Measurement and Analysis of Sagittal Spinal Morphology and Function in Adolescents: A Cross-Sectional Study
Abstract Background: Spine health is a significant aspect of adolescent health, but few studies have focused on adolescent sagittal plane health. This study aimed to investigate the current status of sagittal spine morphology and function in adolescents. Method: This cross-sectional study analysed 1152 effective samples obtained from junior and senior high school students (543 boys and 609 girls) from demonstration, middle-level, and general schools in Beijing. Spinal sagittal morphology and function were measured by Spinal Mouse, a spine measuring instrument. The sacrum angle (SA), thoracic kyphosis angle (TKA), lumbar lordosis angle (LLA), inclination angle (INA), sacral range of motion (SROM), thoracic range of motion (TROM), lumbar range of motion (LROM), and inclination range of motion (IROM) were measured. The Matthiass test was used to measure the change in angle after external load placement on the adolescent spine. Sacral angle change (SAc), thoracic angle change (TKAc), lumbar lordosis angle change (LLAc), and inclination angle change (INAc) were also analysed. Result : Abnormal TKA rate was 48.2% and 44.7% in the junior and senior high school. Abnormal LLA rate was 44.6% and 55.4%. In the spinal mobility test of the junior high school , SROM, TROM, LROM, and IROM were 60.6°±19.1°, 23.0°±16.6°, 23.0°±16.6°, and 136.1°±16.9°, respectively, for boys and 66.0°±34.4°, 14.0°±17.3°, 66.3°±18.6°, and 127.4°±26.8°, for girls. There were significant differences found between boys and girls (P<0.05 or P<0.01). In the Matthiass test, INAc of the junior high school was 5.7°±5.0° and 2.6°±3.7° for boys and girls, whereas INAc of the senior high school was 2.8°±3.3 and 1.6°±3.0, showing significant differences (P<0.01). The canonical correlation coefficient of SA, SROM, LROM, and IROM was 1.3877, -2.5384, -0.6625, and 1.6336. SROM and LROM were found to be negatively correlated with spinal function, whereas IROM was positively correlated with spinal function. Conclusion: Adolescents have a high incidence of thoracic kyphosis. During flexion and extension, the thoracic and lumbar vertebral activity and overall activity are better in boys. However, girls are better at maintaining the strength quality of stable muscle groups with a normal spine shape. Sacral obliquity and pelvic position greatly influence the spinal morphology of adolescents.