Skip to main content
Log in

Relationship between thoracic hypokyphosis, lumbar lordosis and sagittal pelvic parameters in adolescent idiopathic scoliosis

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Purpose

Sagittal spine and pelvic alignment of adolescent idiopathic scoliosis (AIS) is poorly described in the literature. It generally reports the sagittal alignment with regard to the type of curve and never correlated to the thoracic kyphosis. The objective of this study is to investigate the relationship between thoracic kyphosis, lumbar lordosis and sagittal pelvic parameters in thoracic AIS.

Methods

Spinal and pelvic sagittal parameters were evaluated on lateral radiographs of 86 patients with thoracic AIS; patients were separated into hypokyphosis group (n = 42) and normokyphosis group (n = 44). Results were statistically analyzed. The lumbar lordosis was lower in the hypokyphosis group, due to the low proximal lordosis. The thoracic kyphosis was not correlated with any pelvic parameters but with the proximal lordosis. The pelvic incidence was correlated with sacral slope, pelvic tilt, lumbar lordosis and highly correlated with distal lumbar lordosis in the two groups. There was a significant linear regression between thoracic kyphosis and proximal lordosis and between pelvic incidence and distal lordosis.

Conclusions

We can consider that the proximal part of the lordosis depends on the thoracic kyphosis and the distal part depends on the pelvic incidence. The hypokyphosis in AIS is independent of the pelvic parameters and could be described as a structural parameter, characteristic of the scoliotic deformity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Schwab F, Lafage V, Patel A et al (2009) Sagittal plane considerations and the pelvis in the adult patient. Spine 34:1828–1833

    Article  PubMed  Google Scholar 

  2. Duval-Beaupère G, Schmidt C, Cosson P (1992) Abarycentremetric study of the sagittal shape of spine and pelvis: the conditions required for an economic standing position. Ann Biomed Eng 20:451–462

    Article  PubMed  Google Scholar 

  3. Legaye J, Hecquet J, Marty C et al (1993) Sagittal equilibration of the spine: relationship between pelvis and sagittal spinal curves in the standing position (in French). Rachis 5:215–226

    Google Scholar 

  4. Mangione P, Sénégas J (1997) Normal and pathologic sagittal balance of the spine and pelvis (in French). Rev Chir Orthop 83:22–32

    PubMed  CAS  Google Scholar 

  5. Legaye J, Duval-Beaupère G, Hecquet J et al (1998) Pelvic incidence: a fundamental pelvic parameter for three dimensional regulation of spinal sagittal curves. Eur Spine J 7:99–103

    Article  PubMed  CAS  Google Scholar 

  6. Marty C, Boisbaubert B, Descamps H et al (2002) The sagittal anatomy of the sacrum among young adults, infants and spondylolisthesis patients. Eur Spine J 11:119–125

    Article  PubMed  CAS  Google Scholar 

  7. Rajnics P, Templier A, Skalli W et al (2002) The association of sagittal spinal and pelvic parameters in asymptomatic persons and patients with isthmic spondylolisthesis. J Spinal Disord 15:24–30

    Article  Google Scholar 

  8. Roussouly P, Berthonnaud E, Dimmet J (2003) Geometrical and mechanical analysis of lumbar lordosis in an asymptomatic population: proposed classification (in French). Rev Chir Orthop 89:632–639

    PubMed  CAS  Google Scholar 

  9. Boulay C, Tardieu C, Hecquet J et al (2006) Sagittal alignment of spine and pelvis regulated by pelvic incidence: standard values and prediction of lordosis. Eur Spine J 15:415–422

    Article  PubMed  CAS  Google Scholar 

  10. Gelb DE, Lenke LG, Bridwell KH et al (1995) An analysis of sagittal alignment in 100 asymptomatic middle and older aged volunteers. Spine 20:1351–1358

    PubMed  CAS  Google Scholar 

  11. Jackson RP, Peterson MD, MacMamus AC et al (1998) Compensatory spinopelvic balance over the hip axis and better reliability in measuring lordosis to the pelvic radius on standing lateral radiographs of adult volunteers and patients. Spine 23:1750–1767

    Article  PubMed  CAS  Google Scholar 

  12. Vaz G, Roussouly P, Berthonaud E et al (2002) Sagittal morphology and equilibrium of pelvis and spine. Eur Spine J 11:80–87

    Article  PubMed  CAS  Google Scholar 

  13. Kobayashi T, Atsuta Y, Matsuno T et al (2004) A longitudinal study of congruent sagittal spinal alignment in an adult cohort. Spine 29:671–676

    Article  PubMed  Google Scholar 

  14. Öhlen G, Aaro S, Bylund P (1988) The sagittal configuration and mobility of the spine in idiopathic scoliosis. Spine 13:413–416

    Article  PubMed  Google Scholar 

  15. Raso VJ, Russell GC, Hill DL et al (1991) Thoracic lordosis in idiopathic scoliosis. J Pediatr Orthop 11:599–602

    PubMed  CAS  Google Scholar 

  16. Mac-Thiong JM, Labelle H, Charlebois M et al (2003) Sagittal plans analysis of the spine and pelvis in adolescent idiopathic scoliosis according to the coronal curve type. Spine 28:1404–1409

    PubMed  Google Scholar 

  17. Upasani V, Tis J, Bastrom T et al (2007) Analysis of sagittal alignment in thoracic and thoracolumbar curves in adolescent idiopathic scoliosis. How do these two curve types differ. Spine 32:1355–1359

    Article  PubMed  Google Scholar 

  18. Lonner BS, Auerbach JD, Sponseller P et al (2010) Variations in pelvic and other sagittal parameters as a function of race in adolescent idiopathic scoliosis. Spine 35:E374–E377

    PubMed  Google Scholar 

  19. Hanson DS, Bridwell KH, Rhee JM et al (2002) Correlation of pelvic incidence with low-grade and high-grade isthmic spondylolisthesis. Spine 27:2026–2029

    Article  PubMed  Google Scholar 

  20. Mac-Thiong JM, Berthonaud E, Dinar JR et al (2004) Sagittal alignment of the spine and pelvis during growth. Spine 29:1642–1647

    Article  PubMed  Google Scholar 

  21. Mac-Thiong JM, Labelle H, Berthonnaud E et al (2007) Sagittalspinopelvic balance in normal children and adolescents. Eur Spine J 16:227–234

    Article  PubMed  Google Scholar 

  22. Mendoza-Lattes S, Ries Z, Gao Y et al (2010) Natural history of spinoplevic alignment differs from symptomatic deformity of the spine. Spine 35:E792–E798

    Article  PubMed  Google Scholar 

  23. Yong Q, Zhen L, Zezhang Z et al (2012) Comparison of sagittal spinopelvic alignment in Chinese adolescents with and without idiopathic thoracic scoliosis. Spine 37:E714–E720

    Article  PubMed  Google Scholar 

  24. Roussouly P, Labelle H, Rouissi J et al (2013) Pre- and post-operative sagittal balance in idiopathic scoliosis: a comparison over the ages of two cohorts of 132 adolescents and 52 adults. Eur Spine J 22(suppl 2):S203–S215

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jean-Luc Clément.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Clément, JL., Geoffray, A., Yagoubi, F. et al. Relationship between thoracic hypokyphosis, lumbar lordosis and sagittal pelvic parameters in adolescent idiopathic scoliosis. Eur Spine J 22, 2414–2420 (2013). https://doi.org/10.1007/s00586-013-2852-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-013-2852-z

Keywords

Navigation