SagittalMeter Pro vs SagittalBalanceApp Usage & Stats

SagittalMeter is an educative app to easily measure sagittal balance parameters, by directly placing your phone on the sagittal X-Rays. The sagittal balance is an imperative factor to take into consideration for all practitioners treating spine problems and particularly for surgeons during the pre-operative phase. The compensatory mechanisms of a sagittal unbalanced spine may prevent a successful surgery outcome. A fundamental understanding of a correct sagittal alignment is strongly recommended in determining the correct use of fusion or non fusion devices. SagittalMeter enables you to measure 3 fundamental angles which are essential to analyze sagittal alignment (for pre, per and post-operative phases): • Pelvic incidence (PI) • Pelvic tilt (PT) • Sacral slope (SS) Values of lumbar lordosis are also important parameters to describe sagittal balance, so with SagittalMeter you can measure both: • L1-S1 lordosis • L4-S1 lordosis You can do a complete sagittal balance analysis by using advanced mode which extends the previous values with the following measures: • Occipito-C2 angle • Spino-sacral angle (SSA), angle between line from C7/T1 center to S1 plateau center and surface of S1 plateau • C7/T1 slope • C7-C2 angle • Spino-cranial angle (CIA), angle between line from C2 Dens to C7/T1 center and surface of C7/T1 endplate What does it mean? If a patient appears to have sagittal imbalance, this needs to be taken into consideration in the pre-operative planning. Any surgical treatment option should aim at the re-establishment of an ‘economic’ posture, achieved with the restoration of the patient specific sagittal balance. Remembering all theoretical normal values is very important but is definitively not easy and can even be impossible. SagittalMeter gives you the possibility to measure all the parameters in a quick way and gives you the average theoretical normal values for an equivalent asymptomatic healthy patient. How much correction do I need to restore a good balance in daily practice? Before any kind of lumbar fusion including the segment L4 to S1 it is mandatory to analyse the spine balance. If the PT or the lumbar lordosis are not correlated with the value of the PI, an approximation of the amount of correction requested can be evaluated with the FBI technique: C7 translation angle + Femur obliquity angle + PT compensation angle. SagittalMeter enables you to evaluate the FBI index value to get an average correction value.

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SagittalBalanceApp

The assessment of global sagittal alignment and the compensatory mechanisms which are implicated in the spine and the spinopelvic jucture are of paramount importance for spine and joint replacement surgeon. The dynamic interplay between flexibility and balance around the axis of gravity determine the type and the amount of influence in spine and hips. Radiographic parameters to evaluate objectively the sagittal balance are Pelvic incidence (PI), Sacral slope (SS), Pelvic Tilt (PT), Lumbar lordosis (LL),Thoracic Kyphosis, C7 plumb line (C7PL) and its ratio. Drawings in patients X-rays and precise measurements are important in order to quantify the magnitude of spinal deformities, to monitor the success or failure of treatment and thus optimise the management of patients according to the severity of the imbalance. The Sagittal Balance App is medical software aimed for orthopaedic surgeons, providing tools that allow doctors to: -Securely import medical images directly from the camera or stored photos. -By marking several points at the image of X-ray, the App calculates and offers a very convenient way to determine the most accurate possibly way at once, Pelvic incidence (PI), Sacral slope (SS), Pelvic Tilt (PT), Lumbar lordosis (LL), thoracic kyphosis, C7 plumb line (C7PL), C7PLD/sfd ratio, PI–LL, theoretical normal pelvic tilt (tPT),theoretical normal L1-S1 lumbar lordosis (tL1S1), Spino-sacral angle (SSA) According to measured parameters the app categorizes the severity of the imbalance of spine, in three different stages: optimal balanced, balanced with compensatory mechanisms and imbalanced. -Save the planned images, for later review or consultation.The measured values are compared by normal reference databases and also data are exported as txt file, ready to print or to input as cells to excel for research. -The app also allows the calculations of centroids after choosing points in vertebra body in independent manner from order. All information received from the software output must be clinically reviewed regarding its plausibility before patient treatment! Sagittal Balance App indicated for assisting healthcare professionals. Clinical judgment and experience are required to properly use the software. The software is not for primary image interpretation. In a busy everyday practice, the examiner have to draw lines in X-rays or in clinical settings, this it is time consuming and cumbersome. Accessory instruments like protractors, hinged goniometers, well sharped pencils, rulers or even transparent papers must be available. The app offers a very convenient and accurate way to perform most common radiographic measurements for spine, and spinopelvic juncture in a blink of an eye in front of your screen. The build in feature of the app, allows results to be categorized may help decide what could be considered normal or pathologic. The app is not a simple goniometer, is an enhanced product which helps to monitor objectively the course of the treatment and evaluate optimally the spine. This App is particular useful especially in clinical settings where you need a quick results without losing time. Please see tutorial videos at the developer’s web site www.orthopractis.com Reference databases 1.Legaye J, Duval-Beaupe`re G, Hecquet J, Marty C (1998) Pelvic incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves. Eur Spine J 7(2):99–103 2. Cavanilles-Walker JM, Ballestero C, Iborra M, Ubierna MT, Tomasi SO (2014). "Adult Spinal Deformity: Sagittal Imbalance". International Journal of Orthopaedics.