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The rib cage: a new element in the spinopelvic chain

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Abstract

Introduction

This study analyzes anatomical variations of the thoracic cage (TC) according to spinopelvic alignment, age and gender using stereoradiography in erect position.

Methods

This retrospective multicentric study analyzed computed parameters collected from free-standing position bi-planar radiographs, among healthy subjects. Collected data were: age, gender, pelvic parameters (Pelvic Incidence, Pelvic Tilt (PT) and Sacral Slope), T1-T12 Kyphosis (TK), L1-S1 Lordosis (LL), curvilinear spinal length, global TC parameters (maximum thickness and width, rib cage volume, mean Spinal Penetration Index (SPI)), 1st–10th rib parameters (absolute and relative (to the corresponding vertebra) sagittal angles).

Results

Totally, 256 subjects were included (140 females). Mean age was 34 (range: 8–83). Significant correlations were found between TK and TC thickness (0.3, p < 0.001) and with TC Volume (0.3, p = 0.04), as well as rib absolute sagittal angle for upper and middle ribs (0.2, p = 0.02). Conversely, a −0.3 correlation has been exhibited between SPI and TK. Similar correlations were found with LL. PT significantly correlated with TC thickness (0.4, p = 0.003), SPI (−0.3, p = 0.03), and all rib relative sagittal angles. Among global TC parameters, only thickness and SPI significantly changed after 20 years (respectively, 0.39 and −0.52, p < 0.001). Ribs relative sagittal angle showed negative correlation with age in skeletally mature subjects (p < 0.001).

Conclusion

This study demonstrates the correlation between TC anatomy and spinopelvic parameters, confirming its part of the spinopelvic chain of balance. Indeed, higher spinal curvatures were associated with lower SPI and higher TC thickness, TC volume and rib absolute sagittal angles.

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Authors and Affiliations

  1. Orthopaedic Surgery Unit, Hôpital Européen Georges Pompidou, 20, rue Leblanc, 75015, Paris, France

    Marc Khalifé & Emmanuelle Ferrero

  2. Université Paris Cité, Paris, France

    Marc Khalifé & Emmanuelle Ferrero

  3. Arts Et Métiers Institute of Technology, Université Sorbonne Paris Nord, Villetaneuse, France

    Marc Khalifé, Claudio Vergari, Cécile Heidsieck & Wafa Skalli

  4. IBHGC - Institut de Biomécanique Humaine Georges Charpak, HESAM Université, 75013, Paris, France

    Marc Khalifé, Claudio Vergari, Cécile Heidsieck & Wafa Skalli

  5. INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale Et Clinique, Sorbonne Université, Paris, France

    Valérie Attali

  6. Service Des Pathologies du Sommeil (Département “R3S”), Assistance Publique Hôpitaux de Paris (APHP), Hôpitaux Universitaires Pitié Salpêtrière – Charles Foix, Paris, France

    Valérie Attali

  7. Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon

    Ayman Assi

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  1. Marc Khalifé
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  2. Claudio Vergari
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Correspondence to Marc Khalifé.

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Khalifé, M., Vergari, C., Ferrero, E. et al. The rib cage: a new element in the spinopelvic chain. Eur Spine J 31, 1457–1467 (2022). https://doi.org/10.1007/s00586-022-07216-9

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  • DOI: https://doi.org/10.1007/s00586-022-07216-9

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