Normative spino-pelvic sagittal alignment of Lebanese asymptomatic adults: Comparisons with different ethnicities - 13/01/18

Doi : 10.1016/j.otsr.2017.11.017

Z. Bakouny ^a, A. Assi ^a,^⁎ , F. Yared ^a, A.J. Bizdikian ^a, J. Otayek ^a, R. Nacouzi ^a, V. Lafage ^b, R. Lafage ^b, I. Ghanem ^a,^c, G. Kreichati ^a,^c
^a Faculty of Medicine, University of Saint-Joseph, Beirut, Lebanon
^b Spine division, Hospital for Special Surgery, New York, USA
^c Hôtel-Dieu de France Hospital, University of Saint-Joseph, Beirut, Lebanon

^⁎Corresponding author. Laboratory of Biomechanics and Medical Imaging, Faculty of Medicine, Campus of Innovation and Sport, University of Saint-Joseph, Damascus street, PoBox 17-5208 Mar Mikhael, 1104 2020 Beirut, Lebanon.

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Abstract

Background

Normative values of sagittal alignment are used as references for the diagnosis and treatment of spinal pathologies. There are currently no reference values for the normative sagittal alignment of Lebanese subjects. The objective is to describe normative values of full body sagittal alignment parameters in asymptomatic Lebanese adults and to compare the sagittal alignment of this population to that of populations of various origins.

Methods

Included subjects were aged 18 to 28 years old. Each subject underwent a full body biplanar X-ray exam with measurement of spine, pelvis and lower limb parameters of sagittal alignment. The sagittal alignment of the Lebanese population was compared to that of other ethnicities, previously reported in the literature, using one-way ANOVA.

Results

Ninety-two asymptomatic Lebanese young adult volunteers (48 males, 44 females, age=21.5±2.2 years) were enrolled in this study. The mean curvature in the cervical spine was kyphotic (−4.3°) in women, while it was lordotic in men (5.4°). Men were found to be significantly more kyphotic than women (−58.3° vs. −53.0°; p<0.01) but both sexes were found to have similar lordosis (61.6°) and pelvic incidence (52.0°). Lebanese subjects had intermediate pelvic incidence compared to other ethnicities but showed significantly higher thoracic kyphosis (p<0.01) and lumbar lordosis (p<0.01) compared to all other ethnicities.

Conclusions

This study established reference normative values for young adult Lebanese subjects. Most women were found to have kyphotic cervical spines. The sagittal alignment of Lebanese subjects differed significantly compared to that of other ethnicities.