{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T20:01:12Z","timestamp":1792526472857,"version":"4.5.0"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,5,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>In the past decades, it has been recognized that sagittal alignment of the spine is crucial. Although the evolution of spinal alignment with growth has previously been described, there are no data for key parameters such as the exact shapes (extent and magnitude) of spinal curvatures. The goals of this study were therefore to determine normative values of spinopelvic sagittal parameters and to explore their variation during growth, based on the analysis of a large national cohort of healthy children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The radiographic data of 1,059 healthy children were analyzed in a retrospective, multicenter study. Full spine radiographs were used to measure several sagittal parameters, such as pelvic parameters, T1-T12 thoracic kyphosis (TK), and L1-S1 lumbar lordosis (LL). TK was divided into proximal, middle, and distal parts, and LL was divided into proximal and distal parts. Patients were stratified into 5 groups according to skeletal maturity (based on age, Risser stage, and triradiate cartilage status).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>During growth, pelvic incidence increased from 40\u00b0 to 46\u00b0 and pelvic tilt increased from 4\u00b0 to 9\u00b0 (p &lt; 0.05), whereas sacral slope remained constant. The peak of change in pelvic parameters occurred at the beginning of pubertal growth in Group 2 (the first part of the pubertal growth spurt). TK slightly increased among groups from 39\u00b0 to 41\u00b0 (p = 0.005), with the peak of change occurring in Group 4 (pubertal growth deceleration). LL increased from 51\u00b0 to 56\u00b0 (p &lt; 0.001), with the peak of change occurring in Group 3 (the second part of the pubertal growth spurt). Segmental analysis revealed that most of the TK and LL changes occurred in the distal TK and proximal LL, with the other parts remaining constant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This is one of the largest studies showing changes in sagittal alignment with growth in normal children and adolescents. We found that changes in spinal shape were cascading phenomena. At the beginning of the growth peak, pelvic incidence increased. This change in pelvic morphology led to an increase in LL, involving its proximal part. Finally, TK increased, in its distal part, at the end of pubertal growth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Prognostic\n                      <jats:underline>Level IV<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.22.00977","type":"journal-article","created":{"date-parts":[[2023,3,22]],"date-time":"2023-03-22T15:02:59Z","timestamp":1679497379000},"page":"676-686","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":34,"title":["Spinal Sagittal Alignment Changes During Childhood"],"prefix":"10.2106","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2230-2811","authenticated-orcid":false,"given":"S\u00e9bastien","family":"Pesenti","sequence":"first","affiliation":[{"name":"Service d\u2019Orthop\u00e9die P\u00e9diatrique, CHU Timone, Aix-Marseille Universit\u00e9, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0606-211X","authenticated-orcid":false,"given":"Yann Philippe","family":"Charles","sequence":"additional","affiliation":[{"name":"Service de Chirurgie du Rachis, H\u00f4pitaux Universitaires de Strasbourg, Universit\u00e9 de Strasbourg, Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3500-0655","authenticated-orcid":false,"given":"Sol\u00e8ne","family":"Prost","sequence":"additional","affiliation":[{"name":"Unit\u00e9 de Chirurgie Rachidienne, CHU Timone, Aix-Marseille Universit\u00e9, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2735-5330","authenticated-orcid":false,"given":"Federico","family":"Solla","sequence":"additional","affiliation":[{"name":"Service d\u2019Orthop\u00e9die P\u00e9diatrique, Fondation Lenval, Nice, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8896-5277","authenticated-orcid":false,"given":"Benjamin","family":"Blondel","sequence":"additional","affiliation":[{"name":"Unit\u00e9 de Chirurgie Rachidienne, CHU Timone, Aix-Marseille Universit\u00e9, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7245-8366","authenticated-orcid":false,"given":"Brice","family":"Ilharreborde","sequence":"additional","affiliation":[{"name":"Service de Chirurgie Orthop\u00e9dique Infantile, CHU Robert Debr\u00e9, AP-HP, Universit\u00e9 de Paris, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the French Spine Surgery Society (SFCR)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,3,22]]},"reference":[{"issue":"Suppl 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