For a comparative radiographic study, the purpose was to determine how the radiographic lower limb-spinal length proportion affected sagittal radiographic characteristics. Although lumbar spine lordotic realignment was a well-established surgical approach, the appropriate target was yet to be determined. In chosen participants, the widely utilised pelvic incidence-lumbar lordosis discrepancy (PI-LL) approach for guiding the lordotic restoration of the lumber spine in the standing posture might be enhanced further utilising the unique, radiographic lower limb-spinal length proportion metric. In order to measure sagittal radiographic parameters, 100 healthy people were imaged in the standing position utilising EOS imaging to generate whole-body lateral radiographs. To compare radiographic parameters between groups with differing radiographic lower limb-spinal length proportions, univariate analyses were used. Multivariate analyses were used to determine the relationships between lower limb-spinal length proportions and other radiographic data. Global lumbar angle (GLA) diverged from spinal lordosis (SL), with the absolute means of SL and GLA being bigger and smaller than pelvic incidence (PI), respectively, regardless of lower limb-spinal length proportion (mean=1.4). Patients with a proportionately more significant lower limb-to-spinal length ratio have a higher mean T1-slope, global thoracic angle (GTA), spinal kyphosis (SK), GLA, and SL, according to univariate analysis. A bigger lower limb length-to-spinal length proportion was associated with a lower GLA of less than –47.69° (Odds Ratio (OR) 2.660, p=0.026) and a larger T1-slope of more than 18.84° (OR 3.695, p=0.012), according to multivariate analysis. The percentage of lower limb-to-spinal length on radiographs is larger, resulting in naturally accentuated spinal curves. These patients have a bigger lumbar lordosis closer to the PI and a higher T1-slope, so spinal realignment should be addressed. SL is distinct from GLA and should be evaluated individually.
