Basic Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Mar 18, 2017; 8(3): 256-263
Published online Mar 18, 2017. doi: 10.5312/wjo.v8.i3.256
Spinal alignment evolution with age: A prospective gait analysis study
Sébastien Pesenti, Benjamin Blondel, Emilie Peltier, Elke Viehweger, Vincent Pomero, Guillaume Authier, Stéphane Fuentes, Jean-Luc Jouve
Sébastien Pesenti, Emilie Peltier, Jean-Luc Jouve, Pediatric orthopedics, Timone Enfants, Aix-Marseille University, 13005 Marseille, France
Sébastien Pesenti, Institute of Movement Sciences (CNRS UMR 7287), 13288 Marseille, France
Benjamin Blondel, Gait Analysis Laboratory, Hopital Timone Enfants, Aix-Marseille University, 13005 Marseille, France
Benjamin Blondel, Spine Unit, Hôpital de la Timone, 13005 Marseille, France
Elke Viehweger, Vincent Pomero, Guillaume Authier, Spine unit, Timone, Aix-Marseille University, 13005 Marseille, France
Stéphane Fuentes, Neurosurgery, Timone Enfants, Aix-Marseille University, 13005 Marseille, France
Author contributions: All authors contributed equally to this work.
Institutional review board statement: The Spine unit review board reviewed this study and gave his approval.
Institutional animal care and use committee statement: No animal has been involved in this study.
Conflict-of-interest statement: No conflict of interest.
Data sharing statement: Authors agreed to share data with the editor.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Benjamin Blondel, MD, PhD, Spine Unit, Hôpital de la Timone, 264 rue Saint Pierre, 13005 Marseille, France. benjamin.blondel@ap-hm.fr
Telephone: +33-4-91384430 Fax: +33-4-91384247
Received: July 25, 2016
Peer-review started: July 29, 2016
First decision: September 2, 2016
Revised: November 10, 2016
Accepted: December 27, 2016
Article in press: December 28, 2016
Published online: March 18, 2017
Processing time: 234 Days and 18.6 Hours
Abstract
AIM

To describe, using gait analysis, the development of spinal motion in the growing child.

METHODS

Thirty-six healthy children aged from 3 to 16 years old were included in this study for a gait analysis (9 m-walk). Various kinematic parameters were recorded and analyzed such as thoracic angle (TA), lumbar angle (LA) and sagittal vertical axis (SVA). The kinetic parameters were the net reaction moments (N.m/kg) at the thoracolumbar and lumbosacral junctions.

RESULTS

TA and LA curves were not statistically correlated to the age (respectively, P = 0.32 and P = 0.41). SVA increased significantly with age (P < 0.001). Moments in sagittal plane at the lumbosacral junction were statistically correlated to the age (P = 0.003), underlining the fact that sagittal mechanical constraints at the lumbosacral junction increase with age. Moments in transversal plane at the thoracolumbar and lumbosacral junctions were statistically correlated to the age (P = 0.0002 and P = 0.0006), revealing that transversal mechanical constraints decrease with age.

CONCLUSION

The kinetic analysis showed that during growth, a decrease of torsional constraint occurs while an increase of sagittal constraint is observed. These changes in spine biomechanics are related to the crucial role of the trunk for bipedalism acquisition, allowing stabilization despite lower limbs immaturity. With the acquisition of mature gait, the spine will mainly undergo constraints in the sagittal plane.

Keywords: Sagittal balance; Spine biomechanics; Gait analysis; Thorcic kyphosis; Spine growth

Core tip: Many postural changes occur during childhood, including the adaptation of the spine to maintain an erect posture. The aim was to describe, using gait analysis, the development of spinal motion during growth. Various kinematic parameters were recorded in 36 healthy children. Thoracic kyphosis and lumbar lordosis were not found to increase during childhood whereas sagittal vertical axis increased with age. The kinetic analysis showed a decrease of torsional constraint while sagittal constraint increased. These changes in spine biomechanics are related to the crucial role of the trunk for bipedalism acquisition, allowing stabilization despite lower limbs immaturity.