Dionne Alexandra C, Gorroochurn Prakash, Miller Roy, Katiyar Prerana, Bennion Samuel, Bonsignore-Opp Lisa, Coury Josephine R, Hassan Fthimnir M, Lombardi Joseph M, Lenke Lawrence G, Reyes Justin L, Sardar Zeeshan M
Department of Orthopedic Surgery, Columbia University Irving Medical Center/NewYork- Presbyterian Och Spine Hospital, New York, NY.
Department of Orthopedic Surgery, University of California, San Francisco, San Francisco, CA.
Spine (Phila Pa 1976). 2025 Sep 1;50(17):1188-1200. doi: 10.1097/BRS.0000000000005274. Epub 2025 May 23.
Systematic review and meta-analysis.
To describe regional and global spinopelvic sagittal parameters in asymptomatic adults.
Understanding normal alignment is important for management of patients with spinal deformities and essential for patient well-being following corrective surgery. To our knowledge, there exists no meta-analyses on normative alignment.
We searched PubMed for primary studies on asymptomatic individuals with normal spinal anatomy and no prior spinal intervention. The collected variables included: age, gender percentage, global thoracic kyphosis (T1-3-T12 TK), regional TK (T4-5-T12), lumbar lordosis to L5 (T12-L1-L5, LL-L5), LL to S1 (T12-L1-S1, LL-S1), sacral slope (SS), pelvic incidence (PI), pelvic tilt (PT), PI-LL mismatch, sagittal vertical axis (SVA), T1 pelvic angle (TPA), and spinosacral angle (SSA). Data was analyzed according to sex, age (20-40 vs. 40-60 vs. greater than 60 yrs), ethnic group (Asian, Caucasian, Hispanic, and Middle Eastern), and Asian subgroup (Chinese, Japanese, and Korean).
A total of 191 articles from 27 countries including 35,913 participants were reviewed: 16,125 men (44.9%), 18,222 women (50.7%), age range: 18 to 93 years were included. Regional TK and PT increased significantly in patients >60 compared with other groups. Globally, SVA, TPA, and changed with age in patients >60.
LL-S1, PI and PT were all higher in women. Regional TK, PT, PI-LL, SVA, and TPA all increased with age, while LL-S1 and SSA decreased. Global TK, regional TK, LL-S1, PI, and PI-LL all had significant differences across broad ethnic groups, and LL-S1, PI, PT, and SVA showed differences within the Asian subgroup. Global alignment was largely equivalent across ethnic groups.
系统评价和荟萃分析。
描述无症状成年人的区域和全球脊柱骨盆矢状面参数。
了解正常对线对于脊柱畸形患者的治疗很重要，对于矫正手术后患者的健康也至关重要。据我们所知，目前尚无关于正常对线的荟萃分析。
我们在PubMed上搜索了关于脊柱解剖结构正常且既往无脊柱干预的无症状个体的原始研究。收集的变量包括：年龄、性别百分比、全胸段后凸（T1-3-T12 TK）、区域后凸（T4-5-T12）、腰5前凸（T12-L1-L5，LL-L5）、腰5至骶1前凸（T12-L1-S1，LL-S1）、骶骨倾斜度（SS）、骨盆入射角（PI）、骨盆倾斜度（PT）、PI-LL差值、矢状垂直轴（SVA）、T1骨盆角（TPA）和脊柱骶骨角（SSA）。根据性别、年龄（20-40岁 vs. 40-60岁 vs. 大于60岁）、种族（亚洲人、白种人、西班牙裔和中东人）以及亚洲亚组（中国人、日本人、韩国人）对数据进行分析。
共检索了来自27个国家的191篇文章，纳入35913名参与者：16125名男性（44.9%），18222名女性（50.7%），年龄范围为18至93岁。与其他组相比，60岁以上患者的区域后凸和骨盆倾斜度显著增加。在全球范围内，60岁以上患者的矢状垂直轴、T1骨盆角随年龄变化。
女性的LL-S1、PI和PT均较高。区域后凸、骨盆倾斜度、PI-LL、矢状垂直轴和T1骨盆角均随年龄增加，而LL-S1和脊柱骶骨角减小。全胸段后凸、区域后凸、LL-S1、PI和PI-LL在不同种族间均有显著差异，LL-S1、PI、骨盆倾斜度和矢状垂直轴在亚洲亚组内存在差异。不同种族间的整体对线情况大致相当。
