Do Age-Related Variations Of Sagittal Alignment Rely On SpinoPelvic Organization? An Observational Study Of 1540 Subjects

• Published in: Global spine journal Vol. 13; no. 8; pp. 2144 - 2154
• Main Authors: Prost, Solène, Blondel, Benjamin, Bauduin, Eloïse, Pesenti, Sébastien, Ilharreborde, Brice, Laouissat, Féthi, Riouallon, Guillaume, Wolff, Stéphane, Challier, Vincent, Obeid, Ibrahim, Boissière, Louis, Ferrero, Emmanuelle, Solla, Federico, Le Huec, Jean-Charles, Bourret, Stéphane, Faddoul, Joe, Abi Lahoud, Georges Naïm, Fière, Vincent, Vande Kerckhove, Michiel, Campana, Matthieu, Lebhar, Jonathan, Giorgi, Hadrien, Faure, Aymeric, Sauleau, Erik A., Charles, Yann Philippe
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.10.2023; Sage Publications Ltd; SAGE
• Subjects: Age groups; Human health and pathology; Life Sciences; Observational studies; Original; Rhumatology and musculoskeletal system; Santé publique et épidémiologie; Tissues and Organs; thoracolumbar; sagittal alignment; sagittal balance
• ISSN: 2192-5682; 2192-5690
• DOI: 10.1177/21925682221074660

Study design Descriptive radiographic analysis of a prospective multi-center database. Objective This study aims to provide normative values of spinopelvic parameters and their correlations according to age and pelvic incidence (PI) of subjects without spinal deformity. Methods After Institutional Review Board (IRB) approval, 1540 full spine radiographs were analyzed. Subjects were divided into 3 groups of PI: low PI < 45°, intermediate PI 45–60°, high PI > 60°, and then stratified by age (20–34, 35–49, 50–64, > 65 Y.O). Pelvic and spinal parameters were measured. Statistical analysis between parameters was performed using Bayesian inference and correlation. Results Mean age was 53.5 years (845 females, 695 males, range 20–93 years). In low PI group, lumbar lordosis (LL) decrease was mainly observed in the 2 younger age groups. In medium and high PI groups, loss of lordosis was linear during aging and occurred mainly on the distal arch of lordosis. Moderate PI group had a stable lordosis apex and thoracolumbar inflection point. High PI group had a stable thoracolumbar inflection point and a more distal lordosis apex in elderly subjects. For all subjects, kyphosis and pelvic tilt (PT) increased with age. There was a constant chain of correlation between PI and age groups. Proximal lumbar lordosis (PLL) was correlated with kyphosis and sagittal vertical axis (SVA C7), while the distal lumbar lordosis (DLL) was correlated with PI and PT. Conclusion This study provides a detailed repository of sagittal spinopelvic parameters normative values with detailed analysis of segmental kyphosis and lordosis distribution according to gender, age, and PI.