Kyphosis, lordosis and height velocity. What is the effect of rate of growth on the development of the sagittal parameters of the spine in normal children?

Abstract

To identify the effect of the rate of growth in standing height in the development of kyphosis and lordosis of normal children. Analysis of the sagittal parameters of spinal shape from longitudinally collected ISIS2 surface topography measures were analysed alongside measures of standing height by comparing height velocity and the development of kyphosis and lordosis using linear mixed effects modelling techniques. There were 831 measures from 196 children (79 females) between 2010 and 2017 aged between 9 and 18 years of age. Height velocity was between 0 and 12 cm/yr. There was a decrease in both kyphosis and lordosis for females as height velocity increased from 0 to 4 cm/yr whereon the measure plateaued. For males, kyphosis showed less change over all values of height velocity whereas lordosis had some variation between 5 and 6 cm/yr. There was a statistically significant difference between the sexes for lordosis (p = 0.02) but not for kyphosis (p = 0.07). The development of the sagittal shape of the spine is dependent on height velocity, and the effects of this differ between the sexes. This adds to the knowledge about the development of the shape of the spine along with informing future research into the aetiology of scoliosis. National Research Ethics Service UK, NRES committee West MidlandsSouth Birmingham (11/H1207/10) awarded in 29/3/2011.