Assessment of Sagittal Spinopelvic Balance in a Population of Normal Chinese Children

Spine (Phila Pa 1976). 2020 Jul 1;45(13):E787-E791. doi: 10.1097/BRS.0000000000003428.

Abstract

Study design: A retrospective study of 257 normal children at a single center from July 2016 to November 2018 was performed.

Objective: To evaluate the spinopelvic parameters in a population of normal children and adolescents in mainland China.

Summary of background data: Values for sagittal parameters of the spine vary significantly by ages and different population. No study has yet quantified the normal measures for children and adolescents in China, or how these measures compare with other populations.

Methods: Pelvic incidence (PI), sacral slope, pelvic tilt, thoracic kyphosis (TK, T5-T12), lumbar lordosis (LL, L1-S1), and sagittal vertical axis were measured and evaluated by whole spine AP&lateral X-ray images.

Results: A total of 257 subjects, including 116 boys (45%) and 141 girls (55%) aged 3 to 12 years, were enrolled. Correlation matrix analysis demonstrated that sagittal balance is strongly correlated with age and Risser sign, including PI, a reported fixed parameter. Further investigation showed that PI could be expressed by the equation PI = 26.243+1.153×age.

Conclusion: PI was not a fixed but a dynamic parameter in the population under 12-year old. Indeed, PI increases with age and bone maturity in childhood. We also found lower PI, pelvic tilt, and sacral slope compared with published studies of adolescents in other countries. These results may aid in the treatment of patients with spinal deformity, to help them achieve a certain degree of sagittal spinopelvic balance.

Level of evidence: 2.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Asian People
  • Child
  • Child, Preschool
  • China
  • Female
  • Humans
  • Incidence
  • Kyphosis / diagnostic imaging
  • Lordosis / diagnostic imaging
  • Male
  • Middle Aged
  • Pelvis / diagnostic imaging*
  • Posture*
  • Radiography
  • Retrospective Studies
  • Sacrum / diagnostic imaging
  • Spine / diagnostic imaging*