Sagittal Spinopelvic Parameters of Young Children With Scoliosis

Study design: Retrospective, multicenter review of the spinopelvic parameters in young children with scoliosis.

Objectives: To describe sagittal alignment of the spine and pelvis in young children with scoliosis.

Summary of background data: The natural history of spinopelvic parameters has been defined for the first 10 years of life in normal children; however, they have not been described for children with scoliosis. Such information is important because these values can be used as a baseline for the assessment of radiographic outcomes after surgical intervention.

Methods: Seven measures of sagittal alignment were taken from standing lateral radiographs of 80 children with scoliosis (coronal Cobb angle greater than 50°) and compared with age-matched normal children described in the literature. Statistical analysis was performed using 2-tailed Student t tests (level of significance = .05) and Pearson correlation coefficient.

Results: Patients had a mean age of 4.8 years (range, 1-10 years) and a mean Cobb angle of 72.0° ± 16°. Mean sagittal spine parameters were sagittal balance (2.2 ± 4 cm), thoracic kyphosis (38.0° ± 20.8°), and lumbar lordosis (49.0° ± 16.6°). These values were similar to those of children without scoliosis. Mean sagittal pelvic parameters were: pelvic incidence (46.5° ± 15.8°), pelvic tilt (10.7° ± 13.6°), sacral slope (35.5° ± 12.1°), and pelvic radius (55.7° ± 21.3°). Pelvic incidence was not significantly different from that of age-matched normal children; however, pelvic tilt was significantly higher and sacral slope was significantly lower in children with scoliosis.

Conclusions: Sagittal plane spine parameters and some pelvic parameters were similar for young children with scoliosis versus age-matched normal children; however, children with scoliosis showed signs of increased pelvic tilt and decreased sacral slope. These values can be used as a baseline for both the natural history and the assessment of radiographic outcomes after surgical intervention.