Spinal alignment varies with an individual’s race !

A Multi-Ethnic Alignment Normative Study (MEANS)

Spinal alignment is determined by more than just the PI or SS.
We compared individuals from three main races: Asian (A), Arabo-Bèrbère (B), and Caucasian (C).

Key points:
-Pelvic morphology including pelvic incidence (A: 51.0, B: 52.0, C: 52.5, p = 0.37), pelvic tilt (A: 11.9, B: 12.3, C: 12.9, p = 0.44), and sacral slope (A: 39.1, B: 39.7, C: 39.6, p = 0.77) were similar amongst the 3 races
– Thoracic Kyphosis (A: 32.9, B: 43.3, C: 40.0, p < 0.0001) and Lumbar lordosis (A: – 54.2, B: – 60.4, C: – 59.6, p < 0.0001) were lower in Asians compared to Caucasian and Arabo-Bèrbère volunteers despite having similar PI, PT, SS.
– The spine community has placed a lot of emphasis on the pelvis and not enough on the harmonious relationship between the lumbar spine and the thoracic spine
– There are likely genetic, environmental, cultural factors that determine the thoracic kyphosis and the eventual lumbar lordosis in addition to the influence of the pelvis.
– We need to start thinking of the PI LL TK mismatch instead of just the PI LL mismatch.

Read the full article: Sagittal spinal alignment varies with an individual’s race: results of the multi-ethnic alignment normative study (MEANS)

https://pubmed.ncbi.nlm.nih.gov/37428432

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Here are lateral X-rays of three asymptomatic volunteers with similar pelvic morphology (Pelvic Incidence, Pelvic Tilt, Sacral Slope) but different cervical lordosis, thoracic kyphosis, and lumbar lordosis, leading to different spinal shape