Radiographic Assessment of Sagittal Spinopelvic Alignment and Coccygeal Morphology and Mobility in Sitting and Standing Positions in Coccydynia

Radiographic Assessment of Sagittal Spinopelvic Alignment and Coccygeal Morphology and Mobility in Sitting and Standing Positions in Coccydynia | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Radiographic Assessment of Sagittal Spinopelvic Alignment and Coccygeal Morphology and Mobility in Sitting and Standing Positions in Coccydynia Aslinur Keles, Nurullah Yucel, Esra Giray, Ozge Gulsum Illeez, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8064384/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Purpose Coccygeal morphology has been described in coccydynia, but dynamic assessments have been limited to standing or supine positions. As coccydynia is posture-related and aggravated by sitting, evaluating functional postures is essential but lacking. Not all individuals with similar morphology or risk factors develop symptoms, suggesting that posture-dependent biomechanical differences may contribute to pain. The coccyx participates in spinopelvic motion during sitting, and alterations in this dynamic alignment may influence symptom onset. Therefore, this study aimed to investigate posture-dependent changes in spinopelvic and coccygeal parameters among different coccygeal morphologic types and to explore their potential association with coccydynia. Methods Lateral radiographs were obtained in standing and sitting positions for 50 patients with coccydynia. Spinopelvic (thoracic kyphosis [TK], thoracolumbar kyphosis [TLK], lumbar lordosis [LL], thoracopelvic angle [TPA-T1PA], anterior pelvic plane angle [APPA], sagittal vertical axis [SVA], sacral slope [SS], pelvic incidence [PI], pelvic tilt [PT], spinosacral angle [SSA], and sacral kyphosis [SK]) and coccygeal (sacrococcygeal [SCA] and intercoccygeal [ICA] angles, coccygeal [CH], sacral [SH], and sacrococcygeal height [SCH]) parameters were measured and compared. Coccygeal morphology (segments, fusion, mobility) was evaluated and classified using the modified Postacchini-Massobrio system. Logistic regression identified predictors of pain, and analyses by morphology and low back pain (LBP) status examined associations with posture-related adaptability. Results Significant postural changes were observed in spinopelvic (TK, TLK, LL, TPA-T1PA, SVA, APPA, SS, PT, SSA) and coccygeal (SCA, CH) parameters (p < 0.05). Logistic regression identified ICA, TLK, and APPA as pain predictors: ICA increased odds by 9% (p = 0.028), TLK reduced odds by 13% (p = 0.038), and APPA increased odds by 19% (p = 0.002). Types 1 and 2 showed the greatest postural variability, while Types 4 and 5 were more rigid. SK showed a significant interaction with LBP (p = 0.04, η²=0.01), and ICA was associated with morphological type (p = 0.01, η²=0.05). Conclusion Sitting posture significantly alters sagittal spinopelvic alignment in coccydynia. Coccygeal morphology and mobility appear to influence these postural adaptations and pain severity. Patients with coccydynia demonstrated significant changes in spinopelvic parameters, particularly LL, SS, PT, and SVA, with ICA emerging as a morphology-related marker. Dynamic assessment in functional postures, particularly sitting, may provide valuable insights for diagnosis and rehabilitation planning in patients with coccydynia. coccyx coccydynia low back pain mobility morphology morphometry sagittal alignment sitting standing spinopelvic parameters Figures Figure 1 Figure 2 Figure 3 Figure 4 Introduction Prolonged sitting, characteristic of modern sedentary lifestyles, induces substantial changes in spinopelvic alignment and has been strongly associated with low back pain (LBP) and other musculoskeletal disorders. Transitioning from a standing to a sitting position leads to pelvic retroversion and reduced lumbar lordosis, with compensatory mechanisms maintaining sagittal balance.[ 1 ] The dynamic evaluation of spinopelvic parameters in both standing and sitting positions has therefore gained attention for documenting normal alignment and optimizing treatment strategies.[ 2 ] Although these posture-dependent changes have been extensively studied in spinal deformities and degenerative conditions, their relevance to coccydynia remains unclear.[ 3 ] Coccydynia is influenced by trauma, prolonged sitting, and the coccygeal morphology and morphometry. Pathoanatomical factors, such as segment number, angulation, fusion, and spicule, contribute to symptoms, and assessing coccygeal movement provides additional diagnostic value.[ 4 , 5 ] Although symptoms are typically provoked by sitting, only a minority of individuals with similar risk factors develop significant pain, underscoring the multifactorial nature of this condition. The epidemiology of coccydynia also remains poorly defined, and imaging studies have primarily relied on static evaluations, including standing or sitting radiographs and supine computed tomography or magnetic resonance imaging (MRI).[ 5 , 6 ] Since sagittal pelvic orientation is central to posture and load transfer within the lumbosacral region, parameters describing spinopelvic alignment may also influence coccygeal biomechanics. However, only one study has analyzed pelvic parameters in coccydynia, assessing their prognostic value from standing radiographs.[ 7 ] The dynamic relationship between the coccyx and spinopelvic alignment during functional postures such as sitting and standing remains unexplored, and its contribution to pain generation is unclear. This study aims to address these gaps by investigating posture-dependent changes in spinopelvic and coccygeal parameters in coccydynia. The objectives were to: (1) quantify sagittal spinopelvic and coccygeal parameter changes between standing and sitting positions; (2) analyze positional differences according to coccygeal morphologic types and the presence of LBP; and (3) identify radiographic predictors of coccygeal pain severity. It was hypothesized that posture-dependent alterations in spinopelvic parameters and coccygeal morphology would be interrelated, and reduced adaptability during sitting would be associated with greater pain intensity. Material and Methods Study Design This cross-sectional study was approved by the Institutional Research Ethics Committee (XX) and registered in the clinicaltrials.gov system. (Registration number: XX). The study adhered to the STROBE guidelines, and informed consent was obtained from all participants for their voluntary participation and the publication of their data. Participants Between August 2024 and January 2025, patients aged 25–65 years who were clinically diagnosed with coccydynia at our physical medicine and rehabilitation outpatient clinic were consecutively enrolled. Exclusion criteria included spinal disorders causing alignment abnormalities, hip or knee conditions affecting spinal alignment, and a history of surgery involving the cervical, thoracic, lumbar, or coccygeal spine. A total of 60 patients were screened; 10 were excluded due to inadequate radiographs for measurements, resulting in 50 participants included in the final analysis. For further analyses, patients were grouped by the presence of LBP and pain severity of coccyx (Numeric Rating Scale [NRS] < 6 vs. ≥ 6). Radiological Assessment Sagittal analysis was performed using lateral radiographs in standing and sitting positions, extending from C7 to the femoral heads to ensure complete visualization of the coccyx, with patients seated in a relaxed, habitual posture ( Fig. 1 ) . Dynamic coccygeal evaluation included standing images obtained after patients refrained from sitting for 5–10 minutes, followed by sitting radiographs taken as they leaned backward to reproduce their typical pain-provoking posture ( Fig. 2 ) . Scans were analyzed using a Picture Archiving and Communication System (PACS) by an experienced radiologist. Spinopelvic Morphometric Parameters The evaluated parameters included thoracic kyphosis (TK), thoracolumbar kyphosis (TLK), lumbar lordosis (LL), thoracopelvic angle and its modification (TPA-T1PA), anterior pelvic plane angle (APPA), sagittal vertical axis (SVA), sacral slope (SS), pelvic incidence (PI), pelvic tilt (PT), spinosacral angle (SSA), and sacral kyphosis (SK) ( Fig. 3 ) . Coccygeal Morphology, Morphometry, and Mobility Coccygeal features were evaluated based on vertebral segment number, sacrococcygeal and intercoccygeal joint fusion, and mobility status. Morphological types were classified according to the Modified Postacchini–Massobrio (MPM) system.[ 8 ] The presence of coccygeal spicules was recorded. Morphometric assessments included the sacrococcygeal (SCA) and intercoccygeal (ICA) angles, as well as coccygeal (CH), sacral (SH), and sacrococcygeal heights (SCH) ( Fig. 4 ) . Mobility was assessed by measuring the angular displacement between standing and sitting radiographs. It was classified as normal, hypermobile, hypomobile, or posterior luxation based on the flexion-extension response and translation under load.[ 9 ] Statistical Analysis The sample size was estimated based on Misir et al.[ 10 ], from which the effect size (Cohen’s dz) was calculated as 0.92. With a significance level (α) of 0.05 and a desired power (1-β) of 0.95, the minimum required sample size was 18. To improve the generalizability of the results, better represent inter-individual variability, and account for possible data loss, a total of 25 patients (50 radiographs in sitting and standing positions) were planned for inclusion. Statistical analyses were performed using SPSS version 25.0 (IBM Corp., Armonk, NY, USA). Descriptive statistics are presented as means with standard deviations for continuous variables and as frequencies for categorical variables. The normality of continuous data distributions was tested with the Shapiro-Wilk test. Depending on the distribution, paired t-tests or Wilcoxon signed-rank tests were applied to compare morphometric measurements between standing and sitting positions. Repeated-measures ANOVA was employed to examine group effects on these positional changes. Independent-samples t-tests or Mann-Whitney U tests were used to compare morphometric parameter differences between subgroups. Additionally, stepwise logistic regression analysis was performed to identify parameters associated with pain status (NRS ≥ 6). Model fit was assessed using standard indices, and odds ratios (OR) with 95% confidence intervals (CI) were reported. A p-value < 0.05 was considered statistically significant. Results Fifty patients (42 females, eight males; mean age 47.0 ± 9.9 years, mean body mass index [BMI] 27.2 ± 4.7 kg/m²) were included. The mean symptom duration was 29.8 ± 55.6 months, and the average daily sitting time was 5.5 ± 2.5 hours, with 34% of patients classified as prolonged sitters (> 6 hours/day). Trauma history was reported by 60% of the patients, vaginal delivery by 62% of the female patients, and LBP by 50% of the participants. Coccygeal Parameters The most frequent coccygeal vertebral count was four segments (52%), followed by three (44%) and five (4%) segments, with no significant sex-based difference (p = 0.381). Fusion at the sacrococcygeal joint and any level of the intercoccygeal joints was identified in 36% and 38% of cases, respectively, without significant associations to sex or morphology (p > 0.05). Spicules were found in 18% of patients, most often in Type 5 (66.7%), although not statistically significant (p = 0.087) ( Table 1 ) . Table 1 Distribution of Coccygeal Vertebral Number, Joint Fusion, and Spicule Presence According to Gender and Modified Postacchini–Massobrio Classification Female n (%) Male n (%) Total n (%) p Type 1 Type 2 Type 3 Type 4 Type 5 p Coccyx vertebra number 3 19 (%45.2) 3 (%37.5) 22 (%44) 0.381 12 (%54.5) 7 (%38.9) 0 (%0) 1 (%33.3) 2 (%66.7) 0.536 4 22 (%52.4) 4 (%50) 26 (%52) 9 (%40.9) 10 (%55.6) 4 (%100) 2 (%66.7) 1 (%33.3) 5 1 (%2.4) 1 (%12.5) 2 (%4) 1 (%4.5) 1 (%5.6) 0 (%0) 0 (%0) 0 (%0) Sacrococcygeal joint fusion No 27 (%64.3) 5 (%62.5) 32 (%64) 0.923 14 (%63.6) 12 (%66.7) 3 (%75) 2 (%66.7) 1 (%33.3) 0.900 Yes 15 (%35.7) 3 (%37.5) 18 (%36) 8 (%36.4) 6 (%33.3) 1 (%25) 1 (%33.3) 2 (%66.7) Intercoccygeal joint fusion No 25 (%59.5) 6 (%75) 31 (%62) 0.693 14 (%63.6) 11 (%61.1) 3 (%75) 1 (%33.3) 2 (%66.7) 0.903 Yes 17 (%40.5) 2 (%25) 19 (%38) 8 (%36.4) 7 (%38.9) 1 (%25) 2 (%66.7) 1 (%33.3) Spicule No 34 (%81) 7 (%87.5) 41 (%82) 0.659 17 (%77.3) 17 (%94.4) 3 (%75) 3 (%100) 1 (%33.3) 0.087 Yes 8 (%19) 1 (%12.5) 9 (%18) 5 (%22.7) 1 (%5.6) 1 (%25) 0 (%0) 2 (%66.7) Fischer Exact Test: p < 0.05 According to the MPM classification, the most frequent coccygeal morphologies were Type 1 (44%) and Type 2 (36%). Normomobility was the predominant mobility pattern (56%), particularly in Type 1 (59.1%) and Type 2 (66.7%). Hypomobility was most common in Type 5 (66.7%), while posterior luxation predominated in Type 4 (66.7%). No significant association was found between morphology and mobility (p = 0.125) ( Table 2 ). Table 2 Distribution of Coccygeal Morphological Types According to Mobility Patterns Normobility Hypermobility Hypomobility Posterior luxation Total p Type 1 Within Type 13 (%59.1) 2 (%9.1) 3 (%13.6) 4 (%18.2) 22 (%44) 0.125 Within Mobility 13 (%46.4) 2 (%33.3) 3 (%42.9) 4 (%44.4) Type2 Within Type 12 (%66.7) 2 (%11.1) 2 (%11.1) 2 (%11.1) 18 (%36) Within Mobility 12 (%42.9) 2 (%33.3) 2 (%28.6) 2 (%22.2) Type 3 Within Type 2 (%50) 2 (%50) 0 (%0.0) 0 (%0.0) 4 (%8) Within Mobility 2 (%7.1) 2 (%33.3) 0 (%0.0) 0 (%0.0) Type 4 Within Type 1 (%33.3) 0 (%0.0) 0 (%0.0) 2 (%66.7) 3 (%6) Within Mobility 1 (%3.6) 0 (%0.0) 0 (%0.0) 2 (%22.2) Type 5 Within Type 0 (%0.0) 0 (%0.0) 2 (%66.7) 1 (%33.3) 3 (%6) Within Mobility 0 (%0.0) 0 (%0.0) 2 (%28.6) 1 (%11.1) Total 28 (%56) 6 (%12) 7 (%14) 9 (%18) 50 (%100) Sagittal Alignment Parameters As shown in Table 3 , significant postural changes were observed in several spinopelvic (TK, TLK, LL, TPA–T1PA, SVA, APPA, SS, PT, SSA) and coccygeal parameters (SCA, CH) between standing and sitting (p < 0.05). Among spinopelvic parameters, only SK demonstrated a significant interaction with the presence of LBP (p = 0.04, η² = 0.01), while no significant intergroup differences were found across morphological types. For coccygeal parameters, ICA demonstrated a significant association with morphological type (p = 0.01, η² = 0.05). Table 3 Postural Changes in Spinopelvic and Coccygeal Morphometric Parameters and Their Interaction with Morphological Type and Back Pain Standing (Mean ± SD) Sitting (Mean ± SD) p Type × Posture (p) η² Back pain × Posture (p) η² Spinopelvic Morphometric Parameters Thoracic Kyphosis (TK) 39.87 ± 10.56 37.13 ± 12.93 0.043a* 0.17 0.02 0.25 0 Thoracolumbar Kyphosis (TLK) 8.57 ± 6.73 12.28 ± 9.51 < 0.001b* 0.58 0.1 0.09 0.01 Lumbar Lordosis (LL) 57.12 ± 11.21 32.96 ± 15.75 < 0.001a* 0.45 0.01 0.64 0 Thoracolumbar Angle (TPA-T1PA) 9.7 ± 5.45 27.28 ± 13.89 < 0.001a* 0.23 0.04 0.29 0 Sagittal Vertical Axis (SVA) 31.22 ± 27.11 89.4 ± 47.46 < 0.001b* 0.23 0.05 0.43 0 Anterior Pelvic Plane Angle (APPA) 7.63 ± 4.3 19.93 ± 9.87 < 0.001b* 0.65 0.02 0.45 0 Pelvic Incidence (PI) 48.09 ± 12.88 51.1 ± 13.67 0.027a* 0.76 0 0.83 0 Sacral Slope (SS) 36.51 ± 9.78 23.28 ± 11.28 < 0.001a* 0.98 0 0.74 0 Pelvic Tilt (PT) 13.59 ± 6.71 29.92 ± 13 < 0.001a* 0.79 0.01 0.66 0 Spinosacral Angle (SSA) 125.77 ± 13.88 105.95 ± 14.64 < 0.001b* 0.79 0.01 0.8 0 Sacral Kyphosis (SK) 167.92 ± 8.01 166.89 ± 8.45 0.255b 0.69 0 0.04* 0.01 Coccygeal Morphometric Parameters Sacrococcygeal Angle (SCA) 125.23 ± 16.9 129.11 ± 18.62 0.033b* 0.78 0 0.44 0 Intercoccygeal Angle (ICA) 160.5 ± 11.97 160.77 ± 14.09 0.881a 0.01* 0.05 0.36 0 Coccygeal Height (CH) 43.06 ± 6.37 41.5 ± 6.32 0.015b* 0.82 0 0.83 0 