• Yann Philippe Charles, Vincent Lamas, Brice Ilharreborde, Benjamin Blondel, Solène Prost, Eloïse Bauduin, Féthi Laouissat, Guillaume Riouallon, Stéphane Wolff, Vincent Challier, Ibrahim Obeid, Louis Boissière, Emmanuelle Ferrero, Federico Solla, Jean-Charles Le Huec, Stéphane Bourret, Joe Faddoul, Georges N Abi Lahoud, Vincent Fière, Michiel Vande Kerckhove, Jonathan Lebhar, Hadrien Giorgi, Aymeric Faure, Erik A Sauleau, Sébastien Pesenti, and French Spine Surgery Society (SFCR).
• Service de Chirurgie du Rachis, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg.
• Spine. 2022 Sep 15; 47 (18): 1303-1313.

Study DesignRetrospective cross-sectional study.ObjectiveThe aim was to describe spinopelvic alignment types by pelvic incidence (PI) and age to compare the Roussouly classification between pediatric and adult populations.Summary Of Background DataThe Roussouly classification was validated for adults. Alignment types may vary during growth.Materials And MethodsRadiographs of 1706 non pathologic individuals (5-49 yr) were analyzed. Individuals ≤19 years were stratified by chronological age and skeletal maturity (triradiate cartilage, Risser), and compared with adults. Global and spinopelvic alignment parameters were assessed. Roussouly Types 1, 2, 3, 3A (anteverted pelvis), and 4 were determined. The distribution of parameters was analyzed by Bayesian inference. The relationship between PI and age by Roussouly type was modeled by linear regression.ResultsThe Sagittal Vertical Axis C7 decreased during growth and was significantly smaller in adults (20-34 yr) (Pr>0.99). Thoracic kyphosis and lumbar lordosis increased during growth and were larger in adults (Pr<0.025). Lordosis increased mainly in the cranial arch (Pr<0.025). PI and pelvic tilt increased during growth and were larger in adults (Pr<0.025). In children and adolescents, PI<45° represented the largest proportion, significantly larger compared with adults (Pr>0.99). Proportions of Roussouly Types 1 and 2 were similar throughout ages. Types 3 and 4 were rarer during the prepubertal period (Pr<0.025). The proportion of Type 3A was significantly higher in children and adolescents (Pr>0.99). Linear regression showed that Type 4 had the largest PI increase with age, with significantly higher curve slope compared with other types (Pr>0.9999). Types 3, 3A and 2 had similar slopes and lowest PI increase with age.ConclusionGlobal and spinopelvic alignment changed during childhood and adolescence, leading to different kyphosis and lordosis distribution compared with adults. Growth-related PI increase influenced Roussouly types with typical predominance of Type 3A in the pediatric population and larger PI increase in Type 4.Level Of EvidenceLevel III.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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