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Sagittal alignment of the spine is changing!

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Presentation on theme: "Sagittal alignment of the spine is changing!"— Presentation transcript:

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2 Sagittal alignment of the spine is changing!
Evolution theories Life cycles

3 Sagittal alignment Planning of the 3D reconstruction of the spine
Normative data about the sagittal plane Segmental sagittal plane analysis To describe the normative data of the sagittal plane on pediatric age population To document the evolution of sagittal alignment with growth

4 Pediatric vs. adults Greater thoracic kyphosis Smaller lumbar lordosis
Especially upper 3 segments hypolordotic More kyphotic thoracolumbar region 3.6o-9.8o More forward sagittal vertical axis Lower sacral inclination Lordosis Kyphosis

5 Non-ambulatory patient
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6 Purpose Describe normative values in sitting position
Document evolution of alignment with growth The purpose of this study is to describe the normative values of spinal sagittal alignment in the pediatric population, and document the evolution of sagittal alignment with growth in a sitting position. Knowing the relationship between age and sagittal alignment in sitting child will allow precise patient-based preoperative planning

7 Materials & Methods Between 3-16 age Group 1 (3-6 ages)
114 children (54 female, 60 male) NO musculoskeletal abnormality Group 1 (3-6 ages) Group 2 (7-9 ages) Group 3 (10-12 ages) Group 4 (13-16 ages) 30” Lateral X-ray with the arms flexed 30°on sitting position 54 female 60 male totally 114 children without musculoskeletal abnormality between the ages of 3 to 16 years were studied and grouped in to 4 Between 3-6 ages children named as group 1 between 7-9 ages named as 2 between ages grouped 3 finally between ages children named as group 4 A minimum of 7 (at least 3 from each sex) children were in each age group.

8 Materials & Methods Segmental angulations from T1–T2 to L5–S1
Global kyphosis (T1–T12) and lordosis (L1–S1) Segmental angulations of T2–T5, T10– T12, T10– L2, and L4–S1 levels Sacral slope and offsets

9 Results Global kyphosis and lordosis angles are different in sitting positon Smaller thoracic kyphosis and lumbar lordosis Alignment (both segmental and global) is changing with age Statistically significant differences T2-T5, T5–T6, L1–L2, L4–S1, L5-S1, lumbar lordosis and sacral slope

10 Results

11 Conclusion Homo computericus Children is not miniature of adults
Sitting and standing alignments are not same Less kyphosis and lordosis These findings should be considered in preoperative planning of young non-ambulatory patients However, patients with upper extremity weakness/paralysis Self catheterization and hygiene Requires more kyphosis SOLUTION??? Homo computericus


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