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Sagittal spinopelvic alignment in ambulatory persons with cerebral palsy

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Abstract

Purpose

This study aimed to describe the spinopelvic alignment of a cohort of young ambulatory individuals with cerebral palsy (CP) and compare it to published spinopelvic alignment data for the typically developing adolescents.

Methods

Thirty-seven adolescents (18 females) with CP at GMFCS I–III were included in this retrospective case series. Lumbar lordosis and pelvic incidence were measured, and their mismatch was calculated. A model that calculates predicted lumbar lordosis based on pelvic incidence in normative data was utilized to calculate a predicted lumbar lordosis in this cohort with cerebral palsy.

Results

At imaging, ages were mean and standard deviation 13.5 ± 3.0 years. Pelvic incidence was 46.2° ± 12.9°, pelvic tilt was 2.8° ± 9.4°, sacral slope was 43.6° ± 10.8°, and measured lumbar lordosis was 59.4° ± 11.6°. There were no differences in pelvic incidence or lumbar lordosis among the GMFCS levels; however, pelvic incidence was higher in females. Pelvic incidence–lumbar lordosis mismatch greater than 10° was found in 67% of the cohort. Mean predicted lumbar lordosis based on the model was 54.7° ± 8.5°, averaging 8° less than measured lordosis.

Conclusion

PI–LL mismatch was identified in 67% of this cohort of ambulatory adolescents with CP, in part due to greater lordosis than predicted by a model based on data from adolescents without CP. The implications of this finding, such as the correlation between sagittal spinopelvic alignment and quality of life in this population, should be assessed further in ambulatory patients with cerebral palsy.

Level of evidence

Level IV—retrospective cohort study and literature comparison.

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Data availability

The data that support the findings of this study are available on request from the corresponding author, PRPS. The data are not publicly available due to their containing information that could compromise the privacy of research participants.

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Funding

The authors have no disclosures and wish to state that they have received no support or funding for this research project.

Author information

Author notes

  1. Paulo R. P. Selber

    Present address: Hospital for Special Surgery, 535 East 70th Street, 5th Floor Room 5W-540, New York, NY, 10021, USA

Authors and Affiliations

  1. Columbia University Irving Medical Center, 3959 Broadway, 8th Floor North, New York, NY, 10032, USA

    Stephen Plachta

  2. Columbia University Irving Medical Center, 1420 Locust St. #27Q, Philadelphia, PA, 19102, USA

    Sonya B. Levine

  3. Columbia University Irving Medical Center, 3959 Broadway, 8th Floor North – 802A, New York, NY, 10032, USA

    Kirsten Carlberg

  4. University of Illinois College of Medicine Rockford, 1601 Parkview Ave, Rockford, IL, 61107, USA

    Peter M. Cirrincione

  5. Columbia University Irving Medical Center, 3959 Broadway, 8th Floor North – 802, New York, NY, 10032, USA

    Michael Vitale & Benjamin D. Roye

  6. Columbia University Irving Medical Center NewYork-Presbyterian Och Spine Hospital, New York, NY, 10032, USA

    Lawrence G. Lenke

  7. Columbia University Irving Medical Center, New York, NY, 10032, USA

    Paulo R. P. Selber

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Contributions

Stephen Plachta: development of research aims, measurements, data interpretation, primary manuscript drafting, and approval of final manuscript. Sonya B. Levine: development of research aims, measurements, data interpretation, manuscript editing, and approval of final manuscript. Kirsten Carlberg: development of statistical methodology to test the research aims, statistical analysis, data interpretation, manuscript drafting, and final manuscript approval. Peter M. Cirrincione: development of research aims, data interpretation, manuscript editing, and final manuscript approval. Michael Vitale: development of research aims, data interpretation, final manuscript editing, and final manuscript approval. Lawrence G. Lenke: development of research aims, data interpretation, final manuscript editing, and final manuscript approval. Benjamin D Roye: development of research aims, measurements, data interpretation, final manuscript editing, and final manuscript approval. Paulo RP Selber: development of research aims, data interpretation, manuscript drafting, final manuscript editing, and final manuscript approval.

Corresponding author

Correspondence to Paulo R. P. Selber.

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Plachta, S., Levine, S.B., Carlberg, K. et al. Sagittal spinopelvic alignment in ambulatory persons with cerebral palsy. Spine Deform (2024). https://doi.org/10.1007/s43390-024-00866-3

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