ArticleJournal of the Pediatric Orthopaedic Society of North America2026
The Effect of Age, Sex, and Body Mass Index on Spinopelvic Balance Throughout Childhood and Adolescence: An Automated 3D-Computed Tomography Study of 9,721 Pediatric Patients.
Article in Journal of the Pediatric Orthopaedic Society of North America, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Spinopelvic assessment is critical for surgical planning. It is unknown if age, sex, and body mass index (BMI) influence pelvic orientation during development. This study aimed to (1) describe normative pelvic orientation and (2) investigate how patient-specific factors influence pelvic orientation throughout development from childhood to early adulthood. Methods: Computed tomography pelvis scans of supine asymptomatic patients were obtained at a single institution from 2004 to 2022. Three-dimensional measurements of pelvic incidence (PI), sacral slope (SS), and pelvic tilt (PT) were measured utilizing a custom-developed software (VirtualHip, Boston Children's Hospital). Pelvic orientations were modeled as a function of age, sex, and BMI with univariate and multivariable generalized additive models. Results: A total of 9,721 patients (14.2 ± 4.2 years) were included with 49% females ( Conclusions: Unlike adults, there are no significant variations in spinopelvic balance during development from ages 7 to 25. Based on a large sample size of 9,721 patients, this work establishes normative values for supine spinopelvic balance during skeletal development stratified by sex, age, BMI, and skeletal maturity. Future investigations on the clinical impact of minor variations between groups based on these subgroups may uncover phenotypic predispositions to spine-pelvis pathology. Key Concepts: (1)Spinopelvic parameters are not static over the course of pediatric development.(2)Sex- and weight-related differences in spinopelvic parameters prior to skeletal maturity are minimal (<2°, Level of Evidence: III.
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