Sacral Height (SH) 143.7 ± 12.22 143.6 ± 12.08 0.885a 0.94 0 0.79 0 Sacrococcygeal Height (SCH) 172.62 ± 17.66 173.36 ± 16.74 0.563a 0.92 0 0.24 0 *p < 0.05 is considered statistically significant. a: Paired-samples t-test; b: Wilcoxon signed-rank test. η²: Partial eta squared effect size. SD: Standard Deviation In the subgroup analysis by morphological type ( Table 4 ) , significant postural changes were mostly observed in Types 1 and 2. Both types showed significant reductions in LL, SS, and SSA, along with increases in PT and T1PA in the sitting position. Additionally, TLK increased significantly in Type 1 (p < 0.001). Type 3 exhibited a significant increase in PT, while Type 5 showed reductions in LL and SSA. Type 4 demonstrated only minimal adaptation, with a significant increase in TLK but no other positional changes. For coccygeal morphometry, decrease in CH was observed only in Type 3 (p = 0.043). Patients with LBP demonstrated significantly greater positional changes in TLK, LL, SVA, TPA-T1PA, SS, PT, and SSA (p < 0.001). SK also differed significantly in this group (p = 0.041). Among coccygeal parameters, only SCA was associated with LBP status (p = 0.009). Neither coccygeal morphological types nor mobility patterns showed a statistically significant association with LBP (p > 0.05) ( Table 5 ) . Table 4 Comparison of Spinopelvic and Coccygeal Morphometric Parameters in Standing and Sitting Positions According to the Modified Postacchini–Massobrio Classification Type 1 p Type 2 p Type 3 p Type 4 p Type 5 p Standing Sitting Standing Sitting Standing Sitting Standing Sitting Standing Sitting Spinopelvic Morphometric Parameters Thoracic Kyphosis (TK) 42.18 ± 9.81 39.33 ± 14.27 0.189a 37.22 ± 11.02 35.48 ± 11.12 0.428a 37.17 ± 4.98 24.5 ± 2.61 0.009a* 36.33 ± 15.38 40.37 ± 11.54 0.489a 46.03 ± 16.17 44.5 ± 18.92 0.732a Thoracolumbar Kyphosis (TLK) 11.45 (2.3–26.6) 15.4 (0.5–31.3) 0.044b* 4.85 (1.1–16.3) 5.6 (1.3–38.1) 0.191b 2.65 ± 1.79 7.1 ± 5.92 0.253a 8.5 ± 4.93 14.2 ± 6.26 0.018a* 6.9 (1.3–7.2) 7.5 (7.4–30.6) 0.181b Lumbar Lordosis (LL) 55.62 ± 12.36 30.03 ± 12.21 < 0.001a* 59.59 ± 10.16 36.71 ± 16.38 < 0.001a* 58.9 (43.6–59.5) 22.65 (13.9–42.7) 0.1b 50.3 (50.3–76.8) 49.8 (7.3–77.9) 0.789b 53.8 ± 15.17 30 ± 17.51 0.015a* Thoracolumbar Angle (TPA-T1PA) 8.68 ± 5.01 30.36 ± 15.32 < 0.001a* 11.07 ± 6.31 24.22 ± 13.29 < 0.001a* 6.8 ± 2.01 29.3 ± 13.55 0.061a 10.9 (5.4–11) 19.6 (13.5–44.4) 0.181b 13.53 ± 7.6 21.83 ± 8.47 0.075a Sagittal Vertical Axis (SVA) 19.19 (5.15–62.61) 93.57 (19.77-190.23) < 0.001b* 30.71 ± 18.2 85.29 ± 51.44 < 0.001a* 27.18 ± 20.52 99.37 ± 49.6 0.114a 41.49 ± 42.49 62.25 ± 24.29 0.25a 86.71 ± 69.15 92.42 ± 47.23 0.909a Anterior Pelvic Plane Angle (APPA) 8.58 ± 4.73 18.81 ± 10.4 < 0.001a* 6.4 (2.1–15) 18.75 (8.5–51.8) < 0.001b* 6.27 ± 3.7 17.52 ± 9.9 0.042a* 5 ± 2.72 22.73 ± 6.02 0.072a 8.57 ± 6.1 23.73 ± 5.25 0.098a Pelvic Incidence (PI) 46.19 ± 11.76 48.9 ± 15.61 0.134a 51.61 ± 14.87 53.16 ± 14.33 0.511a 48.5 ± 11.26 53.33 ± 6.78 0.583a 47.17 ± 9.78 55.2 ± 10.65 0.11a 41.4 ± 17.7 47.87 ± 7 0.415a Sacral Slope (SS) 35.17 ± 8.73 20.95 ± 11.11 < 0.001a* 38.55 ± 10.6 26.2 ± 9.41 < 0.001a* 38.5 (16.8–41.3) 19.3 (14.1–27.8) 0.1b 44.1 ± 7.15 33.07 ± 24.14 0.445a 30.2 ± 13.16 17.4 ± 12.4 0.253a Pelvic Tilt (PT) 13.64 ± 6.01 29.82 ± 12.41 < 0.001a* 15.12 ± 8.36 29.41 ± 14.72 < 0.001a* 11.22 ± 2.76 33.5 ± 6.67 0.001a* 8.63 ± 5.66 28.57 ± 22.16 0.324a 12.27 ± 6.26 30.37 ± 13.37 0.183a Spinosacral Angle (SSA) 125.08 ± 7.6 102.28 ± 12.08 < 0.001a* 129.95 (47.7-145.4) 110.95 (64.7-129.1) 0.004b* 130.25 (114.8-132.3) 101.95 (97.1-118.7) 0.1b 129.43 ± 8.9 115.77 ± 30.44 0.405a 122.43 ± 1 103.9 ± 1.48 0.005a* Sacral Kyphosis (SK) 170.6 (150.3-178.2) 167.6 (151.6-177.5) 0.049b* 166.02 ± 8.88 166.08 ± 8.39 0.975a 172.9 ± 2.83 172.25 ± 4.14 0.756a 161.57 ± 11.24 162.23 ± 14.17 0.857a 168.7 ± 5.38 169.57 ± 7.88 0.663a Coccygeal Morphometric Parameters Sacrococcygeal Angle (SCA) 127.1 (53.6-158.2) 128.2 (63.9-166.4) 0.673b 120.66 ± 13.79 125.23 ± 16.7 0.062a 121.62 ± 9.89 127.42 ± 6.27 0.098a 136.2 ± 7.59 135.9 ± 7.13 0.95a 133.83 ± 13.19 147.37 ± 25.36 0.219a Intercoccygeal Angle (ICA) 161.7 (138.7-177.5) 162.95 (122.6–176) 0.846b 157.58 ± 11.88 161.98 ± 13.44 0.17a 154.57 ± 8.48 156.88 ± 12.75 0.59a 176.03 ± 12.37 174.27 ± 17.19 0.615a 175.5 (155.1-178.1) 137.5 (136.6–170) 0.181b Coccygeal Height (CH) 43.39 (35.3-60.36) 42.27 (20.19–54.08) 0.127b 41.68 ± 7.52 41.15 ± 6.97 0.383a 42.1 ± 5.18 39.59 ± 5.79 0.043a* 46.07 ± 1.76 45.98 ± 4.2 0.968a 39.85 ± 6.12 38.21 ± 4.26 0.567a Sacral Height (SH) 143.41 ± 14.62 143.3 ± 13.85 0.91a 141.26 ± 10.91 140.66 ± 11.33 0.693a 152.3 ± 9.73 152.28 ± 10.1 0.95a 149.88 ± 5.95 150.78 ± 4.57 0.446a 142.97 ± 6.7 144.85 ± 7.87 0.109a Sacrococcygeal Height (SCH) 174.84 ± 18.53 174.46 ± 16.15 0.864a 165.65 ± 17.35 166.96 ± 18.08 0.563a 178.11 ± 17.15 180.84 ± 14.89 0.161a 189.37 ± 8.83 189.26 ± 7 0.93a 174.25 ± 12.1 177.79 ± 14.32 0.131a *p < 0.05 is considered statistically significant. a: Paired-samples t-test; b: Wilcoxon signed-rank test. Table 5 Spinopelvic and Coccygeal Morphometric Parameters. Modified Postacchini–Massobrio Classification and Coccygeal Mobility According to the Presence of Back Pain Back pain - p Back Pain + p Standing Sitting Standing Sitting Spinopelvic Morphometric Parameters Thoracic Kyphosis (TK) 41.96 ± 9.99 37.7 ± 13.27 0.012a* 37.79 ± 11.12 36.56 ± 13.11 0.568a Thoracolumbar Kyphosis (TLK) 5.8 (1-26.6) 7.5 (0.5–30.3) 0.06b 6.7 (1.1–23.2) 10.9 (1.3–38.1) 0.004b* Lumbar Lordosis (LL) 59.25 ± 10.27 34.32 ± 18.71 < 0.001a* 54.99 ± 12.13 31.61 ± 12.78 < 0.001a* Thoracolumbar Angle (TPA-T1PA) 9.17 ± 5.53 24.66 ± 11.11 < 0.001a* 10.24 ± 5.55 29.9 ± 16.26 < 0.001a* Sagittal Vertical Axis (SVA) 20.9 (5.15-140.91) 79.75 (19.77-148.98) < 0.001b* 27.12 (2.78-110.38) 87.42 (3.83-197.54) < 0.001b* Anterior Pelvic Plane Angle (APPA) 8.42 ± 5.11 21.78 ± 10.58 < 0.001a* 6.6 (2–15) 17.2 (7.2–51.8) < 0.001b* Pelvic Incidence (PI) 47.29 ± 14.74 50.02 ± 12.81 0.122a 48.9 ± 11.28 52.2 ± 14.94 0.12a Sacral Slope (SS) 37.18 ± 10.57 24.47 ± 13.27 < 0.001a* 35.85 ± 9.31 22.1 ± 9.3 < 0.001a* Pelvic Tilt (PT) 12.73 ± 7.57 29.82 ± 14.48 < 0.001a* 14.46 ± 5.93 30.02 ± 11.94 < 0.001a* Spinosacral Angle (SSA) 128.31 ± 8.25 107.9 ± 14.9 < 0.001a* 124 (47.7-145.4) 105 (64.7-124.4) < 0.001b* Sacral Kyphosis (SK) 165.9 (144.6-177.5) 168.6 (146.2-179.8) 0.518b 170.7 (150.2-178.2) 167.4 (149.5-177.5) 0.041b* Coccygeal Morphometric Parameters Sacrococcygeal Angle (SCA) 128.1 (53.6-158.2) 127.4 (63.9-176.3) 0.572b 124.5 ± 13.98 130.04 ± 17.18 0.009a* Intercoccygeal Angle (ICA) 161.56 ± 12.64 160.18 ± 15.6 0.631a 160.7 (134.7-175.5) 167.3 (136.1-177.5) 0.581b Coccygeal Height (CH) 42.89 (23.76–60.36) 41.48 (24.5-50.08) 0.011b* 43.24 ± 6.56 41.52 ± 7.08 0.23a Sacral Height (SH) 143.75 ± 12.69 143.48 ± 13.16 0.761a 143.66 ± 12.26 143.74 ± 11.45 0.941a Sacrococcygeal Height (SCH) 173.86 ± 17.91 173.12 ± 17.78 0.635a 171.4 ± 18.07 173.6 ± 16.36 0.28a Modified Postacchini–Massobrio Classification Type 1 12(%54.5) 10(%45.5) 0.742 Type 2 8(%44.4) 10(%55.6) Type 3 1(%25) 3(%75) Type 4 2(%66.7) 1(%33.3) Type 5 2(%66.7) 1(%33.3) Coccygeal Mobility Normobility 17 (%60.7) 11 (%39.3) 0.392 Hipermobility 2 (%33.3) 4 (%66.7) Hypomobility 2 (%28.6) 5 (%71.4) Posterior Luxation 4 (%44.4) 5 (%55.6) *p < 0.05 is considered statistically significant. a: Paired-samples t-test; b: Wilcoxon signed-rank test. Logistic Regression Analysis A stepwise logistic regression analysis was performed to identify spinopelvic and coccygeal parameters associated with pain status (NRS ≥ 6), as shown in the Supplemental File . The final model demonstrated acceptable overall fit and discrimination (Nagelkerke R²: 0.57, AUC: 0.88, 95% CI: 0.78–0.99, p < 0.001). Among the evaluated variables, ICA, TLK, and APPA remained significant predictors. An increase in ICA was associated with 9% higher odds of pain (p = 0.028), whereas higher TLK reduced the odds of pain by 13% (p = 0.038). APPA showed the strongest association, with a 19% increase in the odds of pain for each unit increase (p = 0.002). Discussion This study demonstrates that posture has a significant influence on sagittal spinopelvic alignment, coccygeal morphology, and mobility in coccydynia, with notable differences between the sitting and standing positions. Morphology Types 1 and 2 showed the greatest postural adaptability, whereas Types 4 and 5 exhibited minimal positional change. ICA and APPA were predictors of coccygeal pain, while TLK was inversely associated. Among spinopelvic parameters, SK was the only variable associated with LBP, and SCA was the only coccygeal parameter related to LBP, despite broader positional differences across the groups. The most common coccygeal morphologies were Types 1 and 2, similar to previous studies.[ 8 ] Segment distribution, fusion rates, and the frequency of spicule formation were also consistent with earlier reports.[ 11 – 14 ] Spicules were most prevalent in Type 5, suggesting that posteriorly angulated coccyges may promote localized bony projections that may increase sitting pressure. Among morphometric parameters, CH significantly decreased in the sitting position, indicating postural compression of the coccyx, which was most evident in Type 3, consistent with its greater mobility. From standing to sitting position, ICA increased in Types 1–3 but decreased in Types 4 and 5, where posterior luxation was most frequent. It was the only parameter demonstrating a significant type×posture interaction, highlighting its value as a morphology-related marker. Increased ICA was also associated with higher odds of coccygeal pain, and regression analysis confirmed ICA as a significant predictor of coccygeal pain. LBP status further influenced the morphologic patterns: in patients without LBP, CH significantly decreased during sitting, reflecting greater postural mobility, whereas in those with LBP, SCA increased, possibly representing altered compensatory mechanisms. Normomobility was the predominant mobility pattern, followed by posterior luxation, hypomobility, and hypermobility. LBP was more frequent among hypomobile cases, although this trend did not reach significance. Previous studies emphasized the role of hypermobility and luxation in coccydynia, whereas our results highlight restricted motion as another potential factor and provide exploratory insight into possible links with LBP.[ 9 ] To our knowledge, no prior study has systematically analyzed coccygeal mobility, MPM classification, and coexisting LBP, emphasizing the novelty of these observations. Sacral slope decreased significantly from standing to sitting, reflecting pelvic retroversion, while PT and APPA increased, indicating substantial backward pelvic rotation. These findings align with prior meta-analyses, which reported sitting-induced reductions in SS of ~ 50% accompanied by corresponding increases in PT.[ 15 ] Across morphological subtypes, SS decreased significantly in all groups during sitting, most prominently in Types 1 and 2. Additionally, Type 4 demonstrated the highest SS values, reflecting anterior sacral inclination, while Type 5 had the lowest values, consistent with a flatter alignment. PT and APPA increased significantly in Types 1–3, whereas Types 4 and 5 showed minimal change, suggesting reduced postural adaptability. Across all subtypes, PI values remained stable, confirming its posture-independent nature. Patients with LBP showed a more pronounced decrease in SS and increase in PT, indicating that excessive pelvic retroversion and sacral verticalization during sitting may contribute to discomfort. Furthermore, APPA was the strongest predictor of coccydynia, with a 19% increase in the odds of pain for each unit increase. Sacral kyphosis, which has a significant correlation with PI and is an important determinant of sagittal balance, showed opposite trends between groups: it slightly increased in patients without LBP but decreased significantly in those with LBP, suggesting enhanced sacral concavity.[ 16 ] This finding is supported by posture×pain interaction analysis, where SK was the only parameter significantly influencing the LBP, although with a small effect size. Its positive relationship with LL, a key compensatory parameter, is consistent with previous findings in lumbar disc herniation, where decreased LL and increased SK indicate impaired lumbopelvic compensation.[ 17 ] Sitting led to reductions in LL and TK, accompanied by a compensatory increase in TLK, consistent with prior literature.[ 18 ] This shift suggests that mechanical load is redistributed toward the thoracolumbar junction, where increased kyphosis may serve as a compensatory adaptation to the loss of lumbar curvature, which explains the inverse association between TLK and coccygeal pain observed in this study.[ 19 ] Furthermore, TK decreased only in LBP-free patients, while LL decreased in both groups, but more prominently in those without LBP. TLK showed a near-significant interaction with LBP, though with limited clinical relevance. Sagittal balance parameters are strongly correlated with T1PA, and elevated values are associated with increased disability; surgical targets are typically set below 10–14°.[ 20 ] In this study, T1PA increased from 9.7° in the standing position to 27.3° in the sitting position, indicating deterioration in sagittal alignment. SSA, another global indicator of sagittal balance known to correlate with SS and LL, also decreased significantly, reflecting verticalization of the sacrum and a loss of global spinal harmony.[ 21 ] Morphologically, TPA-T1PA increased significantly in Types 1 and 2, while SSA decreased in Types 1, 2, and 5 during sitting. Both parameters changed significantly with posture, but the magnitude of change was smaller in patients with LBP, suggesting restricted pelvic adaptation and greater spinal loading. These findings are consistent with previous reports in degenerative kyphosis, rheumatoid arthritis, and discogenic back pain, supporting SSA as not only a static anatomical measure but also a dynamic marker of biomechanical dysfunction linked to symptoms.[ 22 ] SVA was also significantly increased in the sitting position, reflecting a forward shift of the center of gravity. Standing measurements remained within normative ranges, while sitting values were markedly higher, especially in patients with LBP, suggesting increased anterior displacement and sagittal malalignment.[ 15 ] This study has several limitations. First, the study was conducted at a single center with a relatively small sample size, which may limit its generalizability. Second, reliance on two-dimensional radiographs may not fully capture the complexity of dynamic postural changes, particularly during transitions between standing and sitting. Third, despite standardized protocols, variations in seated posture may have introduced measurement inconsistencies. In conclusion, patients with coccydynia exhibit significant posture-related changes in spinopelvic parameters, particularly LL, SS, PT, and SVA, with ICA emerging as a morphology-related marker. Coccygeal morphology and mobility influence sagittal alignment, and dynamic assessment in functional postures may enhance diagnostic accuracy and guide rehabilitation strategies. Declarations Author Contribution Study conception and design: A.K., N.Y., E.G., O.G.I., P.K.; Data collection and materials: A.K., E.G., O.G.I., F.E.B.U.; Analysis and/or Interpretation of results: A.K., N.Y., E.G., O.G.I., F.E.B.U., S.A., K.S., I.A., P.K.; Literature review and control: A.K., N.Y., E.G., O.G.I., P.K.; Writing the article and critical review: A.K., N.Y., E.G., O.G.I., K.S. I.A., P.K.; References and fundings: A.K., N.Y., E.G., O.G.I., P.K. Acknowledgement FundingNo specific grant from funding agencies in the public, commercial, or not-for-profit sectors supported this research. Conflict of Interest All authors certify that they have no affiliations with or involvement in any organization or entity with any financial or non-financial interest in the subject matter or materials discussed in this manuscript.Data availability The data supporting the findings of this study are available from the corresponding author upon request.AcknowledmentsThe authors appreciate all patients who contributed clinical information in this study. References Durbas, A., et al., Evaluating Variations in Spinopelvic Parameters from Sitting to Standing: A Comparative Analysis of 1447 Older Adults Across Age, BMI, and Gender Subgroups. Journal of Clinical Medicine, 2025. 