Spinopelvic Alignment in Subjects With Down Syndrome.

Area of Science:

• Orthopedics
• Genetics
• Radiology

Background:

• Down syndrome (DS) is associated with a high prevalence of scoliosis, impacting postural alignment.
• No previous studies have investigated spinopelvic alignment in individuals with DS.

Purpose of the Study:

• To characterize the spinopelvic alignment in subjects with Down syndrome.
• To compare spinopelvic parameters and alignment patterns between subjects with DS and controls.

Main Methods:

• A cross-sectional study involving 41 subjects with DS and 41 age/sex-matched controls.
• Biplanar X-rays and 3D reconstructions were used to measure spinopelvic sagittal and coronal alignment parameters.
• Subjects were classified using Roussouly's 4 types of sagittal alignment.

Main Results:

• Subjects with DS showed relative hypokyphosis (T4-T12) and hyperlordosis (L1-L5) compared to controls.
• Increased pelvic incidence, sacral slope, Cobb angle, and apical vertebral rotation were observed in the DS group.
• Roussouly's type 4 alignment pattern was significantly more frequent in subjects with DS (68.3% vs. 14.6%).

Conclusions:

• Individuals with Down syndrome exhibit a unique spinopelvic alignment characterized by hypokyphosis, hyperlordosis, large pelvic incidence, and small pelvic tilt.
• This altered alignment may predispose individuals with DS to hip instability and osteoarthritis.
• Further research is warranted to explore the long-term implications of these findings.