Sagittal spinopelvic parameters in children and adolescents: a retrospective cross-sectional radiographic study from Turkey.

BACKGROUND

Sagittal spinal parameters are used to assess upright alignment during growth.

OBJECTIVE

To describe sagittal spinopelvic parameters and assess their associations with age and sex in children and adolescents in Turkey.

MATERIALS AND

METHODS

This retrospective cross-sectional study at a single tertiary orthopedic center included 344 children aged 6-17 years (186 boys, 158 girls) who underwent clinically indicated standing full-spine radiography. Pelvic incidence, pelvic tilt, sacral slope, lumbar lordosis, thoracic kyphosis, sagittal vertical axis, cervical vertebra (C) 2 tilt, thoracic vertebra (T) 4 tilt, lumbar vertebra (L) 1 tilt, T4 pelvic angle, and L1 pelvic angle were assessed. Age-group comparisons and age- and sex-adjusted linear models were used.

RESULTS

Mean (standard deviation) pelvic incidence, pelvic tilt, sacral slope, lumbar lordosis, and thoracic kyphosis were 45.4 (12.3)°, 11.3 (6.9)°, 34.2 (10.4)°, 57.5 (13.8)°, and 46.0 (13.4)°, respectively; sagittal vertical axis was 46.6 (27.6) mm. C2, T4, and L1 tilts were 5.0 (2.9)°, 10.4 (4.6)°, and 9.0 (4.7)°; T4 pelvic angle and L1 pelvic angle were 4.1 (3.1)° and 3.4 (3.1)°. Lumbar lordosis showed the largest adjusted age coefficient (1.81°/year; 95% confidence interval (CI) 1.28-2.34; adjusted R2=0.121). T4 pelvic angle and L1 pelvic angle did not differ significantly across age groups (P=0.308 and P=0.966).

CONCLUSION

In children and adolescents without radiographic spinal or pelvic deformity, lumbar lordosis had the clearest cross-sectional association with age. No statistically significant age-group differences were detected for T4 pelvic angle or L1 pelvic angle. These data provide clinically relevant standing-radiograph reference data for sagittal spinopelvic parameters.