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Lumbopelvic parameters can be used to predict thoracic kyphosis in adolescents

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Abstract

Purpose

Distal thoracic kyphosis (DTK) equivalent to proximal lumbar lordosis (PLL) is the sum of pelvic tilt (PT) and the difference (Δ) between lumbar lordosis (LL) and pelvic incidence (PI): PLL = DTK = PT + Δ. With the assumption that proximal thoracic kyphosis (PTK) is similar to DTK, we propose the equation TK = 2(PT + LL − PI) to express the relationship between thoracic kyphosis (TK) and pelvic parameters. The objective of this work is to verify this relationship in a normal population.

Methods

Full spine radiographs of 100 adolescents and young adults (13 to 20 years old), free from vertebral pathology, were analyzed. Measurements included pelvic parameters, LL, PLL, DLL, TK, PTK, DTK and C7 global tilt. The measured global TK was compared with the theoretical TK calculated according to the formula TK = 2(PT + LL − PI).

Results

The difference between measured TK and calculated TK was + 2.3° and correlated with the C7 global tilt (r = 0.86). There was a significant linear regression between TK and PT + ∆ (p < 0.0001). Given radiographs’ inter-rater reliability of 5° for angled measurements, the p value (0.047) between measured TK and calculated TK is statistically significant to support the hypothesis.

Conclusion

This work validates the formula TK = 2(PT + LL − PI) which allows the calculation of global TK as a function of PT, LL and PI. This calculated TK can be used as a target for sagittal correction of adolescents with spine deformities.

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Funding

Jean-Luc Clément has received consultancy fees and financial support for attending symposia (unrelated to this study) from Médicrea. Federico Solla has received financial support for attending symposia (unrelated to this study) from Médicrea (Médicréa International, Rillieux La Pape, France).

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Authors and Affiliations

  1. Department of Pediatric Orthopedics and Scoliosis Surgery, Hôpitaux pédiatriques de Nice CHU LENVAL, 57 Avenue de la Californie, Nice, France

    Jean-Luc Clément, Federico Solla, Veronica Amorese, Ioana Oborocianu, Olivier Rosello & Virginie Rampal

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  1. Jean-Luc Clément
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  2. Federico Solla
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  3. Veronica Amorese
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  4. Ioana Oborocianu
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  5. Olivier Rosello
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  6. Virginie Rampal
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Correspondence to Jean-Luc Clément.

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Clément, JL., Solla, F., Amorese, V. et al. Lumbopelvic parameters can be used to predict thoracic kyphosis in adolescents. Eur Spine J 29, 2281–2286 (2020). https://doi.org/10.1007/s00586-020-06373-z

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  • DOI: https://doi.org/10.1007/s00586-020-06373-z

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