open access

Vol 78, No 1 (2019)
ORIGINAL ARTICLES
Published online: 2018-06-21
Submitted: 2018-04-20
Accepted: 2018-05-23
Get Citation

Examination of inclinations of the spine at childhood and adolescence

A. Tokpınar, H. Ülger, S. Yılmaz, N. Acer, T. Ertekin, S. B. Görkem, H. Güler
DOI: 10.5603/FM.a2018.0053
·
Pubmed: 30009371
·
Folia Morphol 2019;78(1):47-53.

open access

Vol 78, No 1 (2019)
ORIGINAL ARTICLES
Published online: 2018-06-21
Submitted: 2018-04-20
Accepted: 2018-05-23

Abstract

Background: Spine is a column that consists of consecutively lined up vertebras. It includes medulla spinalis. It contributes the motions of head, neck and body. Spine is not a straight column. There is a convexity towards the front of the spine (lordosis) at cervical and lumbar areas in adults and a convexity towards the back of the spine (kyphosis) at thoracic and sacral spine areas. 

Materials and methods: In this study, lateral magnetic resonance images of 731 children between 1 and 16 years of age were examined and their cervical lordosis, thoracic kyphosis and lumbar lordosis angles were measured with Cobb method using ImageJ programme for every age group. 

Results: The mean calculated cervical lordosis angles in 1–16-year-old children were found to be 20.51o ± 6.11o (minimum 17.96o ± 6.29o, maximum 23.50o ± ± 4.14o). It has been observed that cervical angle values decrease with age. The mean thoracic kyphosis angle measured was 28.71o ± 6.99o (minimum 24.55o ± ± 5.65o, maximum 30.44o ± 4.68o). Lumbar lordosis angle was 28.08o ± 7.39o (minimum 20.36o ± 6.59o, maximum 32.68o ± 6.03o). Thoracic kyphosis and lumbar lordosis angle values increased with age. In our study, a statistical differ- ence was found in increasing thoracic kyphosis angle between 1-year-old group and 14-year-old group. Statistical difference was also found in decreasing cervical lordosis angle value between 1-year-old group and 16-year-old group. When we compare our study results with literature values, cervical lordosis values were similar, but lumbar lordosis values were lower. 

Conclusions: In summary, we think that knowing sagittal plane inclinations of the spine developing in childhood and adolescence will contribute to earlier de- termination of pathologies. We also hope that it will contribute to clinical stages and other studies in this field. 

Abstract

Background: Spine is a column that consists of consecutively lined up vertebras. It includes medulla spinalis. It contributes the motions of head, neck and body. Spine is not a straight column. There is a convexity towards the front of the spine (lordosis) at cervical and lumbar areas in adults and a convexity towards the back of the spine (kyphosis) at thoracic and sacral spine areas. 

Materials and methods: In this study, lateral magnetic resonance images of 731 children between 1 and 16 years of age were examined and their cervical lordosis, thoracic kyphosis and lumbar lordosis angles were measured with Cobb method using ImageJ programme for every age group. 

Results: The mean calculated cervical lordosis angles in 1–16-year-old children were found to be 20.51o ± 6.11o (minimum 17.96o ± 6.29o, maximum 23.50o ± ± 4.14o). It has been observed that cervical angle values decrease with age. The mean thoracic kyphosis angle measured was 28.71o ± 6.99o (minimum 24.55o ± ± 5.65o, maximum 30.44o ± 4.68o). Lumbar lordosis angle was 28.08o ± 7.39o (minimum 20.36o ± 6.59o, maximum 32.68o ± 6.03o). Thoracic kyphosis and lumbar lordosis angle values increased with age. In our study, a statistical differ- ence was found in increasing thoracic kyphosis angle between 1-year-old group and 14-year-old group. Statistical difference was also found in decreasing cervical lordosis angle value between 1-year-old group and 16-year-old group. When we compare our study results with literature values, cervical lordosis values were similar, but lumbar lordosis values were lower. 

Conclusions: In summary, we think that knowing sagittal plane inclinations of the spine developing in childhood and adolescence will contribute to earlier de- termination of pathologies. We also hope that it will contribute to clinical stages and other studies in this field. 

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Keywords

spine; radiography; kyphosis; lordosis

About this article
Title

Examination of inclinations of the spine at childhood and adolescence

Journal

Folia Morphologica

Issue

Vol 78, No 1 (2019)

Pages

47-53

Published online

2018-06-21

DOI

10.5603/FM.a2018.0053

Pubmed

30009371

Bibliographic record

Folia Morphol 2019;78(1):47-53.