14 (9): p. 2952. Suzuki, H., et al., Radiographic Assessment of Spinopelvic Sagittal Alignment from Sitting to Standing Position. Spine Surg Relat Res, 2018. 2 (4): p. 290-293. Prasetya, A., et al., Analyzing spinopelvic parameter differences between standing and supine position. Journal of Musculoskeletal Surgery and Research. 9 . Özkal, B., S. Avnioğlu, and B. Candan, Morphometric evaluation of coccyx in patients with coccydynia and classification. Acta Medica Alanya, 2020. 4 (1): p. 61-67. Yagi, F., et al., Three-dimensional evaluation of the coccyx movement between supine and standing positions using conventional and upright computed tomography imaging. Scientific Reports, 2021. 11 (1): p. 6886. Bo, K., et al., Dynamic MRI of the pelvic floor muscles in an upright sitting position. Neurourol Urodyn, 2001. 20 (2): p. 167-74. Ersen, O., et al., Pelvic Incidence as a Prognostic Factor in Coccydynia. Turkish Neurosurgery, 2019. 29 (3): p. 400-403. Postacchini, F. and M. Massobrio, Idiopathic coccygodynia. Analysis of fifty-one operative cases and a radiographic study of the normal coccyx. J Bone Joint Surg Am, 1983. 65 (8): p. 1116-24. Maigne, J.-Y. and B. Tamalet, Standardized Radiologic Protocol for the Study of Common Coccygodynia and Characteristics of the Lesions Observed in the Sitting Position: Clinical Elements Differentiating Luxation, Hypermobility, and Normal Mobility. Spine, 1996. 21 (22): p. 2588-2593. Misir, A., et al., Lumbar spine posture and spinopelvic parameters change in various standing and sitting postures. Eur Spine J, 2019. 28 (5): p. 1072-1081. Guneri, B. and G. Gungor, Morphological Features of the Coccyx in the Turkish Population and Interrelationships Among the Parameters: A Computerized Tomography-Based Analysis. Cureus, 2021. 13 (11): p. e19687. Hekimoglu, A. and O. Ergun, Morphological evaluation of the coccyx with multidetector computed tomography. Surg Radiol Anat, 2019. 41 (12): p. 1519-1524. Kuytu T., K.A., Detailed Coccygeal Morphology on Multislice 3d Ct in 1000 Asymptomatic Turkish Adults. Acta Medica Alanya, 2024. 8 (1): p. 49-57. Lirette, L.S., et al., Coccydynia: an overview of the anatomy, etiology, and treatment of coccyx pain. Ochsner J, 2014. 14 (1): p. 84-7. Tan, T.H., J.H. Tan, and H.W.D. Hey, Changes in Spinopelvic Parameters Between Standing and Sitting Postures: A Systematic Review and Meta-analysis. Clin Spine Surg, 2024. 37 (3): p. 97-113. Ru, N., et al., Sacral anatomical parameters varies in different Roussouly sagittal shapes as well as their relations to lumbopelvic parameters. JOR Spine, 2021. 4 (4): p. e1180. Ergun, T., H. Lakadamyali, and M.S. Sahin, The relation between sagittal morphology of the lumbosacral spine and the degree of lumbar intervertebral disc degeneration. Acta Orthop Traumatol Turc, 2010. 44 (4): p. 293-9. Tsagkaris, C., et al., The sitting vs standing spine. N Am Spine Soc J, 2022. 9 : p. 100108. Liu, C., et al., Thoracolumbar/Lumbar Degenerative Kyphosis—The Importance of Thoracolumbar Junction in Sagittal Alignment and Balance. Journal of Personalized Medicine, 2024. 14 (1): p. 36. Cho, I.Y., et al., The Effect of Standing and Different Sitting Positions on Lumbar Lordosis: Radiographic Study of 30 Healthy Volunteers. Asian Spine J, 2015. 9 (5): p. 762-9. Roussouly, P. and J.L. Pinheiro-Franco, Sagittal parameters of the spine: biomechanical approach. Eur Spine J, 2011. 20 Suppl 5 (Suppl 5): p. 578-85. Savarese, L.G., et al., Spinopelvic sagittal balance: what does the radiologist need to know? Radiol Bras, 2020. 53 (3): p. 175-184. Additional Declarations No competing interests reported. Supplementary Files SupplementaryTable.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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14:11:23","extension":"png","order_by":24,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":58168,"visible":true,"origin":"","legend":"","description":"","filename":"OnlineFig4.png","url":"https://assets-eu.researchsquare.com/files/rs-8064384/v1/684cb002330badf4210fa40a.png"},{"id":96806147,"identity":"a41e1065-7a54-4b09-987a-6c36590b525a","added_by":"auto","created_at":"2025-11-26 09:16:18","extension":"png","order_by":25,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":377002,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-8064384/v1/2fd42e02b20aadf09361d709.png"},{"id":96806145,"identity":"467587dd-17f6-4838-9269-fb40750c2c56","added_by":"auto","created_at":"2025-11-26 09:16:18","extension":"png","order_by":26,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":315033,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-8064384/v1/52ca0a6080d61c796415ad23.png"},{"id":96806146,"identity":"3ec9608f-b1b2-4e29-9bf3-186e36ff0042","added_by":"auto","created_at":"2025-11-26 09:16:18","extension":"png","order_by":27,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":774730,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-8064384/v1/9b0128870e8a4377f24b8e35.png"},{"id":96917646,"identity":"60bf393b-87ca-42fc-b23c-23b9a1313648","added_by":"auto","created_at":"2025-11-27 14:10:19","extension":"png","order_by":28,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":58216,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-8064384/v1/d26242f9e3dc4f34565cf58d.png"},{"id":96806154,"identity":"5edc57f1-84e1-46ca-b6f1-6b4a07d81203","added_by":"auto","created_at":"2025-11-26 09:16:19","extension":"xml","order_by":29,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":214322,"visible":true,"origin":"","legend":"","description":"","filename":"03fba9752964453d809eb32ed52927c41structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-8064384/v1/1e13bbd85eeee2a2804e1fb6.xml"},{"id":96806148,"identity":"e147c7ec-0296-44f3-8927-28bd3ab194fd","added_by":"auto","created_at":"2025-11-26 09:16:18","extension":"html","order_by":30,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":224344,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-8064384/v1/bcef8bd970b8b5dadb2fd4c2.html"},{"id":96806119,"identity":"7513b36e-3e33-47fa-9936-d8b6248dc77b","added_by":"auto","created_at":"2025-11-26 09:16:18","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":444559,"visible":true,"origin":"","legend":"\u003cp\u003eLateral sagittal radiographs were obtained in standing and relaxed sitting positions. a, patient positioning; b, corresponding radiographs used for spinopelvic assessment.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-8064384/v1/a1daa0641230fbe73f4c7ccd.png"},{"id":96918267,"identity":"70afad91-8c0e-45f9-8809-24bf1645be02","added_by":"auto","created_at":"2025-11-27 14:11:33","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":747446,"visible":true,"origin":"","legend":"\u003cp\u003eLateral coccyx radiographs were obtained in both the standing and sitting positions, with patients leaning backward to replicate the posture associated with maximum pain. a, patient positioning; b, corresponding radiographs used for coccygeal assessment.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-8064384/v1/4b355e46e09347728a8af5af.png"},{"id":96916960,"identity":"0a41d829-a215-4ef4-b038-d0e2d09853c3","added_by":"auto","created_at":"2025-11-27 14:09:05","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":311369,"visible":true,"origin":"","legend":"\u003cp\u003eRadiographic measurement of sagittal parameters. a, spinal parameters: thoracic kyphosis (TK), thoracolumbar kyphosis (TLK), lumbar lordosis (LL), thoracopelvic angle (TPA–T1PA), sagittal vertical axis (SVA), spinosacral angle (SSA). b, pelvic parameters: sacral slope (SS), pelvic incidence (PI), pelvic tilt (PT), sacral kyphosis (SK), anterior pelvic plane angle (APPA).\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-8064384/v1/eeb6a020e115482b2592e87d.png"},{"id":96806118,"identity":"d4e2bbef-7490-40b7-96d7-27fa5d97c4b2","added_by":"auto","created_at":"2025-11-26 09:16:18","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":318184,"visible":true,"origin":"","legend":"\u003cp\u003eRadiographic measurement of coccygeal parameters. Sacrococcygeal angle (SCA), intercoccygeal angle (ICA), coccygeal height (CH), sacral height (SH), and sacrococcygeal height (SCH).\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-8064384/v1/6379fb348759d95dd89a475e.png"},{"id":100719657,"identity":"798b8189-3958-4b61-9600-88025ad15eda","added_by":"auto","created_at":"2026-01-20 19:29:23","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":4308516,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8064384/v1/530dc5a0-d761-47f8-8cc9-6e1893ca15fe.pdf"},{"id":96806122,"identity":"c4646188-2d93-4a93-ba9a-3aca367e7324","added_by":"auto","created_at":"2025-11-26 09:16:18","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":19640,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryTable.docx","url":"https://assets-eu.researchsquare.com/files/rs-8064384/v1/15328acd5e28310deb7a6d5c.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Radiographic Assessment of Sagittal Spinopelvic Alignment and Coccygeal Morphology and Mobility in Sitting and Standing Positions in Coccydynia","fulltext":[{"header":"Introduction","content":"\u003cp\u003eProlonged sitting, characteristic of modern sedentary lifestyles, induces substantial changes in spinopelvic alignment and has been strongly associated with low back pain (LBP) and other musculoskeletal disorders. Transitioning from a standing to a sitting position leads to pelvic retroversion and reduced lumbar lordosis, with compensatory mechanisms maintaining sagittal balance.[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e] The dynamic evaluation of spinopelvic parameters in both standing and sitting positions has therefore gained attention for documenting normal alignment and optimizing treatment strategies.[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e] Although these posture-dependent changes have been extensively studied in spinal deformities and degenerative conditions, their relevance to coccydynia remains unclear.[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/p\u003e\u003cp\u003eCoccydynia is influenced by trauma, prolonged sitting, and the coccygeal morphology and morphometry. Pathoanatomical factors, such as segment number, angulation, fusion, and spicule, contribute to symptoms, and assessing coccygeal movement provides additional diagnostic value.[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e] Although symptoms are typically provoked by sitting, only a minority of individuals with similar risk factors develop significant pain, underscoring the multifactorial nature of this condition. The epidemiology of coccydynia also remains poorly defined, and imaging studies have primarily relied on static evaluations, including standing or sitting radiographs and supine computed tomography or magnetic resonance imaging (MRI).[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] Since sagittal pelvic orientation is central to posture and load transfer within the lumbosacral region, parameters describing spinopelvic alignment may also influence coccygeal biomechanics. However, only one study has analyzed pelvic parameters in coccydynia, assessing their prognostic value from standing radiographs.[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] The dynamic relationship between the coccyx and spinopelvic alignment during functional postures such as sitting and standing remains unexplored, and its contribution to pain generation is unclear.\u003c/p\u003e\u003cp\u003eThis study aims to address these gaps by investigating posture-dependent changes in spinopelvic and coccygeal parameters in coccydynia. The objectives were to: (1) quantify sagittal spinopelvic and coccygeal parameter changes between standing and sitting positions; (2) analyze positional differences according to coccygeal morphologic types and the presence of LBP; and (3) identify radiographic predictors of coccygeal pain severity. It was hypothesized that posture-dependent alterations in spinopelvic parameters and coccygeal morphology would be interrelated, and reduced adaptability during sitting would be associated with greater pain intensity.\u003c/p\u003e"},{"header":"Material and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eStudy Design\u003c/h2\u003e\u003cp\u003e This cross-sectional study was approved by the Institutional Research Ethics Committee (XX) and registered in the clinicaltrials.gov system. (Registration number: XX). The study adhered to the STROBE guidelines, and informed consent was obtained from all participants for their voluntary participation and the publication of their data.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eParticipants\u003c/h3\u003e\n\u003cp\u003eBetween August 2024 and January 2025, patients aged 25\u0026ndash;65 years who were clinically diagnosed with coccydynia at our physical medicine and rehabilitation outpatient clinic were consecutively enrolled. Exclusion criteria included spinal disorders causing alignment abnormalities, hip or knee conditions affecting spinal alignment, and a history of surgery involving the cervical, thoracic, lumbar, or coccygeal spine. A total of 60 patients were screened; 10 were excluded due to inadequate radiographs for measurements, resulting in 50 participants included in the final analysis. For further analyses, patients were grouped by the presence of LBP and pain severity of coccyx (Numeric Rating Scale [NRS]\u0026thinsp;\u0026lt;\u0026thinsp;6 vs. \u0026ge; 6).\u003c/p\u003e\n\u003ch3\u003eRadiological Assessment\u003c/h3\u003e\n\u003cp\u003eSagittal analysis was performed using lateral radiographs in standing and sitting positions, extending from C7 to the femoral heads to ensure complete visualization of the coccyx, with patients seated in a relaxed, habitual posture \u003cb\u003e(\u003c/b\u003eFig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e. Dynamic coccygeal evaluation included standing images obtained after patients refrained from sitting for 5\u0026ndash;10 minutes, followed by sitting radiographs taken as they leaned backward to reproduce their typical pain-provoking posture \u003cb\u003e(\u003c/b\u003eFig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e. Scans were analyzed using a Picture Archiving and Communication System (PACS) by an experienced radiologist.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\n\u003ch3\u003eSpinopelvic Morphometric Parameters\u003c/h3\u003e\n\u003cp\u003eThe evaluated parameters included thoracic kyphosis (TK), thoracolumbar kyphosis (TLK), lumbar lordosis (LL), thoracopelvic angle and its modification (TPA-T1PA), anterior pelvic plane angle (APPA), sagittal vertical axis (SVA), sacral slope (SS), pelvic incidence (PI), pelvic tilt (PT), spinosacral angle (SSA), and sacral kyphosis (SK) \u003cb\u003e(\u003c/b\u003eFig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\n\u003ch3\u003eCoccygeal Morphology, Morphometry, and Mobility\u003c/h3\u003e\n\u003cp\u003eCoccygeal features were evaluated based on vertebral segment number, sacrococcygeal and intercoccygeal joint fusion, and mobility status. Morphological types were classified according to the Modified Postacchini\u0026ndash;Massobrio (MPM) system.