Comparison of Spinopelvic Configuration and Roussouly Alignment Types Between Pediatric and Adult Populations

Area of Science:

• Orthopedics
• Radiology
• Biomedical Engineering

Background:

• The Roussouly classification is a validated system for adult spinopelvic alignment.
• Understanding alignment changes during growth is crucial for pediatric spinal health.
• Existing classifications may not fully capture developmental variations in spinopelvic alignment.

Purpose of the Study:

• To describe spinopelvic alignment types based on pelvic incidence (PI) and age.
• To compare the Roussouly classification between pediatric and adult populations.
• To analyze how spinal alignment parameters evolve during childhood and adolescence.

Main Methods:

• Retrospective cross-sectional study of 1706 non-pathologic individuals aged 5-49 years.
• Analysis of radiographs to assess global and spinopelvic alignment parameters.
• Stratification of pediatric and adolescent groups by age and skeletal maturity for comparison with adults.

Main Results:

• Sagittal Vertical Axis (SVA) decreased with age; thoracic kyphosis and lumbar lordosis increased in adults.
• Pelvic incidence (PI) and pelvic tilt increased with age, being larger in adults.
• Type 3A was more prevalent in children/adolescents, while Type 4 showed the largest PI increase with age.

Conclusions:

• Global and spinopelvic alignment significantly change from childhood through adolescence into adulthood.
• Growth-related PI increases influence Roussouly types, with Type 3A common in pediatrics and Type 4 showing substantial PI progression.
• These findings highlight developmental differences in spinal alignment crucial for clinical interpretation.