Normal spino-pelvic parameters and correlation between lumbar lordosis (LL) and pelvic incidence (PI) in children and adolescents in Indian population.

Abstract

The purpose of this work is to describe normal spino-pelvic parameters for pediatric and adolescent Indian population (and compare it with a cohort of different ethnicity) and to find out the correlation of pelvis incidence (PI) and lumbar lordosis (LL) METHODS: 129 asymptomatic subjects (66 males, 63 females) with age 4-15years were studied. Pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and lumbar lordosis (LL) were measured on lateral whole-spine standing radiographs using computer software and compared in relation to age, sex, and ethnicity. Using correlation and regression analysis, the association and predictability of LL with PI was studied within the entire sample and then among age groups 4-10 and 11-15years. Mean PI was 42° ± 8.1°, whereas PT and SS were 12.9° ± 7.8° and 29.3° ± 9.62°, respectively. PI and SS were lower (p < 0.0001), but PT was higher than Caucasians. Overall PI remained unchanged in the age group > 10years in comparison to the younger age. Mean PT was lower (p = 0.0020), but SS and LL were higher (p = 0.0027 and p = 0.0002 respectively). Angular spino-pelvic parameters were similar between sex groups. Overall correlation between PI and LL was 0.4 (p < 0.0001) which was 0.1 (p = 0.2345) and 0.5 (p < 0.0001) for ages 4-10 and 11-15years, respectively. Overall, the prediction of PI based on LL is not very accurate with a simple linear term between PI and LL (R2 = 0.1) and only improve marginally with a restricted cubic spline function. In pediatric and adolescent' population, ethnicity and age-related variations of normal sagittal spino-pelvic parameters exist and should be considered in patient management.