Abstract
PurposeTo investigate the spinopelvic alignment and vertebral shape in children, and associations with body composition and structural spinal abnormalities on magnetic resonance imaging (MRI).MethodsWe performed a cross-sectional study embedded in the Generation R Study, a prospective population-based birth cohort. Pelvic incidence and vertebral concavity ratios for each lumbar level were determined on sagittal MRI images in 9-year-old children, and structural spinal abnormalities were scored semi-quantitatively. The BMI-SD score was calculated, and body composition was assessed using DXA scans. Associations of pelvic incidence and vertebral concavity ratios with structural abnormalities and body composition measures were assessed using (multilevel) regression analyses.ResultsThis study included 522 participants (47.7% boys), aged 9.9 years (IQR 9.7–10.0). The mean pelvic incidence was 36.6° (SD 8.0). Vertebral concavity ratios ranged from 0.87 to 0.90, with significantly lower ratios for boys compared to girls. Associations were found for a larger pelvic incidence with decreased disc height [OR 1.03 (95% CI 1.02–1.05)], and a pelvic incidence in the lowest tertile with less disc bulging [OR 0.73 (95% CI 0.56–0.95)]. Increased vertebral concavity ratio was associated with decreased disc height [OR 14.16 (95% CI 1.28–157.13)]. Finally, increased fat-free mass index was associated with a smaller pelvic incidence [adjusted OR 0.85 (95% CI 0.07–1.63)].ConclusionThe mean pelvic incidence of 9-year-old children is 36.6° on supine MRI images, and a slightly concave shape of the lumbar vertebrae is seen. Spinopelvic alignment is associated with structural spinal abnormalities, and might itself be influenced by the children’s body composition.
Highlights
The human standing posture involves a delicate balance between the spine and pelvis [1]
Both a larger pelvic incidence angle and a larger vertebral concavity ratio were associated with a decreased disc height, and a smaller pelvic incidence was associated with less disc bulging
A higher fat-free mass index was associated with a smaller pelvic incidence, while none of the body composition measures were associated with the vertebral concavity ratio
Summary
The human standing posture involves a delicate balance between the spine and pelvis [1]. The positioning of the spine and pelvis determines the spinopelvic alignment, which can be described by parameters, like sacral slope, pelvic tilt, pelvic incidence, and lumbar lordosis. While most of these parameters depend on a person’s position, e.g. a standing or supine position, the pelvic incidence is described to be position-independent [1]. Several factors might influence this growth and development, among which is the loading on the spine. Overweight causes higher sustained loading in the lumbar vertebrae, influencing the stress distribution over the endplate [3]. Since the shape of the vertebrae is still developing in
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