Purpose
Recently, there is concern for spinal sagittal alignment associated with back pain. Nowadays many women wear high heels or high-heeled shoes for their beauty. We study change of spinal sagittal alignment when women are wearing high heels.
Materials and Methods
We raised 15 female adult volunteers to accept our study. They do not have past history, operation history and especially back pain. We applied X-rays for anteroposterior and lateral whole spine radiography when women were bare foot (Group I). In addition, we applied each X-rays when women were wearing 5 cm high heels (Group II) and 12 cm high heels (Group III). We estimate the spinal sagittal alignment distinguishing pelvic index from spinal index. We use ANOVA test of SPSS v18.0 statistically.
Results
The average age of women was 29.3(23-41) years old, and mean BMI (Body Mass Index) was 18.7(16.2-24.5) kg/m 2 . When volunteers were bare foot, the average pelvic incidence (PI) was 49.3 degree, pelvic tilt (PT) was 10.8 degree, and sacral slope (SS) was 37.9 degree. The each average of lumbar lordosis (LL), thoracic kyphosis (TK), T12 slope, and sagittal vertical line on middle point of C7 (C7 SVA) and T12 (T12 SVA) was 55.5 degree, 28.5 degree, 19.3 degree, -1.2 cm, and -3.8 cm. When women were wearing 5 Cm high heels, the average was each 49.2 degree, 18.9 degree, 35.4 degree, 54.9 degree, 29.1 degree, 20.5 degree, -2.0 cm, -2.5 cm. When women were wearing 12 cm high heels, the average was each 49.9 degree, 18.2 degree, 31.2 degree, 52.6 degree, 30.8 degree, 22.8 degree, -4.1 Cm, -4.1 cm. Compared with each group, sacral slope (SS) and vertical line on middle point of C7 was statistically significant in group III (p<0.05). There was no statistically correlation between group I and group II.
Conclusion
Spinal sagittal alignment can be changed if adult women wear high heels excessively. For maintaining of normal spinal sagittal alignment, We conclude adult women wearing high heels for a long time pay attention to change of their spinal sagittal alignment.

Background
Cervical kyphosis is frequently observed in the patients without axial neck pain and sigmoid curvatures are parts of the variety of cervical kyphosis. Purpose: This study was designed to investigate the characteristics of the static and dynamic alignment of the cervical spine with sigmoid configurations.
Methods
Figty patients without changes of the cervical curvatures after subsidence of axial neck pain were enrolled in this study. Based on the alignment of cervical spine on lateral radiographs, cervical alignments were classified: kyphotic (K), kypho-lordotic (KL), lordo-kyphotic (LK), and Lordotic (L) group. The sagittal alignment angles and each segmental angle were measured using the Harrison method on neutral, flexion, and extension-lateral radiographs.
Results
The mean ratio of segmental ROM to C2-7 ROM revealed a similar pattern across the cervical levels without statistical difference between the groups. In the KL and LK group, the linear graphs for the mean ratio of segmental angles to C2-7 angles in flexion and extension showed a mirror image with respect to the C4-5 level. The lordotic components of both curves demonstrated larger ratio of segmental angles in flexion than the kyphotic components. The kyphotic components of both curves demonstrated larger ratio of segmental angles in extension than the lordotic components.
Conclusions
The lordotic and kyphotic components regardless of the type of sigmoid curvatures seem to adhere to constant dynamic behavior during flexion and extension. Therefore, the KL and LK cervical alignments may have the opposite dynamic behaviors in the high and low cervical levels.