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Purpose <p>To systematically evaluate the normative distribution of sagittal spinopelvic profiles and Roussouly classification types among asymptomatic adults across different ethnic populations, using original, updated, and pelvic incidence (PI)-based classification systems.</p> Methods <p>A systematic literature search was conducted in PubMed, Web of Science, and Scopus for studies published between January 2005 and March 2025. Studies were included if they assessed asymptomatic adults, applied Roussouly (original or updated) or PI-based classifications, and reported quantitative spinopelvic data. Eight original studies (<i>n</i> = 2,149) from France, Canada, Turkey, India, China, Argentina, and an international multicenter cohort were included. Methodological quality was evaluated using the Joanna Briggs Institute criteria. Due to significant heterogeneity (I<sup>2</sup> &gt; 60%), meta-analysis was not performed.</p> Results <p>The most common sagittal profile was Roussouly type 3 (25. 0%–37. 8%), but substantial variation in type distribution and spinopelvic parameter values was observed between populations and classification systems. The 3AP variant, distinguishable only with updated/PI-based classification, showed high prevalence in Indian and international cohorts (16. 0%–28. 8%).</p> Conclusion <p>Roussouly type distribution and spinopelvic morphology vary significantly across populations and classification systems in asymptomatic adults. Updated classification systems, together with PI-based interpretative approaches, enable a more nuanced description of sagittal morphology, particularly for the 3AP variant. These normative data support the interpretation of the Roussouly classification as a biomechanical framework for understanding sagittal balance and lumbar lordosis distribution, rather than as a system defining fixed angular surgical targets.</p>

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Normatıve sagıttal spınopelvıc profıles: A systematıc revıew of the Roussouly classıfıcatıon across dıfferent ethnıc groups ın asymptomatıc adults

  • 期刊论文

  • 发表日期：

    2026年5月8日

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  • Halil Gok,
  • Alim Can Baymurat,
  • Aliekber Yapar,
  • Mehmet Ali Tokgoz,
  • Alpaslan Senkoylu

摘要

Purpose

To systematically evaluate the normative distribution of sagittal spinopelvic profiles and Roussouly classification types among asymptomatic adults across different ethnic populations, using original, updated, and pelvic incidence (PI)-based classification systems.

Methods

A systematic literature search was conducted in PubMed, Web of Science, and Scopus for studies published between January 2005 and March 2025. Studies were included if they assessed asymptomatic adults, applied Roussouly (original or updated) or PI-based classifications, and reported quantitative spinopelvic data. Eight original studies (n = 2,149) from France, Canada, Turkey, India, China, Argentina, and an international multicenter cohort were included. Methodological quality was evaluated using the Joanna Briggs Institute criteria. Due to significant heterogeneity (I2 > 60%), meta-analysis was not performed.

Results

The most common sagittal profile was Roussouly type 3 (25. 0%–37. 8%), but substantial variation in type distribution and spinopelvic parameter values was observed between populations and classification systems. The 3AP variant, distinguishable only with updated/PI-based classification, showed high prevalence in Indian and international cohorts (16. 0%–28. 8%).

Conclusion

Roussouly type distribution and spinopelvic morphology vary significantly across populations and classification systems in asymptomatic adults. Updated classification systems, together with PI-based interpretative approaches, enable a more nuanced description of sagittal morphology, particularly for the 3AP variant. These normative data support the interpretation of the Roussouly classification as a biomechanical framework for understanding sagittal balance and lumbar lordosis distribution, rather than as a system defining fixed angular surgical targets.