van den Heuvel Marleen M, Griffioen Nathalie E, Achterberg Hakim C, Oei Edwin H G, Renkens Jeroen J M, Bierma-Zeinstra Sita M A, van Middelkoop Marienke
Department of General Practice, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
The Generation R Study Group, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
Eur Spine J. 2022 Feb;31(2):248-257. doi: 10.1007/s00586-021-07054-1. Epub 2021 Nov 19.
To investigate the spinopelvic alignment and vertebral shape in children, and associations with body composition and structural spinal abnormalities on magnetic resonance imaging (MRI).
We performed a cross-sectional study embedded in the Generation R Study, a prospective population-based birth cohort. Pelvic incidence and vertebral concavity ratios for each lumbar level were determined on sagittal MRI images in 9-year-old children, and structural spinal abnormalities were scored semi-quantitatively. The BMI-SD score was calculated, and body composition was assessed using DXA scans. Associations of pelvic incidence and vertebral concavity ratios with structural abnormalities and body composition measures were assessed using (multilevel) regression analyses.
This study included 522 participants (47.7% boys), aged 9.9 years (IQR 9.7-10.0). The mean pelvic incidence was 36.6° (SD 8.0). Vertebral concavity ratios ranged from 0.87 to 0.90, with significantly lower ratios for boys compared to girls. Associations were found for a larger pelvic incidence with decreased disc height [OR 1.03 (95% CI 1.02-1.05)], and a pelvic incidence in the lowest tertile with less disc bulging [OR 0.73 (95% CI 0.56-0.95)]. Increased vertebral concavity ratio was associated with decreased disc height [OR 14.16 (95% CI 1.28-157.13)]. Finally, increased fat-free mass index was associated with a smaller pelvic incidence [adjusted OR 0.85 (95% CI 0.07-1.63)].
The mean pelvic incidence of 9-year-old children is 36.6° on supine MRI images, and a slightly concave shape of the lumbar vertebrae is seen. Spinopelvic alignment is associated with structural spinal abnormalities, and might itself be influenced by the children's body composition.
研究儿童的脊柱骨盆对线及椎体形态，以及与磁共振成像（MRI）上身体成分和脊柱结构异常的相关性。
我们在基于人群的前瞻性出生队列“Generation R研究”中进行了一项横断面研究。在9岁儿童的矢状面MRI图像上确定每个腰椎水平的骨盆倾斜角和椎体凹陷率，并对脊柱结构异常进行半定量评分。计算BMI-SD评分，并使用双能X线吸收法扫描评估身体成分。使用（多水平）回归分析评估骨盆倾斜角和椎体凹陷率与结构异常及身体成分测量值之间的相关性。
本研究纳入了522名参与者（47.7%为男孩），年龄为9.9岁（四分位间距9.7 - 10.0）。平均骨盆倾斜角为36.6°（标准差8.0）。椎体凹陷率在0.87至0.90之间，男孩的比率显著低于女孩。发现骨盆倾斜角较大与椎间盘高度降低相关[比值比1.03（95%置信区间1.02 - 1.05）]，骨盆倾斜角处于最低三分位数与椎间盘膨出较少相关[比值比0.73（95%置信区间0.56 - 0.95）]。椎体凹陷率增加与椎间盘高度降低相关[比值比14.16（95%置信区间1.28 - 157.13）]。最后，去脂体重指数增加与较小的骨盆倾斜角相关[校正比值比0.85（95%置信区间0.07 - 1.63）]。
仰卧位MRI图像上9岁儿童的平均骨盆倾斜角为36.6°，腰椎呈轻度凹陷形状。脊柱骨盆对线与脊柱结构异常相关，其本身可能受儿童身体成分的影响。