[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e] The presence of coccygeal spicules was recorded. Morphometric assessments included the sacrococcygeal (SCA) and intercoccygeal (ICA) angles, as well as coccygeal (CH), sacral (SH), and sacrococcygeal heights (SCH) \u003cb\u003e(\u003c/b\u003eFig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e. Mobility was assessed by measuring the angular displacement between standing and sitting radiographs. It was classified as normal, hypermobile, hypomobile, or posterior luxation based on the flexion-extension response and translation under load.[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eStatistical Analysis\u003c/h2\u003e\u003cp\u003eThe sample size was estimated based on Misir et al.[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], from which the effect size (Cohen\u0026rsquo;s dz) was calculated as 0.92. With a significance level (α) of 0.05 and a desired power (1-β) of 0.95, the minimum required sample size was 18. To improve the generalizability of the results, better represent inter-individual variability, and account for possible data loss, a total of 25 patients (50 radiographs in sitting and standing positions) were planned for inclusion.\u003c/p\u003e\u003cp\u003eStatistical analyses were performed using SPSS version 25.0 (IBM Corp., Armonk, NY, USA). Descriptive statistics are presented as means with standard deviations for continuous variables and as frequencies for categorical variables. The normality of continuous data distributions was tested with the Shapiro-Wilk test. Depending on the distribution, paired t-tests or Wilcoxon signed-rank tests were applied to compare morphometric measurements between standing and sitting positions. Repeated-measures ANOVA was employed to examine group effects on these positional changes. Independent-samples t-tests or Mann-Whitney U tests were used to compare morphometric parameter differences between subgroups. Additionally, stepwise logistic regression analysis was performed to identify parameters associated with pain status (NRS\u0026thinsp;\u0026ge;\u0026thinsp;6). Model fit was assessed using standard indices, and odds ratios (OR) with 95% confidence intervals (CI) were reported.\u003c/p\u003e\u003cp\u003eA p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eFifty patients (42 females, eight males; mean age 47.0\u0026thinsp;\u0026plusmn;\u0026thinsp;9.9 years, mean body mass index [BMI] 27.2\u0026thinsp;\u0026plusmn;\u0026thinsp;4.7 kg/m\u0026sup2;) were included. The mean symptom duration was 29.8\u0026thinsp;\u0026plusmn;\u0026thinsp;55.6 months, and the average daily sitting time was 5.5\u0026thinsp;\u0026plusmn;\u0026thinsp;2.5 hours, with 34% of patients classified as prolonged sitters (\u0026gt;\u0026thinsp;6 hours/day). Trauma history was reported by 60% of the patients, vaginal delivery by 62% of the female patients, and LBP by 50% of the participants.\u003c/p\u003e\n\u003ch3\u003eCoccygeal Parameters\u003c/h3\u003e\n\u003cp\u003eThe most frequent coccygeal vertebral count was four segments (52%), followed by three (44%) and five (4%) segments, with no significant sex-based difference (p\u0026thinsp;=\u0026thinsp;0.381). Fusion at the sacrococcygeal joint and any level of the intercoccygeal joints was identified in 36% and 38% of cases, respectively, without significant associations to sex or morphology (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Spicules were found in 18% of patients, most often in Type 5 (66.7%), although not statistically significant (p\u0026thinsp;=\u0026thinsp;0.087) \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDistribution of Coccygeal Vertebral Number, Joint Fusion, and Spicule Presence According to Gender and Modified Postacchini\u0026ndash;Massobrio Classification\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"12\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFemale n (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMale n (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eTotal n (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eType 1\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eType 2\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003eType 3\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u003cp\u003eType 4\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c11\"\u003e\u003cp\u003eType 5\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c12\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eCoccyx vertebra number\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e3\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e19 (%45.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3 (%37.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e22 (%44)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.381\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e12 (%54.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e7 (%38.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0 (%0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e1 (%33.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e2 (%66.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.536\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e4\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e22 (%52.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4 (%50)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e26 (%52)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e9 (%40.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e10 (%55.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e4 (%100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e2 (%66.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e1 (%33.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e5\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1 (%2.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1 (%12.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2 (%4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e1 (%4.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1 (%5.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0 (%0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0 (%0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e0 (%0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eSacrococcygeal joint fusion\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eNo\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e27 (%64.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5 (%62.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e32 (%64)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.923\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e14 (%63.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e12 (%66.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e3 (%75)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e2 (%66.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e1 (%33.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.900\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eYes\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e15 (%35.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3 (%37.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e18 (%36)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e8 (%36.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e6 (%33.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1 (%25)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e1 (%33.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e2 (%66.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eIntercoccygeal joint fusion\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eNo\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e25 (%59.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6 (%75)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e31 (%62)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.693\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e14 (%63.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e11 (%61.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e3 (%75)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e1 (%33.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e2 (%66.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.903\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eYes\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e17 (%40.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2 (%25)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e19 (%38)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e8 (%36.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e7 (%38.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1 (%25)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e2 (%66.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e1 (%33.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eSpicule\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eNo\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e34 (%81)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7 (%87.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e41 (%82)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.659\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e17 (%77.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e17 (%94.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e3 (%75)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e3 (%100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e1 (%33.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c12\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.087\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eYes\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8 (%19)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1 (%12.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e9 (%18)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e5 (%22.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1 (%5.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1 (%25)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0 (%0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e2 (%66.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"12\"\u003eFischer Exact Test: p\u0026thinsp;\u0026lt;\u0026thinsp;0.05\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eAccording to the MPM classification, the most frequent coccygeal morphologies were Type 1 (44%) and Type 2 (36%). Normomobility was the predominant mobility pattern (56%), particularly in Type 1 (59.1%) and Type 2 (66.7%). Hypomobility was most common in Type 5 (66.7%), while posterior luxation predominated in Type 4 (66.7%). No significant association was found between morphology and mobility (p\u0026thinsp;=\u0026thinsp;0.125) \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u003cb\u003e).\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDistribution of Coccygeal Morphological Types According to Mobility Patterns\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNormobility\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eHypermobility\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eHypomobility\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003ePosterior luxation\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eType 1\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eWithin Type\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13 (%59.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2 (%9.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3 (%13.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e4 (%18.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e22 (%44)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"9\" rowspan=\"10\"\u003e\u003cp\u003e0.125\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eWithin Mobility\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13 (%46.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2 (%33.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3 (%42.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e4 (%44.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eType2\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eWithin Type\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12 (%66.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2 (%11.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2 (%11.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2 (%11.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e18 (%36)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eWithin Mobility\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12 (%42.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2 (%33.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2 (%28.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2 (%22.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eType 3\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eWithin Type\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2 (%50)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2 (%50)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0 (%0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0 (%0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e4 (%8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eWithin Mobility\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2 (%7.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2 (%33.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0 (%0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0 (%0.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eType 4\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eWithin Type\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1 (%33.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0 (%0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0 (%0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2 (%66.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e3 (%6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eWithin Mobility\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1 (%3.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0 (%0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0 (%0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2 (%22.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eType 5\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eWithin Type\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (%0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0 (%0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2 (%66.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1 (%33.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e3 (%6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eWithin Mobility\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (%0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0 (%0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2 (%28.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1 (%11.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e28 (%56)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6 (%12)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e7 (%14)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e9 (%18)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e50 (%100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003eSagittal Alignment Parameters\u003c/h2\u003e\u003cp\u003eAs shown in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, significant postural changes were observed in several spinopelvic (TK, TLK, LL, TPA\u0026ndash;T1PA, SVA, APPA, SS, PT, SSA) and coccygeal parameters (SCA, CH) between standing and sitting (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Among spinopelvic parameters, only SK demonstrated a significant interaction with the presence of LBP (p\u0026thinsp;=\u0026thinsp;0.04, η\u0026sup2; = 0.01), while no significant intergroup differences were found across morphological types. For coccygeal parameters, ICA demonstrated a significant association with morphological type (p\u0026thinsp;=\u0026thinsp;0.01, η\u0026sup2; = 0.05).