title: Spinal alignment evolution with age: A prospective gait analysis study.
abstract: OBJECTIVE
  To describe, using gait analysis, the development of spinal motion in the growing child.
  
  
  METHODS
  Thirty-six healthy children aged from 3 to 16 years old were included in this study for a gait analysis (9 m-walk). Various kinematic parameters were recorded and analyzed such as thoracic angle (TA), lumbar angle (LA) and sagittal vertical axis (SVA). The kinetic parameters were the net reaction moments (N.m/kg) at the thoracolumbar and lumbosacral junctions.
  
  
  RESULTS
  TA and LA curves were not statistically correlated to the age (respectively,P= 0.32 andP= 0.41). SVA increased significantly with age (P< 0.001). Moments in sagittal plane at the lumbosacral junction were statistically correlated to the age (P= 0.003), underlining the fact that sagittal mechanical constraints at the lumbosacral junction increase with age. Moments in transversal plane at the thoracolumbar and lumbosacral junctions were statistically correlated to the age (P= 0.0002 andP= 0.0006), revealing that transversal mechanical constraints decrease with age.
  
  
  CONCLUSIONS
  The kinetic analysis showed that during growth, a decrease of torsional constraint occurs while an increase of sagittal constraint is observed. These changes in spine biomechanics are related to the crucial role of the trunk for bipedalism acquisition, allowing stabilization despite lower limbs immaturity. With the acquisition of mature gait, the spine will mainly undergo constraints in the sagittal plane.
authors.affiliation: Sébastien Pesenti, Emilie Peltier, Jean-Luc Jouve, Pediatric orthopedics, Timone Enfants, Aix-Marseille University, 13005 Marseille, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Pesenti
authors.affiliation: Sébastien Pesenti, Emilie Peltier, Jean-Luc Jouve, Pediatric orthopedics, Timone Enfants, Aix-Marseille University, 13005 Marseille, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Blondel
authors.affiliation: Sébastien Pesenti, Emilie Peltier, Jean-Luc Jouve, Pediatric orthopedics, Timone Enfants, Aix-Marseille University, 13005 Marseille, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Peltier
authors.affiliation: Sébastien Pesenti, Emilie Peltier, Jean-Luc Jouve, Pediatric orthopedics, Timone Enfants, Aix-Marseille University, 13005 Marseille, France.
authors.forename: Elke
authors.initials: E
authors.lastname: Viehweger
authors.affiliation: Sébastien Pesenti, Emilie Peltier, Jean-Luc Jouve, Pediatric orthopedics, Timone Enfants, Aix-Marseille University, 13005 Marseille, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Pomero
authors.affiliation: Sébastien Pesenti, Emilie Peltier, Jean-Luc Jouve, Pediatric orthopedics, Timone Enfants, Aix-Marseille University, 13005 Marseille, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Authier
authors.affiliation: Sébastien Pesenti, Emilie Peltier, Jean-Luc Jouve, Pediatric orthopedics, Timone Enfants, Aix-Marseille University, 13005 Marseille, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Fuentes
authors.affiliation: Sébastien Pesenti, Emilie Peltier, Jean-Luc Jouve, Pediatric orthopedics, Timone Enfants, Aix-Marseille University, 13005 Marseille, France.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Jouve
keywords: Gait analysis; Sagittal balance; Spine biomechanics; Spine growth; Thorcic kyphosis