Classification of spinopelvic balance in ambulatory adolescents and adults with cerebral palsy: a cross-sectional study

Abstract We aimed to determine the spinopelvic profile types of ambulatory adolescents and adults with diplegic CP, and their relationship with functional ability (Gross Motor Function Classification System [GMFCS]), pain, and previous orthopaedic treatments. We measured anatomical variables on radi...

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Main Authors: Emmanuelle Chaléat-Valayer, Carole Vernez, Stéphane Verdun, Soline Bellaiche, Laure Mathevon, Rachel Bard Pondarré, Hovannes Agopyan, Marianne Bagnol, Kariman Abelin
Format: Article
Language:English
Published: Nature Portfolio 2025-06-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-03762-6
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author Emmanuelle Chaléat-Valayer
Carole Vernez
Stéphane Verdun
Soline Bellaiche
Laure Mathevon
Rachel Bard Pondarré
Hovannes Agopyan
Marianne Bagnol
Kariman Abelin
author_facet Emmanuelle Chaléat-Valayer
Carole Vernez
Stéphane Verdun
Soline Bellaiche
Laure Mathevon
Rachel Bard Pondarré
Hovannes Agopyan
Marianne Bagnol
Kariman Abelin
author_sort Emmanuelle Chaléat-Valayer
collection DOAJ
description Abstract We aimed to determine the spinopelvic profile types of ambulatory adolescents and adults with diplegic CP, and their relationship with functional ability (Gross Motor Function Classification System [GMFCS]), pain, and previous orthopaedic treatments. We measured anatomical variables on radiographs from 77 individuals with CP (mean age, 28.4, SD, 11.9 years), GMFCS levels I–III. We applied a non-supervised hierarchical ascendant classification followed by k-medoids analysis to 5 key anatomical variables. We compared radiological and clinical variable values between the spinopelvic profiles identified. Three spinopelvic profiles emerged, according to whether the pelvis was anteverted (sacral slope ≥ 38°) or retroverted (< 38°) and whether this was concordant with the pelvic incidence (≥ 54° for anteversion and < 54° for retroversion). Most (61/77, 79%) participants had anteversion, concordant for only 28/61 (46%); 16/77 (21%) had retroversion, concordant for 14/16 (88%). More participants with concordant anteversion experienced pain than participants with discordant anteversion (P = 0.03). Rates of previous treatments did not differ between concordant and discordant anteversion. More participants with GMFCS level III had discordant anteversion than those with levels I–II (P = 0.02). Categorising the spinopelvic profile is the first step to understanding pain causes and proposing targeted interventions and/or rehabilitation programs.
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spelling doaj-art-b1761c95d34e4b3e913f65e522abc3d92025-08-20T03:25:18ZengNature PortfolioScientific Reports2045-23222025-06-011511810.1038/s41598-025-03762-6Classification of spinopelvic balance in ambulatory adolescents and adults with cerebral palsy: a cross-sectional studyEmmanuelle Chaléat-Valayer0Carole Vernez1Stéphane Verdun2Soline Bellaiche3Laure Mathevon4Rachel Bard Pondarré5Hovannes Agopyan6Marianne Bagnol7Kariman Abelin8CMCR Des Massues - Croix-Rouge FrançaisePhysical Medicine and Rehabilitation Department, Henry Gabrielle Hospital, Hospices Civils de LyonBiostatistics Department- Delegations for Clinical Research and Innovation, Lille Catholic Hospitals, Lille Catholic UniversityCMCR Des Massues - Croix-Rouge FrançaiseCMCR Des Massues - Croix-Rouge FrançaiseCMCR Des Massues - Croix-Rouge FrançaiseCMCR Des Massues - Croix-Rouge FrançaiseCMCR Des Massues - Croix-Rouge FrançaiseCMCR Des Massues - Croix-Rouge FrançaiseAbstract We aimed to determine the spinopelvic profile types of ambulatory adolescents and adults with diplegic CP, and their relationship with functional ability (Gross Motor Function Classification System [GMFCS]), pain, and previous orthopaedic treatments. We measured anatomical variables on radiographs from 77 individuals with CP (mean age, 28.4, SD, 11.9 years), GMFCS levels I–III. We applied a non-supervised hierarchical ascendant classification followed by k-medoids analysis to 5 key anatomical variables. We compared radiological and clinical variable values between the spinopelvic profiles identified. Three spinopelvic profiles emerged, according to whether the pelvis was anteverted (sacral slope ≥ 38°) or retroverted (< 38°) and whether this was concordant with the pelvic incidence (≥ 54° for anteversion and < 54° for retroversion). Most (61/77, 79%) participants had anteversion, concordant for only 28/61 (46%); 16/77 (21%) had retroversion, concordant for 14/16 (88%). More participants with concordant anteversion experienced pain than participants with discordant anteversion (P = 0.03). Rates of previous treatments did not differ between concordant and discordant anteversion. More participants with GMFCS level III had discordant anteversion than those with levels I–II (P = 0.02). Categorising the spinopelvic profile is the first step to understanding pain causes and proposing targeted interventions and/or rehabilitation programs.https://doi.org/10.1038/s41598-025-03762-6Cerebral palsySpinopelvic complexPelvic incidenceSagittal imbalanceHierarchical ascendant classification
spellingShingle Emmanuelle Chaléat-Valayer
Carole Vernez
Stéphane Verdun
Soline Bellaiche
Laure Mathevon
Rachel Bard Pondarré
Hovannes Agopyan
Marianne Bagnol
Kariman Abelin
Classification of spinopelvic balance in ambulatory adolescents and adults with cerebral palsy: a cross-sectional study
Scientific Reports
Cerebral palsy
Spinopelvic complex
Pelvic incidence
Sagittal imbalance
Hierarchical ascendant classification
title Classification of spinopelvic balance in ambulatory adolescents and adults with cerebral palsy: a cross-sectional study
title_full Classification of spinopelvic balance in ambulatory adolescents and adults with cerebral palsy: a cross-sectional study
title_fullStr Classification of spinopelvic balance in ambulatory adolescents and adults with cerebral palsy: a cross-sectional study
title_full_unstemmed Classification of spinopelvic balance in ambulatory adolescents and adults with cerebral palsy: a cross-sectional study
title_short Classification of spinopelvic balance in ambulatory adolescents and adults with cerebral palsy: a cross-sectional study
title_sort classification of spinopelvic balance in ambulatory adolescents and adults with cerebral palsy a cross sectional study
topic Cerebral palsy
Spinopelvic complex
Pelvic incidence
Sagittal imbalance
Hierarchical ascendant classification
url https://doi.org/10.1038/s41598-025-03762-6
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