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

Abstract

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.