Spinal posture and pelvic position in three hundred forty-five elementary school children: a rasterstereographic pilot study

Abstract

Children's posture has been of growing concern due to observations that it seems to be impaired compared to previous generations. So far there is no reference data for spinal posture and pelvic position in healthy children available. Purpose of this pilot study was to determine rasterstereographic posture values in children during their second growth phase. Three hundred and forty-five pupils were measured with a rasterstereographic device in a neutral standing position with hanging arms. To further analyse for changes in spinal posture during growth, the children were divided into 12-month age clusters. A mean kyphotic angle of 47.1°±7.5 and a mean lordotic angle of 42.1°±9.9 were measured. Trunk imbalance in girls (5.85 mm±0.74) and boys (7.48 mm± 0.83) varied only little between the age groups, with boys showing slightly higher values than girls. The trunk inclination did not show any significant differences between the age groups in boys or girls. Girls' inclination was 2.53°±1.96 with a tendency to decreasing angles by age, therefore slightly smaller compared to boys (2.98°±2.18). Lateral deviation (4.8 mm) and pelvic position (tilt: 2.75 mm; torsion: 1.53°; inclination: 19.8°±19.8) were comparable for all age groups and genders. This study provides the first systematic rasterstereographic analysis of spinal posture in children between 6 and 11 years. With the method of rasterstereography a reliable three-dimensional analysis of spinal posture and pelvic position is possible. Spinal posture and pelvic position does not change significantly with increasing age in this collective of children during the second growth phase.

Keywords: back pain; children; pelvic position.; posture; rasterstereography; spine.

Figure 1

This figure shows a rasterstereographic measurement of a child. After the acquisition of the picture with a digital video camera, the image is then analysed by the computer, the anatomical landmarks are automatically detected, and transformed into a 3-D surface map of the back surface. The red colour on the back surface represents convex surface areas, while the blue colour stands for concave surface areas.

Figure 2

Mean and SD of the variables trunk length (left) and body height (right) across the age groups, separated by sex. In contrast to the measured body height, the calculated trunk length (distance between spinous process of the 7th vertebrae to the midpoint of the lumbar dimples), increased only slightly from the youngest to the oldest group (girls 0.5 cm, boys 0.4 cm).

Figure 3

The kyphotic angle did not show any significant changes between the measured age groups. For the lordotic angle, we observed a small increase according to age, that was more pronounced in girls than in boys. However, no significant differences were found between the age groups or genders.