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ePostural Changes in Spinopelvic and Coccygeal Morphometric Parameters and Their Interaction with Morphological Type and Back Pain\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStanding (Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSitting (Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eType \u0026times; Posture (p)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eη\u0026sup2;\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eBack pain \u0026times; Posture (p)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eη\u0026sup2;\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e\u003cp\u003eSpinopelvic Morphometric Parameters\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eThoracic Kyphosis (TK)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e39.87\u0026thinsp;\u0026plusmn;\u0026thinsp;10.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e37.13\u0026thinsp;\u0026plusmn;\u0026thinsp;12.93\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0.043a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eThoracolumbar Kyphosis (TLK)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8.57\u0026thinsp;\u0026plusmn;\u0026thinsp;6.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12.28\u0026thinsp;\u0026plusmn;\u0026thinsp;9.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001b*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eLumbar Lordosis (LL)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e57.12\u0026thinsp;\u0026plusmn;\u0026thinsp;11.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e32.96\u0026thinsp;\u0026plusmn;\u0026thinsp;15.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eThoracolumbar Angle (TPA-T1PA)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e9.7\u0026thinsp;\u0026plusmn;\u0026thinsp;5.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e27.28\u0026thinsp;\u0026plusmn;\u0026thinsp;13.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSagittal Vertical Axis (SVA)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e31.22\u0026thinsp;\u0026plusmn;\u0026thinsp;27.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e89.4\u0026thinsp;\u0026plusmn;\u0026thinsp;47.46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001b*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAnterior Pelvic Plane Angle (APPA)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e7.63\u0026thinsp;\u0026plusmn;\u0026thinsp;4.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e19.93\u0026thinsp;\u0026plusmn;\u0026thinsp;9.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001b*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePelvic Incidence (PI)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e48.09\u0026thinsp;\u0026plusmn;\u0026thinsp;12.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e51.1\u0026thinsp;\u0026plusmn;\u0026thinsp;13.67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0.027a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSacral Slope (SS)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e36.51\u0026thinsp;\u0026plusmn;\u0026thinsp;9.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e23.28\u0026thinsp;\u0026plusmn;\u0026thinsp;11.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePelvic Tilt (PT)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e13.59\u0026thinsp;\u0026plusmn;\u0026thinsp;6.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e29.92\u0026thinsp;\u0026plusmn;\u0026thinsp;13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSpinosacral Angle (SSA)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e125.77\u0026thinsp;\u0026plusmn;\u0026thinsp;13.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e105.95\u0026thinsp;\u0026plusmn;\u0026thinsp;14.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001b*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSacral Kyphosis (SK)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e167.92\u0026thinsp;\u0026plusmn;\u0026thinsp;8.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e166.89\u0026thinsp;\u0026plusmn;\u0026thinsp;8.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.255b\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e0.04*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e0.01\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCoccygeal Morphometric Parameters\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSacrococcygeal Angle (SCA)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e125.23\u0026thinsp;\u0026plusmn;\u0026thinsp;16.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e129.11\u0026thinsp;\u0026plusmn;\u0026thinsp;18.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0.033b*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIntercoccygeal Angle (ICA)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e160.5\u0026thinsp;\u0026plusmn;\u0026thinsp;11.97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e160.77\u0026thinsp;\u0026plusmn;\u0026thinsp;14.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.881a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.01*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e0.05\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCoccygeal Height (CH)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e43.06\u0026thinsp;\u0026plusmn;\u0026thinsp;6.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e41.5\u0026thinsp;\u0026plusmn;\u0026thinsp;6.32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0.015b*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSacral Height (SH)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e143.7\u0026thinsp;\u0026plusmn;\u0026thinsp;12.22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e143.6\u0026thinsp;\u0026plusmn;\u0026thinsp;12.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.885a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSacrococcygeal Height (SCH)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e172.62\u0026thinsp;\u0026plusmn;\u0026thinsp;17.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e173.36\u0026thinsp;\u0026plusmn;\u0026thinsp;16.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.563a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e*p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 is considered statistically significant.\u003c/p\u003e\u003cp\u003ea: Paired-samples t-test; b: Wilcoxon signed-rank test.\u003c/p\u003e\u003cp\u003eη\u0026sup2;: Partial eta squared effect size.\u003c/p\u003e\u003cp\u003eSD: Standard Deviation\u003c/p\u003e\u003cp\u003eIn the subgroup analysis by morphological type \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e, significant postural changes were mostly observed in Types 1 and 2. Both types showed significant reductions in LL, SS, and SSA, along with increases in PT and T1PA in the sitting position. Additionally, TLK increased significantly in Type 1 (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Type 3 exhibited a significant increase in PT, while Type 5 showed reductions in LL and SSA. Type 4 demonstrated only minimal adaptation, with a significant increase in TLK but no other positional changes. For coccygeal morphometry, decrease in CH was observed only in Type 3 (p\u0026thinsp;=\u0026thinsp;0.043).\u003c/p\u003e\u003cp\u003ePatients with LBP demonstrated significantly greater positional changes in TLK, LL, SVA, TPA-T1PA, SS, PT, and SSA (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). SK also differed significantly in this group (p\u0026thinsp;=\u0026thinsp;0.041). Among coccygeal parameters, only SCA was associated with LBP status (p\u0026thinsp;=\u0026thinsp;0.009). Neither coccygeal morphological types nor mobility patterns showed a statistically significant association with LBP (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05) \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComparison of Spinopelvic and Coccygeal Morphometric Parameters in Standing and Sitting Positions According to the Modified Postacchini\u0026ndash;Massobrio Classification\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"16\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c15\" colnum=\"15\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c16\" colnum=\"16\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eType 1\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003eType 2\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u003cp\u003eType 3\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c12\" namest=\"c11\"\u003e\u003cp\u003eType 4\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c13\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c15\" namest=\"c14\"\u003e\u003cp\u003eType 5\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c16\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStanding\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSitting\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eStanding\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eSitting\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eStanding\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003eSitting\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c11\"\u003e\u003cp\u003eStanding\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c12\"\u003e\u003cp\u003eSitting\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c14\"\u003e\u003cp\u003eStanding\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c15\"\u003e\u003cp\u003eSitting\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"16\" nameend=\"c16\" namest=\"c1\"\u003e\u003cp\u003eSpinopelvic Morphometric Parameters\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eThoracic Kyphosis (TK)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e42.18\u0026thinsp;\u0026plusmn;\u0026thinsp;9.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e39.33\u0026thinsp;\u0026plusmn;\u0026thinsp;14.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.189a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e37.22\u0026thinsp;\u0026plusmn;\u0026thinsp;11.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e35.48\u0026thinsp;\u0026plusmn;\u0026thinsp;11.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.428a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e37.17\u0026thinsp;\u0026plusmn;\u0026thinsp;4.98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e24.5\u0026thinsp;\u0026plusmn;\u0026thinsp;2.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e\u003cb\u003e0.009a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e36.33\u0026thinsp;\u0026plusmn;\u0026thinsp;15.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e40.37\u0026thinsp;\u0026plusmn;\u0026thinsp;11.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e0.489a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e46.03\u0026thinsp;\u0026plusmn;\u0026thinsp;16.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e44.5\u0026thinsp;\u0026plusmn;\u0026thinsp;18.92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u003cp\u003e0.732a\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eThoracolumbar Kyphosis (TLK)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e11.45 (2.3\u0026ndash;26.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e15.4 (0.5\u0026ndash;31.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0.044b*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4.85 (1.1\u0026ndash;16.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e5.6 (1.3\u0026ndash;38.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.191b\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e2.65\u0026thinsp;\u0026plusmn;\u0026thinsp;1.79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e7.1\u0026thinsp;\u0026plusmn;\u0026thinsp;5.92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.253a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e8.5\u0026thinsp;\u0026plusmn;\u0026thinsp;4.93\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e14.2\u0026thinsp;\u0026plusmn;\u0026thinsp;6.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u003cb\u003e0.018a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e6.9 (1.3\u0026ndash;7.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e7.5 (7.4\u0026ndash;30.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u003cp\u003e0.181b\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eLumbar Lordosis (LL)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e55.62\u0026thinsp;\u0026plusmn;\u0026thinsp;12.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e30.03\u0026thinsp;\u0026plusmn;\u0026thinsp;12.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e59.59\u0026thinsp;\u0026plusmn;\u0026thinsp;10.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e36.71\u0026thinsp;\u0026plusmn;\u0026thinsp;16.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e58.9 (43.6\u0026ndash;59.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e22.65 (13.9\u0026ndash;42.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.1b\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e50.3 (50.3\u0026ndash;76.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e49.8 (7.3\u0026ndash;77.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e0.789b\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e53.8\u0026thinsp;\u0026plusmn;\u0026thinsp;15.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e30\u0026thinsp;\u0026plusmn;\u0026thinsp;17.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u003cp\u003e\u003cb\u003e0.015a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eThoracolumbar Angle (TPA-T1PA)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8.68\u0026thinsp;\u0026plusmn;\u0026thinsp;5.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e30.36\u0026thinsp;\u0026plusmn;\u0026thinsp;15.32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e11.07\u0026thinsp;\u0026plusmn;\u0026thinsp;6.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e24.22\u0026thinsp;\u0026plusmn;\u0026thinsp;13.29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e6.8\u0026thinsp;\u0026plusmn;\u0026thinsp;2.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e29.3\u0026thinsp;\u0026plusmn;\u0026thinsp;13.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.061a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e10.9 (5.4\u0026ndash;11)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e19.6 (13.5\u0026ndash;44.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e0.181b\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e13.53\u0026thinsp;\u0026plusmn;\u0026thinsp;7.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e21.83\u0026thinsp;\u0026plusmn;\u0026thinsp;8.47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u003cp\u003e0.075a\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSagittal Vertical Axis (SVA)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e19.19 (5.15\u0026ndash;62.61)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e93.57 (19.77-190.23)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001b*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e30.71\u0026thinsp;\u0026plusmn;\u0026thinsp;18.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e85.29\u0026thinsp;\u0026plusmn;\u0026thinsp;51.44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e27.18\u0026thinsp;\u0026plusmn;\u0026thinsp;20.52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e99.37\u0026thinsp;\u0026plusmn;\u0026thinsp;49.