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Coronal plane trunk asymmetry is associated with whole-body sagittal alignment in healthy young adolescents before pubertal peak growth

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Abstract

Purpose

To investigate coronal plane trunk asymmetry (TA) and its association with sagittal postural alignment in healthy subjects before pubertal peak growth.

Methods

In this cross-sectional baseline study, 1190 healthy pre-peak growth velocity subjects were included. Coronal plane TA was evaluated using back surface topography. Whole-body sagittal alignment (previously validated and objectively classified as neutral, sway-back or leaning-forward) and sagittal spinopelvic profile (trunk lean, lumbar lordosis, thoracic kyphosis, sacral inclination and length of the posteriorly inclined thoracolumbar segment) were determined, as were height, proportion of trunk to body length, body mass index, generalized joint laxity, and handedness.

Results

Logistic regression analysis yielded overall sagittal posture class to be independently associated with coronal plane TA: having a leaning-forward posture associated with a nearly three times higher odds of coronal TA (p < 0.001) compared to neutrals. A sway-back was 2.2 times more likely to show TA (p = 0.016) than a neutral, yet only in boys. Significant associations with coronal TA were also found for trunk lean, thoracic kyphosis and body mass index. These correlations, however, were gender and posture class specific. The spinal region where asymmetry is seen, varies according to the whole-body sagittal alignment type: primary thoracic curves were the most frequent in leaning-forwards, whereas primary curves in the lumbar or declive thoracolumbar segment were the most common in sway-backs.

Conclusions

In immature spines without known scoliosis, coronal plane TA is associated with whole-body sagittal alignment. It is more often seen in non-neutral than neutral sagittal posture types. Whether adolescent idiopathic scoliosis is related with postural characteristics before pubertal growth peak, should be addressed in future prospective studies.

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Acknowledgements

We are indebted to the pupils, parents and staff of the schools and pupil guidance centers for taking part in this study.

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Authors and Affiliations

  1. Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Campus Heymans (UZ, 3B3), De Pintelaan 185, 9000, Ghent, Belgium

    Mieke Dolphens, Andry Vleeming, Guy Vanderstraeten & Lieven Danneels

  2. Department of Anatomy, Medical Faculty, Center of Excellence in Neuroscience, University of New England, Biddeford, ME, USA

    Andry Vleeming

  3. Department of Orthopaedic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands

    René Castelein & Tom Schlösser

  4. Department of Physical and Rehabilitation Medicine, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium

    Guy Vanderstraeten

  5. Department of Orthopedics and Traumatology, Ghent University Hospital, Ghent, Belgium

    Frank Plasschaert

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  1. Mieke Dolphens
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  2. Andry Vleeming
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  3. René Castelein
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  4. Guy Vanderstraeten
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  7. Lieven Danneels
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Correspondence to Mieke Dolphens.

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The authors declare no conflict of interest. The authors had full control of all primary data. The authors agree to allow the journal to review our data if requested.

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Dolphens, M., Vleeming, A., Castelein, R. et al. Coronal plane trunk asymmetry is associated with whole-body sagittal alignment in healthy young adolescents before pubertal peak growth. Eur Spine J 27, 448–457 (2018). https://doi.org/10.1007/s00586-017-5156-x

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  • DOI: https://doi.org/10.1007/s00586-017-5156-x

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