BACKGROUND: Spinopelvic alignment is central to spinal biomechanics and surgical planning. Normative spinopelvic parameters vary by geography and ethnicity, and reference data for Ethiopia have not previously been reported. OBJECTIVES: This study aimed to determine normative spinopelvic parameters in healthy Ethiopian adults and examine their variation based on age and sex. METHODS: An observational cross-sectional study was conducted at Tikur Anbessa Specialized Hospital between August and December 2025. The study included 117 healthy adults (60 men, 57 women). Standardized standing lateral lumbosacral radiographs were obtained. Two spine surgeons independently measured pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), and lumbar lordosis (LL). RESULTS: The median age was 40 years. The mean values were PI 52.6° ± 8.9°, SS 39.8° ± 7.4°, PT 12.9° ± 7.0°, and LL 60.1° ± 8.5° (measured from the inflection point to S1). LL exceeded values reported in Asian and North American cohorts but was comparable with African and European populations. Women demonstrated higher values across all parameters. Multivariable regression identified PI (β = 0.83, p < 0.001), PT (β = −0.76, p < 0.001), and female sex (β = 3.05, p = 0.008) as independent predictors of LL (R(2) = 0.64). CONCLUSIONS: This study establishes the first normative spinopelvic reference values for asymptomatic Ethiopian adults, providing a foundation for population-specific alignment assessment and future outcome studies. LEVEL OF EVIDENCE: Level IV Diagnostic. See Instructions for Authors for a complete description of levels of evidence.
Seyoum et al. (Tue,) studied this question.