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.114a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e41.49\u0026thinsp;\u0026plusmn;\u0026thinsp;42.49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e62.25\u0026thinsp;\u0026plusmn;\u0026thinsp;24.29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e0.25a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e86.71\u0026thinsp;\u0026plusmn;\u0026thinsp;69.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e92.42\u0026thinsp;\u0026plusmn;\u0026thinsp;47.23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u003cp\u003e0.909a\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAnterior Pelvic Plane Angle (APPA)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8.58\u0026thinsp;\u0026plusmn;\u0026thinsp;4.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18.81\u0026thinsp;\u0026plusmn;\u0026thinsp;10.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e6.4 (2.1\u0026ndash;15)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e18.75 (8.5\u0026ndash;51.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001b*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e6.27\u0026thinsp;\u0026plusmn;\u0026thinsp;3.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e17.52\u0026thinsp;\u0026plusmn;\u0026thinsp;9.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e\u003cb\u003e0.042a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e5\u0026thinsp;\u0026plusmn;\u0026thinsp;2.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e22.73\u0026thinsp;\u0026plusmn;\u0026thinsp;6.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e0.072a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e8.57\u0026thinsp;\u0026plusmn;\u0026thinsp;6.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e23.73\u0026thinsp;\u0026plusmn;\u0026thinsp;5.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u003cp\u003e0.098a\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePelvic Incidence (PI)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e46.19\u0026thinsp;\u0026plusmn;\u0026thinsp;11.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e48.9\u0026thinsp;\u0026plusmn;\u0026thinsp;15.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.134a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e51.61\u0026thinsp;\u0026plusmn;\u0026thinsp;14.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e53.16\u0026thinsp;\u0026plusmn;\u0026thinsp;14.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.511a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e48.5\u0026thinsp;\u0026plusmn;\u0026thinsp;11.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e53.33\u0026thinsp;\u0026plusmn;\u0026thinsp;6.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.583a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e47.17\u0026thinsp;\u0026plusmn;\u0026thinsp;9.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e55.2\u0026thinsp;\u0026plusmn;\u0026thinsp;10.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e0.11a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e41.4\u0026thinsp;\u0026plusmn;\u0026thinsp;17.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e47.87\u0026thinsp;\u0026plusmn;\u0026thinsp;7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u003cp\u003e0.415a\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSacral Slope (SS)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e35.17\u0026thinsp;\u0026plusmn;\u0026thinsp;8.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20.95\u0026thinsp;\u0026plusmn;\u0026thinsp;11.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e38.55\u0026thinsp;\u0026plusmn;\u0026thinsp;10.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e26.2\u0026thinsp;\u0026plusmn;\u0026thinsp;9.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e38.5 (16.8\u0026ndash;41.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e19.3 (14.1\u0026ndash;27.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.1b\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e44.1\u0026thinsp;\u0026plusmn;\u0026thinsp;7.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e33.07\u0026thinsp;\u0026plusmn;\u0026thinsp;24.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e0.445a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e30.2\u0026thinsp;\u0026plusmn;\u0026thinsp;13.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e17.4\u0026thinsp;\u0026plusmn;\u0026thinsp;12.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u003cp\u003e0.253a\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePelvic Tilt (PT)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e13.64\u0026thinsp;\u0026plusmn;\u0026thinsp;6.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e29.82\u0026thinsp;\u0026plusmn;\u0026thinsp;12.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e15.12\u0026thinsp;\u0026plusmn;\u0026thinsp;8.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e29.41\u0026thinsp;\u0026plusmn;\u0026thinsp;14.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e11.22\u0026thinsp;\u0026plusmn;\u0026thinsp;2.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e33.5\u0026thinsp;\u0026plusmn;\u0026thinsp;6.67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e\u003cb\u003e0.001a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e8.63\u0026thinsp;\u0026plusmn;\u0026thinsp;5.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e28.57\u0026thinsp;\u0026plusmn;\u0026thinsp;22.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e0.324a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e12.27\u0026thinsp;\u0026plusmn;\u0026thinsp;6.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e30.37\u0026thinsp;\u0026plusmn;\u0026thinsp;13.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u003cp\u003e0.183a\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSpinosacral Angle (SSA)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e125.08\u0026thinsp;\u0026plusmn;\u0026thinsp;7.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e102.28\u0026thinsp;\u0026plusmn;\u0026thinsp;12.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e129.95 (47.7-145.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e110.95 (64.7-129.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e0.004b*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e130.25 (114.8-132.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e101.95 (97.1-118.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.1b\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e129.43\u0026thinsp;\u0026plusmn;\u0026thinsp;8.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e115.77\u0026thinsp;\u0026plusmn;\u0026thinsp;30.44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e0.405a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e122.43\u0026thinsp;\u0026plusmn;\u0026thinsp;1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e103.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u003cp\u003e\u003cb\u003e0.005a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSacral Kyphosis (SK)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e170.6 (150.3-178.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e167.6 (151.6-177.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0.049b*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e166.02\u0026thinsp;\u0026plusmn;\u0026thinsp;8.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e166.08\u0026thinsp;\u0026plusmn;\u0026thinsp;8.39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.975a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e172.9\u0026thinsp;\u0026plusmn;\u0026thinsp;2.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e172.25\u0026thinsp;\u0026plusmn;\u0026thinsp;4.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.756a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e161.57\u0026thinsp;\u0026plusmn;\u0026thinsp;11.24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e162.23\u0026thinsp;\u0026plusmn;\u0026thinsp;14.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e0.857a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e168.7\u0026thinsp;\u0026plusmn;\u0026thinsp;5.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e169.57\u0026thinsp;\u0026plusmn;\u0026thinsp;7.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u003cp\u003e0.663a\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"16\" nameend=\"c16\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCoccygeal Morphometric Parameters\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSacrococcygeal Angle (SCA)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e127.1 (53.6-158.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e128.2 (63.9-166.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.673b\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e120.66\u0026thinsp;\u0026plusmn;\u0026thinsp;13.79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e125.23\u0026thinsp;\u0026plusmn;\u0026thinsp;16.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.062a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e121.62\u0026thinsp;\u0026plusmn;\u0026thinsp;9.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e127.42\u0026thinsp;\u0026plusmn;\u0026thinsp;6.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.098a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e136.2\u0026thinsp;\u0026plusmn;\u0026thinsp;7.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e135.9\u0026thinsp;\u0026plusmn;\u0026thinsp;7.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e0.95a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e133.83\u0026thinsp;\u0026plusmn;\u0026thinsp;13.19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e147.37\u0026thinsp;\u0026plusmn;\u0026thinsp;25.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u003cp\u003e0.219a\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIntercoccygeal Angle (ICA)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e161.7 (138.7-177.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e162.95 (122.6\u0026ndash;176)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.846b\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e157.58\u0026thinsp;\u0026plusmn;\u0026thinsp;11.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e161.98\u0026thinsp;\u0026plusmn;\u0026thinsp;13.44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.17a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e154.57\u0026thinsp;\u0026plusmn;\u0026thinsp;8.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e156.88\u0026thinsp;\u0026plusmn;\u0026thinsp;12.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.59a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e176.03\u0026thinsp;\u0026plusmn;\u0026thinsp;12.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e174.27\u0026thinsp;\u0026plusmn;\u0026thinsp;17.19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e0.615a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e175.5 (155.1-178.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e137.5 (136.6\u0026ndash;170)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u003cp\u003e0.181b\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCoccygeal Height (CH)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e43.39 (35.3-60.36)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e42.27 (20.19\u0026ndash;54.08)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.127b\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e41.68\u0026thinsp;\u0026plusmn;\u0026thinsp;7.52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e41.15\u0026thinsp;\u0026plusmn;\u0026thinsp;6.97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.383a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e42.1\u0026thinsp;\u0026plusmn;\u0026thinsp;5.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e39.59\u0026thinsp;\u0026plusmn;\u0026thinsp;5.79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e\u003cb\u003e0.043a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e46.07\u0026thinsp;\u0026plusmn;\u0026thinsp;1.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e45.98\u0026thinsp;\u0026plusmn;\u0026thinsp;4.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e0.968a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e39.85\u0026thinsp;\u0026plusmn;\u0026thinsp;6.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e38.21\u0026thinsp;\u0026plusmn;\u0026thinsp;4.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u003cp\u003e0.567a\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSacral Height (SH)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e143.41\u0026thinsp;\u0026plusmn;\u0026thinsp;14.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e143.3\u0026thinsp;\u0026plusmn;\u0026thinsp;13.85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.91a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e141.26\u0026thinsp;\u0026plusmn;\u0026thinsp;10.91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e140.66\u0026thinsp;\u0026plusmn;\u0026thinsp;11.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.693a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e152.3\u0026thinsp;\u0026plusmn;\u0026thinsp;9.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e152.28\u0026thinsp;\u0026plusmn;\u0026thinsp;10.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.95a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e149.88\u0026thinsp;\u0026plusmn;\u0026thinsp;5.95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e150.78\u0026thinsp;\u0026plusmn;\u0026thinsp;4.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e0.446a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e142.97\u0026thinsp;\u0026plusmn;\u0026thinsp;6.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e144.85\u0026thinsp;\u0026plusmn;\u0026thinsp;7.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u003cp\u003e0.109a\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSacrococcygeal Height (SCH)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e174.84\u0026thinsp;\u0026plusmn;\u0026thinsp;18.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e174.46\u0026thinsp;\u0026plusmn;\u0026thinsp;16.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.864a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e165.65\u0026thinsp;\u0026plusmn;\u0026thinsp;17.35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e166.96\u0026thinsp;\u0026plusmn;\u0026thinsp;18.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.563a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e178.11\u0026thinsp;\u0026plusmn;\u0026thinsp;17.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e180.84\u0026thinsp;\u0026plusmn;\u0026thinsp;14.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.161a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e189.37\u0026thinsp;\u0026plusmn;\u0026thinsp;8.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e189.26\u0026thinsp;\u0026plusmn;\u0026thinsp;7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e0.93a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e174.25\u0026thinsp;\u0026plusmn;\u0026thinsp;12.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c15\"\u003e\u003cp\u003e177.79\u0026thinsp;\u0026plusmn;\u0026thinsp;14.32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c16\"\u003e\u003cp\u003e0.131a\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e*p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 is considered statistically significant.\u003c/p\u003e\u003cp\u003ea: Paired-samples t-test; b: Wilcoxon signed-rank test.