Keywords

spine
radiography
kyphosis
lordosis

Authors

A. Tokpınar
H. Ülger
S. Yılmaz
N. Acer
T. Ertekin
S. B. Görkem
H. Güler

References (27)
  1. Abelin-Genevois K, Idjerouidene A, Roussouly P, et al. Cervical spine alignment in the pediatric population: a radiographic normative study of 150 asymptomatic patients. Eur Spine J. 2014; 23(7): 1442–1448.
  2. Arıncı K, Elhan A. Anatomi, 2.cilt, 4. baskı, Güneş Kitabevi, Ankara. 2006: 58–65.
  3. Bernhardt M, Bridwell K. Segmental analysis of the sagittal plane alignment of the normal thoracic and lumbar spines and thoracolumbar junction. Spine. 1989; 14(7): 717–721.
  4. Boseker EH, Moe JH, Winter RB, et al. Determination of. J Pediatr Orthop. 2000; 20(6): 796–798.
  5. Cil A, Yazici M, Uzumcugil A, et al. The evolution of sagittal segmental alignment of the spine during childhood. Spine. 2005; 30(1): 93–100.
  6. Dere F. Anatomi Atlası ve Ders Kitabı. 5. Baskı, Nobel yayın evi, Adana. 1999: 765–766.
  7. Ecerkale Ö. Postür Analizinde Symmetrigraf ile Orthoröntgenogram Sonuçlarının Değerlendirilmesi, Uzmanlık tezi, Okmeydanı Eğitim ve Araştırma Hastanesi Fizik Tedavi ve Rehabilitasyon Kliniği, İstanbul. 2006: 68–80.
  8. Gelb DE, Lenke LG, Bridwell KH, et al. An analysis of sagittal spinal alignment in 100 asymptomatic middle and older aged volunteers. Spine. 1995; 20(12): 1351–1358.
  9. Harrison DE. Pediatric Cervical Lordosis: Values, Disorders, and Interventions. American Journal of Clinical Chiropractic (AJCC). http://www.chiropractic-biophysics.com/clinical_chiropractic/2011/2/11/pediatric-cervical-lordosis-values-disorders-and-interventio.html.
  10. Hasday CA, Passoff TL, Perry J. Gait abnormalities arising from latrogenic loss of lumbar lordosis secondary to Harrington instrumentation in lumbar fractures. Spine. 1983; 8(5): 501–511.
  11. Itoi E. Roentgenographic analysis of posture in spinal osteoporotics. Spine. 1991; 16(7): 750–756.
  12. Jackson RP, McManus AC. Radiographic analysis of sagittal plane alignment and balance in standing volunteers and patients with low back pain matched for age, sex, and size. A prospective controlled clinical study. Spine. 1994; 19(14): 1611–1618.
  13. Kasai T, Ikata T, Katoh S, et al. Growth of the cervical spine with special reference to its lordosis and mobility. Spine. 1996; 21(18): 2067–2073.
  14. Kostuik JP, Hall BB. Spinal fusions to the sacrum in adults with scoliosis. Spine. 1983; 8(5): 489–500.
  15. Köse N, Sevencan A. Konjenital skolyoz ve torasik yetmezlik sendromu, Türk Ortopedi ve Travmatoloji Birliği Derneği Dergisi. 2007; 6: 3–4.
  16. Legaye J, Duval-Beaupère G, Hecquet J, et al. Pelvic incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves. Eur Spine J. 1998; 7(2): 99–103.
  17. Mac-Thiong JM, Berthonnaud E, Dimar JR, et al. Sagittal alignment of the spine and pelvis during growth. Spine. 2004; 29(15): 1642–1647.
  18. Mac-Thiong JM, Labelle H, Roussouly P. Pediatric sagittal alignment. Eur Spine J. 2011; 20 Suppl 5: 586–590.
  19. McAviney J. Determining the relationship between cervical lordosis and neck complaints. Manipulative Physiol Ther. 2005; 28: 187–193.
  20. Moore KL, Persaud TVN. The Developing Human: Clinically Oriented Embryology, 5th edition. Philadelphia 1998: 354–360.
  21. Morrissy RT, Goldsmith GS, Hall EC, et al. Measurement of the Cobb angle on radiographs of patients who have scoliosis. Evaluation of intrinsic error. J Bone Joint Surg Am. 1990; 72(3): 320–327.
  22. Okçu G, Yercan H, Yorulmaz İ. Lomber Omurganın Sagittal Planda Radyolojik Analizi. 2000: 146–150.
  23. Polly DW, Kilkelly FX, McHale KA, et al. Measurement of lumbar lordosis. Evaluation of intraobserver, interobserver, and technique variability. Spine. 1996; 21(13): 1530–1535.
  24. Stagnara P, De Mauroy JC, Dran G, et al. Reciprocal angulation of vertebral bodies in a sagittal plane: approach to references for the evaluation of kyphosis and lordosis. Spine. 1982; 7(4): 335–342.
  25. Unur E, Ülger H, Ekinci N. Anatomi, 3. Baskı, Kıvılcım Kitapevi, Kayseri. 2009: 13–17.
  26. Voutsinas SA, MacEwen GD. Sagittal profiles of the spine. Clin Orthop Relat Res. 1986(210): 235–242.
  27. Wiltse LL, Winter RB. Terminology and measurement of spondylolisthesis. J Bone Joint Surg Am. 1983; 65(6): 768–772.

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