Sagittal morphology of the spine and its predictive role in the pathogenesis of degenerative conditions. Historical aspects and contemporary views on the problem

Bipedalism in humans is linked to the need for constant horizontal gaze maintenance and an ergonomic vertical posture. These physiological characteristics of Homo sapiens are made possible by three reciprocal sagittal curvatures of the spine, the profile configuration of which, as studies have shown, exhibits considerable variability in the population of healthy individuals. The issue of systematizing the sagittal morphology of the spinopelvic complex, considering its constitutional ambiguity, has been a subject of increasing attention among researchers since the mid-1970s. The classification proposed by Roussouly in 2005 can be considered the quintessence of the accumulated global experience. In addition to systematizing the profile configuration of the spine, the author placed significant emphasis on the biomechanical specificity of its morphotypes and their predictive role in the pathogenesis of degenerative diseases. The problem of sagittal morphology variability and its morphotyping remains relevant to this day and is the subject of numerous scientific discussions. However, forming a comprehensive understanding of this issue is difficult due to the narrow focus of the conclusions and the lack of systematic works. The present review is analytical in nature and was conducted using medical scientific databases and search resources such as PubMed and eLibrary. The article explores the historical aspects of the formation of the concept of the spinopelvic complex morphotyping, as well as analyzes the predictive role of sagittal biomechanics of the spine in the pathogenesis of its degenerative condition.