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSpinopelvic and Coccygeal Morphometric Parameters. Modified Postacchini\u0026ndash;Massobrio Classification and Coccygeal Mobility According to the Presence of Back Pain\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u003cp\u003eBack pain -\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u003cp\u003eBack Pain +\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStanding\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003eSitting\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eStanding\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSitting\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e\u003cp\u003eSpinopelvic Morphometric Parameters\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eThoracic Kyphosis (TK)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e41.96\u0026thinsp;\u0026plusmn;\u0026thinsp;9.99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e37.7\u0026thinsp;\u0026plusmn;\u0026thinsp;13.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.012a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e37.79\u0026thinsp;\u0026plusmn;\u0026thinsp;11.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e36.56\u0026thinsp;\u0026plusmn;\u0026thinsp;13.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.568a\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eThoracolumbar Kyphosis (TLK)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5.8 (1-26.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e7.5 (0.5\u0026ndash;30.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.06b\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e6.7 (1.1\u0026ndash;23.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e10.9 (1.3\u0026ndash;38.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e0.004b*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eLumbar Lordosis (LL)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e59.25\u0026thinsp;\u0026plusmn;\u0026thinsp;10.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e34.32\u0026thinsp;\u0026plusmn;\u0026thinsp;18.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e54.99\u0026thinsp;\u0026plusmn;\u0026thinsp;12.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e31.61\u0026thinsp;\u0026plusmn;\u0026thinsp;12.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eThoracolumbar Angle (TPA-T1PA)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e9.17\u0026thinsp;\u0026plusmn;\u0026thinsp;5.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e24.66\u0026thinsp;\u0026plusmn;\u0026thinsp;11.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e10.24\u0026thinsp;\u0026plusmn;\u0026thinsp;5.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e29.9\u0026thinsp;\u0026plusmn;\u0026thinsp;16.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSagittal Vertical Axis (SVA)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e20.9 (5.15-140.91)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e79.75 (19.77-148.98)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001b*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e27.12 (2.78-110.38)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e87.42 (3.83-197.54)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001b*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAnterior Pelvic Plane Angle (APPA)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8.42\u0026thinsp;\u0026plusmn;\u0026thinsp;5.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e21.78\u0026thinsp;\u0026plusmn;\u0026thinsp;10.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e6.6 (2\u0026ndash;15)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e17.2 (7.2\u0026ndash;51.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001b*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePelvic Incidence (PI)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e47.29\u0026thinsp;\u0026plusmn;\u0026thinsp;14.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e50.02\u0026thinsp;\u0026plusmn;\u0026thinsp;12.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.122a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e48.9\u0026thinsp;\u0026plusmn;\u0026thinsp;11.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e52.2\u0026thinsp;\u0026plusmn;\u0026thinsp;14.94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.12a\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSacral Slope (SS)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e37.18\u0026thinsp;\u0026plusmn;\u0026thinsp;10.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e24.47\u0026thinsp;\u0026plusmn;\u0026thinsp;13.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e35.85\u0026thinsp;\u0026plusmn;\u0026thinsp;9.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e22.1\u0026thinsp;\u0026plusmn;\u0026thinsp;9.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePelvic Tilt (PT)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e12.73\u0026thinsp;\u0026plusmn;\u0026thinsp;7.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e29.82\u0026thinsp;\u0026plusmn;\u0026thinsp;14.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e14.46\u0026thinsp;\u0026plusmn;\u0026thinsp;5.93\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e30.02\u0026thinsp;\u0026plusmn;\u0026thinsp;11.94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSpinosacral Angle (SSA)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e128.31\u0026thinsp;\u0026plusmn;\u0026thinsp;8.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e107.9\u0026thinsp;\u0026plusmn;\u0026thinsp;14.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e124 (47.7-145.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e105 (64.7-124.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001b*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSacral Kyphosis (SK)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e165.9 (144.6-177.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e168.6 (146.2-179.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.518b\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e170.7 (150.2-178.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e167.4 (149.5-177.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e0.041b*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCoccygeal Morphometric Parameters\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSacrococcygeal Angle (SCA)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e128.1 (53.6-158.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e127.4 (63.9-176.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.572b\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e124.5\u0026thinsp;\u0026plusmn;\u0026thinsp;13.98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e130.04\u0026thinsp;\u0026plusmn;\u0026thinsp;17.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e0.009a*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIntercoccygeal Angle (ICA)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e161.56\u0026thinsp;\u0026plusmn;\u0026thinsp;12.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e160.18\u0026thinsp;\u0026plusmn;\u0026thinsp;15.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.631a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e160.7 (134.7-175.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e167.3 (136.1-177.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.581b\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCoccygeal Height (CH)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e42.89 (23.76\u0026ndash;60.36)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e41.48 (24.5-50.08)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.011b*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e43.24\u0026thinsp;\u0026plusmn;\u0026thinsp;6.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e41.52\u0026thinsp;\u0026plusmn;\u0026thinsp;7.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.23a\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSacral Height (SH)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e143.75\u0026thinsp;\u0026plusmn;\u0026thinsp;12.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e143.48\u0026thinsp;\u0026plusmn;\u0026thinsp;13.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.761a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e143.66\u0026thinsp;\u0026plusmn;\u0026thinsp;12.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e143.74\u0026thinsp;\u0026plusmn;\u0026thinsp;11.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.941a\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSacrococcygeal Height (SCH)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e173.86\u0026thinsp;\u0026plusmn;\u0026thinsp;17.91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e173.12\u0026thinsp;\u0026plusmn;\u0026thinsp;17.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.635a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e171.4\u0026thinsp;\u0026plusmn;\u0026thinsp;18.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e173.6\u0026thinsp;\u0026plusmn;\u0026thinsp;16.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.28a\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eModified Postacchini\u0026ndash;Massobrio Classification\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eType 1\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e12(%54.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c7\" namest=\"c4\"\u003e\u003cp\u003e10(%45.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003e0.742\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eType 2\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e8(%44.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c7\" namest=\"c4\"\u003e\u003cp\u003e10(%55.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eType 3\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e1(%25)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c7\" namest=\"c4\"\u003e\u003cp\u003e3(%75)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eType 4\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e2(%66.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c7\" namest=\"c4\"\u003e\u003cp\u003e1(%33.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eType 5\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e2(%66.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c7\" namest=\"c4\"\u003e\u003cp\u003e1(%33.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCoccygeal Mobility\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNormobility\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e17 (%60.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c7\" namest=\"c4\"\u003e\u003cp\u003e11 (%39.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e0.392\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eHipermobility\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e2 (%33.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c7\" namest=\"c4\"\u003e\u003cp\u003e4 (%66.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eHypomobility\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e2 (%28.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c7\" namest=\"c4\"\u003e\u003cp\u003e5 (%71.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePosterior Luxation\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e4 (%44.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c7\" namest=\"c4\"\u003e\u003cp\u003e5 (%55.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e*p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 is considered statistically significant.\u003c/p\u003e\u003cp\u003ea: Paired-samples t-test; b: Wilcoxon signed-rank test.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eLogistic Regression Analysis\u003c/h2\u003e\u003cp\u003eA stepwise logistic regression analysis was performed to identify spinopelvic and coccygeal parameters associated with pain status (NRS\u0026thinsp;\u0026ge;\u0026thinsp;6), as shown in the \u003cb\u003eSupplemental File\u003c/b\u003e. The final model demonstrated acceptable overall fit and discrimination (Nagelkerke R\u0026sup2;: 0.57, AUC: 0.88, 95% CI: 0.78\u0026ndash;0.99, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Among the evaluated variables, ICA, TLK, and APPA remained significant predictors. An increase in ICA was associated with 9% higher odds of pain (p\u0026thinsp;=\u0026thinsp;0.028), whereas higher TLK reduced the odds of pain by 13% (p\u0026thinsp;=\u0026thinsp;0.038). APPA showed the strongest association, with a 19% increase in the odds of pain for each unit increase (p\u0026thinsp;=\u0026thinsp;0.002).\u003c/p\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study demonstrates that posture has a significant influence on sagittal spinopelvic alignment, coccygeal morphology, and mobility in coccydynia, with notable differences between the sitting and standing positions. Morphology Types 1 and 2 showed the greatest postural adaptability, whereas Types 4 and 5 exhibited minimal positional change. ICA and APPA were predictors of coccygeal pain, while TLK was inversely associated. Among spinopelvic parameters, SK was the only variable associated with LBP, and SCA was the only coccygeal parameter related to LBP, despite broader positional differences across the groups.\u003c/p\u003e\u003cp\u003eThe most common coccygeal morphologies were Types 1 and 2, similar to previous studies.[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e] Segment distribution, fusion rates, and the frequency of spicule formation were also consistent with earlier reports.[\u003cspan additionalcitationids=\"CR12 CR13\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] Spicules were most prevalent in Type 5, suggesting that posteriorly angulated coccyges may promote localized bony projections that may increase sitting pressure. Among morphometric parameters, CH significantly decreased in the sitting position, indicating postural compression of the coccyx, which was most evident in Type 3, consistent with its greater mobility. From standing to sitting position, ICA increased in Types 1\u0026ndash;3 but decreased in Types 4 and 5, where posterior luxation was most frequent. It was the only parameter demonstrating a significant type\u0026times;posture interaction, highlighting its value as a morphology-related marker. Increased ICA was also associated with higher odds of coccygeal pain, and regression analysis confirmed ICA as a significant predictor of coccygeal pain. LBP status further influenced the morphologic patterns: in patients without LBP, CH significantly decreased during sitting, reflecting greater postural mobility, whereas in those with LBP, SCA increased, possibly representing altered compensatory mechanisms.\u003c/p\u003e\u003cp\u003eNormomobility was the predominant mobility pattern, followed by posterior luxation, hypomobility, and hypermobility. LBP was more frequent among hypomobile cases, although this trend did not reach significance. Previous studies emphasized the role of hypermobility and luxation in coccydynia, whereas our results highlight restricted motion as another potential factor and provide exploratory insight into possible links with LBP.[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e] To our knowledge, no prior study has systematically analyzed coccygeal mobility, MPM classification, and coexisting LBP, emphasizing the novelty of these observations.\u003c/p\u003e\u003cp\u003eSacral slope decreased significantly from standing to sitting, reflecting pelvic retroversion, while PT and APPA increased, indicating substantial backward pelvic rotation. These findings align with prior meta-analyses, which reported sitting-induced reductions in SS of ~\u0026thinsp;50% accompanied by corresponding increases in PT.