What are normal radiographic spine and shoulder balance parameters among adolescent patients?

• Published in: Spine deformity 2020-08, Vol.8 (4), p.621-627
• Main Authors: Clement, R. Carter, Anari, Jason, Bartley, Carrie E., Bastrom, Tracey P., Shah, Ronit, Talwar, Divya, Upasani, Vidyadhar V.
• Format: Article
• Language: English
• Subjects: Case Series; Medicine; Medicine & Public Health; Orthopedics
• ISSN: 2212-134X; 2212-1358
• DOI: 10.1007/s43390-020-00074-9

Study design Retrospective. Objectives To define normal values and distributions for sagittal, coronal, and shoulder balance among healthy adolescents, both for traditional radiographs and biplanar radiography. Summary of background data Our understanding of spine balance, especially in the sagittal plane, has expanded rapidly in recent years. Additionally, there has been growing use of simultaneous biplanar radiography which requires slightly different patient positioning. However, the normal ranges of several commonly used parameters have not yet been defined, either in traditional or biplanar radiography. Methods Radiographs were retrospectively reviewed of 273 patients aged 10–18 years seen in spine clinics at two high-volume centers and not diagnosed with any spine pathology. One center utilized traditional radiography and the other biplanar radiography. Coronal, sagittal, and shoulder balance were measured for each patient. Intra-observer reliability and normal values with distributions were reported for each parameter. Results Intra-observer reliability was excellent (intra-class correlation coefficients ≥ 0.98). Each parameter was normally distributed at each institution based on Kolmogorov–Smirnov testing. Sagittal balance was more negative at the institution using traditional radiographs (− 3.4 ± 4.2 vs. 0.3 ± 2.2, p