declining bone strength in postmenopausal women. As a determinant of sagittal alignment, SS influences pelvic orientation and lumbar curvature. Its reduction may signal a forward shift in the center of gravity, increasing fall risk. Incorporating SS evaluation into standard imaging may aid early identification of at-risk individuals. Prospective studies are needed to confirm its clinical relevance and predictive value for fractures and functional decline.