[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e] Across morphological subtypes, SS decreased significantly in all groups during sitting, most prominently in Types 1 and 2. Additionally, Type 4 demonstrated the highest SS values, reflecting anterior sacral inclination, while Type 5 had the lowest values, consistent with a flatter alignment. PT and APPA increased significantly in Types 1\u0026ndash;3, whereas Types 4 and 5 showed minimal change, suggesting reduced postural adaptability. Across all subtypes, PI values remained stable, confirming its posture-independent nature. Patients with LBP showed a more pronounced decrease in SS and increase in PT, indicating that excessive pelvic retroversion and sacral verticalization during sitting may contribute to discomfort. Furthermore, APPA was the strongest predictor of coccydynia, with a 19% increase in the odds of pain for each unit increase.\u003c/p\u003e\u003cp\u003eSacral kyphosis, which has a significant correlation with PI and is an important determinant of sagittal balance, showed opposite trends between groups: it slightly increased in patients without LBP but decreased significantly in those with LBP, suggesting enhanced sacral concavity.[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e] This finding is supported by posture\u0026times;pain interaction analysis, where SK was the only parameter significantly influencing the LBP, although with a small effect size. Its positive relationship with LL, a key compensatory parameter, is consistent with previous findings in lumbar disc herniation, where decreased LL and increased SK indicate impaired lumbopelvic compensation.[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/p\u003e\u003cp\u003eSitting led to reductions in LL and TK, accompanied by a compensatory increase in TLK, consistent with prior literature.[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] This shift suggests that mechanical load is redistributed toward the thoracolumbar junction, where increased kyphosis may serve as a compensatory adaptation to the loss of lumbar curvature, which explains the inverse association between TLK and coccygeal pain observed in this study.[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e] Furthermore, TK decreased only in LBP-free patients, while LL decreased in both groups, but more prominently in those without LBP. TLK showed a near-significant interaction with LBP, though with limited clinical relevance.\u003c/p\u003e\u003cp\u003eSagittal balance parameters are strongly correlated with T1PA, and elevated values are associated with increased disability; surgical targets are typically set below 10\u0026ndash;14\u0026deg;.[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] In this study, T1PA increased from 9.7\u0026deg; in the standing position to 27.3\u0026deg; in the sitting position, indicating deterioration in sagittal alignment. SSA, another global indicator of sagittal balance known to correlate with SS and LL, also decreased significantly, reflecting verticalization of the sacrum and a loss of global spinal harmony.[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] Morphologically, TPA-T1PA increased significantly in Types 1 and 2, while SSA decreased in Types 1, 2, and 5 during sitting. Both parameters changed significantly with posture, but the magnitude of change was smaller in patients with LBP, suggesting restricted pelvic adaptation and greater spinal loading. These findings are consistent with previous reports in degenerative kyphosis, rheumatoid arthritis, and discogenic back pain, supporting SSA as not only a static anatomical measure but also a dynamic marker of biomechanical dysfunction linked to symptoms.[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e] SVA was also significantly increased in the sitting position, reflecting a forward shift of the center of gravity. Standing measurements remained within normative ranges, while sitting values were markedly higher, especially in patients with LBP, suggesting increased anterior displacement and sagittal malalignment.[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/p\u003e\u003cp\u003eThis study has several limitations. First, the study was conducted at a single center with a relatively small sample size, which may limit its generalizability. Second, reliance on two-dimensional radiographs may not fully capture the complexity of dynamic postural changes, particularly during transitions between standing and sitting. Third, despite standardized protocols, variations in seated posture may have introduced measurement inconsistencies.\u003c/p\u003e\u003cp\u003eIn conclusion, patients with coccydynia exhibit significant posture-related changes in spinopelvic parameters, particularly LL, SS, PT, and SVA, with ICA emerging as a morphology-related marker. Coccygeal morphology and mobility influence sagittal alignment, and dynamic assessment in functional postures may enhance diagnostic accuracy and guide rehabilitation strategies.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\n\u003cp\u003eStudy conception and design: A.K., N.Y., E.G., O.G.I., P.K.; Data collection and materials: A.K., E.G., O.G.I., F.E.B.U.; Analysis and/or Interpretation of results: A.K., N.Y., E.G., O.G.I., F.E.B.U., S.A., K.S., I.A., P.K.; Literature review and control: A.K., N.Y., E.G., O.G.I., P.K.; Writing the article and critical review: A.K., N.Y., E.G., O.G.I., K.S. I.A., P.K.; References and fundings: A.K., N.Y., E.G., O.G.I., P.K.\u003c/p\u003e\n\u003ch2\u003eAcknowledgement\u003c/h2\u003e\n\u003cp\u003eFundingNo specific grant from funding agencies in the public, commercial, or not-for-profit sectors supported this research. Conflict of Interest All authors certify that they have no affiliations with or involvement in any organization or entity with any financial or non-financial interest in the subject matter or materials discussed in this manuscript.Data availability The data supporting the findings of this study are available from the corresponding author upon request.AcknowledmentsThe authors appreciate all patients who contributed clinical information in this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eDurbas, A., et al., \u003cem\u003eEvaluating Variations in Spinopelvic Parameters from Sitting to Standing: A Comparative Analysis of 1447 Older Adults Across Age, BMI, and Gender Subgroups.\u003c/em\u003e Journal of Clinical Medicine, 2025. \u003cstrong\u003e14\u003c/strong\u003e(9): p. 2952.\u003c/li\u003e\n \u003cli\u003eSuzuki, H., et al., \u003cem\u003eRadiographic Assessment of Spinopelvic Sagittal Alignment from Sitting to Standing Position.\u003c/em\u003e Spine Surg Relat Res, 2018. \u003cstrong\u003e2\u003c/strong\u003e(4): p. 290-293.\u003c/li\u003e\n \u003cli\u003ePrasetya, A., et al., \u003cem\u003eAnalyzing spinopelvic parameter differences between standing and supine position.\u003c/em\u003e Journal of Musculoskeletal Surgery and Research. \u003cstrong\u003e9\u003c/strong\u003e.\u003c/li\u003e\n \u003cli\u003e\u0026Ouml;zkal, B., S. Avnioğlu, and B. Candan, \u003cem\u003eMorphometric evaluation of coccyx in patients with coccydynia and classification.\u003c/em\u003e Acta Medica Alanya, 2020. \u003cstrong\u003e4\u003c/strong\u003e(1): p. 61-67.\u003c/li\u003e\n \u003cli\u003eYagi, F., et al., \u003cem\u003eThree-dimensional evaluation of the coccyx movement between supine and standing positions using conventional and upright computed tomography imaging.\u003c/em\u003e Scientific Reports, 2021. \u003cstrong\u003e11\u003c/strong\u003e(1): p. 6886.\u003c/li\u003e\n \u003cli\u003eBo, K., et al., \u003cem\u003eDynamic MRI of the pelvic floor muscles in an upright sitting position.\u003c/em\u003e Neurourol Urodyn, 2001. \u003cstrong\u003e20\u003c/strong\u003e(2): p. 167-74.\u003c/li\u003e\n \u003cli\u003eErsen, O., et al., \u003cem\u003ePelvic Incidence as a Prognostic Factor in Coccydynia.\u003c/em\u003e Turkish Neurosurgery, 2019. \u003cstrong\u003e29\u003c/strong\u003e(3): p. 400-403.\u003c/li\u003e\n \u003cli\u003ePostacchini, F. and M. Massobrio, \u003cem\u003eIdiopathic coccygodynia. Analysis of fifty-one operative cases and a radiographic study of the normal coccyx.\u003c/em\u003e J Bone Joint Surg Am, 1983. \u003cstrong\u003e65\u003c/strong\u003e(8): p. 1116-24.\u003c/li\u003e\n \u003cli\u003eMaigne, J.-Y. and B. Tamalet, \u003cem\u003eStandardized Radiologic Protocol for the Study of Common Coccygodynia and Characteristics of the Lesions Observed in the Sitting Position: Clinical Elements Differentiating Luxation, Hypermobility, and Normal Mobility.\u003c/em\u003e Spine, 1996. \u003cstrong\u003e21\u003c/strong\u003e(22): p. 2588-2593.\u003c/li\u003e\n \u003cli\u003eMisir, A., et al., \u003cem\u003eLumbar spine posture and spinopelvic parameters change in various standing and sitting postures.\u003c/em\u003e Eur Spine J, 2019. \u003cstrong\u003e28\u003c/strong\u003e(5): p. 1072-1081.\u003c/li\u003e\n \u003cli\u003eGuneri, B. and G. Gungor, \u003cem\u003eMorphological Features of the Coccyx in the Turkish Population and Interrelationships Among the Parameters: A Computerized Tomography-Based Analysis.\u003c/em\u003e Cureus, 2021. \u003cstrong\u003e13\u003c/strong\u003e(11): p. e19687.\u003c/li\u003e\n \u003cli\u003eHekimoglu, A. and O. Ergun, \u003cem\u003eMorphological evaluation of the coccyx with multidetector computed tomography.\u003c/em\u003e Surg Radiol Anat, 2019. \u003cstrong\u003e41\u003c/strong\u003e(12): p. 1519-1524.\u003c/li\u003e\n \u003cli\u003eKuytu T., K.A., \u003cem\u003eDetailed Coccygeal Morphology on Multislice\u0026nbsp;\u003c/em\u003e\u003cem\u003e3d Ct in 1000 Asymptomatic Turkish Adults.\u003c/em\u003e Acta Medica Alanya, 2024. \u003cstrong\u003e8\u003c/strong\u003e(1): p. 49-57.\u003c/li\u003e\n \u003cli\u003eLirette, L.S., et al., \u003cem\u003eCoccydynia: an overview of the anatomy, etiology, and treatment of coccyx pain.\u003c/em\u003e Ochsner J, 2014. \u003cstrong\u003e14\u003c/strong\u003e(1): p. 84-7.\u003c/li\u003e\n \u003cli\u003eTan, T.H., J.H. Tan, and H.W.D. Hey, \u003cem\u003eChanges in Spinopelvic Parameters Between Standing and Sitting Postures: A Systematic Review and Meta-analysis.\u003c/em\u003e Clin Spine Surg, 2024. \u003cstrong\u003e37\u003c/strong\u003e(3): p. 97-113.\u003c/li\u003e\n \u003cli\u003eRu, N., et al., \u003cem\u003eSacral anatomical parameters varies in different Roussouly sagittal shapes as well as their relations to lumbopelvic parameters.\u003c/em\u003e JOR Spine, 2021. \u003cstrong\u003e4\u003c/strong\u003e(4): p. e1180.\u003c/li\u003e\n \u003cli\u003eErgun, T., H. Lakadamyali, and M.S. Sahin, \u003cem\u003eThe relation between sagittal morphology of the lumbosacral spine and the degree of lumbar intervertebral disc degeneration.\u003c/em\u003e Acta Orthop Traumatol Turc, 2010. \u003cstrong\u003e44\u003c/strong\u003e(4): p. 293-9.\u003c/li\u003e\n \u003cli\u003eTsagkaris, C., et al., \u003cem\u003eThe sitting vs standing spine.\u003c/em\u003e N Am Spine Soc J, 2022. \u003cstrong\u003e9\u003c/strong\u003e: p. 100108.\u003c/li\u003e\n \u003cli\u003eLiu, C., et al., \u003cem\u003eThoracolumbar/Lumbar Degenerative Kyphosis\u0026mdash;The Importance of Thoracolumbar Junction in Sagittal Alignment and Balance.\u003c/em\u003e Journal of Personalized Medicine, 2024. \u003cstrong\u003e14\u003c/strong\u003e(1): p. 36.\u003c/li\u003e\n \u003cli\u003eCho, I.Y., et al., \u003cem\u003eThe Effect of Standing and Different Sitting Positions on Lumbar Lordosis: Radiographic Study of 30 Healthy Volunteers.\u003c/em\u003e Asian Spine J, 2015. \u003cstrong\u003e9\u003c/strong\u003e(5): p. 762-9.\u003c/li\u003e\n \u003cli\u003eRoussouly, P. and J.L. Pinheiro-Franco, \u003cem\u003eSagittal parameters of the spine: biomechanical approach.\u003c/em\u003e Eur Spine J, 2011. \u003cstrong\u003e20 Suppl 5\u003c/strong\u003e(Suppl 5): p. 578-85.\u003c/li\u003e\n \u003cli\u003eSavarese, L.G., et al., \u003cem\u003eSpinopelvic sagittal balance: what does the radiologist need to know?\u003c/em\u003e Radiol Bras, 2020. \u003cstrong\u003e53\u003c/strong\u003e(3): p. 175-184.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"coccyx, coccydynia, low back pain, mobility, morphology, morphometry, sagittal alignment, sitting, standing, spinopelvic parameters","lastPublishedDoi":"10.21203/rs.3.rs-8064384/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8064384/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003ePurpose\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCoccygeal morphology has been described in coccydynia, but dynamic assessments have been limited to standing or supine positions. As coccydynia is posture-related and aggravated by sitting, evaluating functional postures is essential but lacking. Not all individuals with similar morphology or risk factors develop symptoms, suggesting that posture-dependent biomechanical differences may contribute to pain. The coccyx participates in spinopelvic motion during sitting, and alterations in this dynamic alignment may influence symptom onset. Therefore, this study aimed to investigate posture-dependent changes in spinopelvic and coccygeal parameters among different coccygeal morphologic types and to explore their potential association with coccydynia.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLateral radiographs were obtained in standing and sitting positions for 50 patients with coccydynia. Spinopelvic (thoracic kyphosis [TK], thoracolumbar kyphosis [TLK], lumbar lordosis [LL], thoracopelvic angle [TPA-T1PA], anterior pelvic plane angle [APPA], sagittal vertical axis [SVA], sacral slope [SS], pelvic incidence [PI], pelvic tilt [PT], spinosacral angle [SSA], and sacral kyphosis [SK]) and coccygeal (sacrococcygeal [SCA] and intercoccygeal [ICA] angles, coccygeal [CH], sacral [SH], and sacrococcygeal height [SCH]) parameters were measured and compared. Coccygeal morphology (segments, fusion, mobility) was evaluated and classified using the modified Postacchini-Massobrio system. Logistic regression identified predictors of pain, and analyses by morphology and low back pain (LBP) status examined associations with posture-related adaptability.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSignificant postural changes were observed in spinopelvic (TK, TLK, LL, TPA-T1PA, SVA, APPA, SS, PT, SSA) and coccygeal (SCA, CH) parameters (p \u0026lt; 0.05). Logistic regression identified ICA, TLK, and APPA as pain predictors: ICA increased odds by 9% (p = 0.028), TLK reduced odds by 13% (p = 0.038), and APPA increased odds by 19% (p = 0.002). Types 1 and 2 showed the greatest postural variability, while Types 4 and 5 were more rigid. SK showed a significant interaction with LBP (p = 0.04, η²=0.01), and ICA was associated with morphological type (p = 0.01, η²=0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSitting posture significantly alters sagittal spinopelvic alignment in coccydynia. Coccygeal morphology and mobility appear to influence these postural adaptations and pain severity. Patients with coccydynia demonstrated significant changes in spinopelvic parameters, particularly LL, SS, PT, and SVA, with ICA emerging as a morphology-related marker. Dynamic assessment in functional postures, particularly sitting, may provide valuable insights for diagnosis and rehabilitation planning in patients with coccydynia.\u003c/p\u003e","manuscriptTitle":"Radiographic Assessment of Sagittal Spinopelvic Alignment and Coccygeal Morphology and Mobility in Sitting and Standing Positions in Coccydynia","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-26 09:16:13","doi":"10.21203/rs.3.rs-8064384/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"9800d725-1416-4d09-a4a5-0e7c1a7a4301","owner":[],"postedDate":"November 26th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-01-20T16:20:44+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-26 09:16:13","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8064384","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8064384","identity":"rs-8064384","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}