European Spine Journal - 2026-08-08 - Journal Article
Kyphosis, lordosis and height velocity. What is the effect of rate of growth on the development of the sagittal parameters of the spine in normal children?
Gardner A, Berryman F, Pynsent P
Topics
Key Takeaway
In 196 children aged 9–18, increasing height velocity from 0 to 4 cm/yr was associated with decreasing kyphosis and lordosis in females, with a statistically significant sex difference for lordosis (p=0.02) but not kyphosis (p=0.07).
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Summary
This study examined whether height velocity influences sagittal spinal shape development in normal children aged 9–18 using ISIS2 surface topography and linear mixed effects modelling. In females, both kyphosis and lordosis decreased as height velocity rose from 0 to 4 cm/yr and then plateaued; males showed minimal kyphosis change across all velocities with modest lordosis variation between 5–6 cm/yr. A statistically significant sex difference existed for lordosis (p=0.02) but not kyphosis (p=0.07).
Key Limitation
Surface topography does not capture true vertebral endplate angles, so the magnitude of kyphosis and lordosis changes reported cannot be directly compared to radiographic Cobb-based normative data used in clinical decision-making.
Original Abstract
PURPOSE
To identify the effect of the rate of growth in standing height in the development of kyphosis and lordosis of normal children.
METHODS
Analysis of the sagittal parameters of spinal shape from longitudinally collected ISIS2 surface topography measures were analysed alongside measures of standing height by comparing height velocity and the development of kyphosis and lordosis using linear mixed effects modelling techniques.
RESULTS
There were 831 measures from 196 children (79 females) between 2010 and 2017 aged between 9 and 18 years of age. Height velocity was between 0 and 12 cm/yr. There was a decrease in both kyphosis and lordosis for females as height velocity increased from 0 to 4 cm/yr whereon the measure plateaued. For males, kyphosis showed less change over all values of height velocity whereas lordosis had some variation between 5 and 6 cm/yr. There was a statistically significant difference between the sexes for lordosis (p = 0.02) but not for kyphosis (p = 0.07).
CONCLUSION
The development of the sagittal shape of the spine is dependent on height velocity, and the effects of this differ between the sexes. This adds to the knowledge about the development of the shape of the spine along with informing future research into the aetiology of scoliosis.
TRIAL REGISTRATION
National Research Ethics Service UK, NRES committee West MidlandsSouth Birmingham (11/H1207/10) awarded in 29/3/2011.