Friederike Eva Roch, Fiona Kletschka, Katharina Jäckle, Hartmut Stinus, Wolfgang Lehmann, Ronny Perthel, Paul Jonathan Roch
Acta Orthopaedica et Traumatologica Turcica - 2025;59(6):379-386
Objective: This study aimed to investigate the relationship between spinopelvic parameters and radiographic foot axes and to examine whether these associations differ across age groups. Methods: This retrospective radiographic study analyzed imaging from patients treated at a university medical center for degenerative or traumatic conditions. Cases with weight-bearing, 2-view foot radiographs and standing lumbar spine radiographs, including the femoral heads, were included. Spinopelvic parameters (lumbar lordosis, pelvic tilt, sacral slope, and pelvic incidence) and radiographic foot axes (including hallux valgus angle, tibiotalar angle, and metatarsal declination angle) were measured, and correlation analyses were performed with age-based subgroup comparisons. Results: A total of 46 Caucasian patients (33 females, 13 males) were included (mean age 55.6 +/- 18.5 years). Lumbar lordosis showed a significant negative correlation with hallux valgus angle (r = -0.29, P = .015). Sacral slope was negatively correlated with the hallux valgus angle (r = -0.42, P < .001). Pelvic tilt correlated positively with tibiotalar angle (r = 0.34, P = .004) and metatarsal declination angle (r = 0.25, P = .042). Age-stratified analyses demonstrated age-related differences in correlation patterns. Conclusion: Spinopelvic alignment demonstrates measurable associations with radiographic foot alignment, supporting the concept of the spine-pelvis-lower-limb unit as a biomechanically integrated system. Clinically, these findings suggest that integrated, chain-oriented assessment and management strategies (considering both spinal and foot alignment, particularly with aging) may be relevant when evaluating patients with coexisting spine and foot disorders.
