Association of Body Mass Index and Central Obesity with Spino-Pelvic Alignment Parameters in a Chinese Population: A Prospective Study

The purpose of this study was to explore the impact of central obesity on spinal sagittal balance in adults aged 18 and older by examining correlations between waist and abdominal circumferences and spinopelvic alignment parameters. This prospective cohort study included 350 adults aged 18 and older. Participants underwent whole-body biplanar radiography using the EOS imaging system. Spinal and pelvic parameters were measured and correlated with body mass index (BMI), waist, and abdominal circumferences (WC, AC). Statistical analyses included one-way ANOVA, Wilcoxon rank-sum tests for data with non-homogeneous variances, and chi-squared tests for categorical data. Intra-rater and inter-rater reliability were assessed using intraclass correlation coefficients, with subsequent analyses to explore correlations between body measurements and spinal parameters. The study found significant correlations between increased waist and abdominal circumferences and changes in spinopelvic parameters. However, obesity did not uniformly influence all sagittal alignment parameters. Significant variations in spinal measurements indicate that central obesity plays a role in altering spinal stability and alignment. The findings highlight the impact of central obesity on spinal alignment and emphasize the importance of considering central obesity in clinical assessments of spinal pathologies. Further research is essential to better understand the relationship between obesity, spinal sagittal balance, and related health conditions.