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Normative data for parameters of sagittal spinal alignment in healthy subjects: an analysis of gender specific differences and changes with aging in 626 asymptomatic individuals

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Abstract

Purpose

This study aims to establish normative data for parameters of spino-pelvic and spinal sagittal alignment, gender related differences and age-related changes in asymptomatic subjects.

Methods

A total of 626 asymptomatic volunteers from Japanese population were enrolled in this study, including 50 subjects at least for each gender and each decade from 3rd to 8th. Full length, free-standing spine radiographs were obtained. Cervical lordosis (CL; C3–7), thoracic kyphosis (TK; T1–12), lumbar lordosis (LL; T12–S1), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS) and sagittal vertical axis (SVA) were measured.

Results

The average values (degrees) are 4.1 ± 11.7 for CL, 36.0 ± 10.1 for TK, 49.7 ± 11.2 for LL, 53.7 ± 10.9 for PI, 14.5 ± 8.4 for PT, and 39.4 ± 8.0 for SS. Mean SVA is 3.1 ± 12.6 mm. Advancing age caused an increase in CL, PT and SVA, and a decrease in LL and SS. There was a significant gender difference in CL, TK, LL, PI, PT and SVA. From 7th decade to 8th decade, remarkable decrease of LL & TK and increase of PT were seen. A large increase of SVA was also seen between 60’ and 70’.

Conclusion

Standard values of spino-pelvic sagittal alignment were established in each gender and each decade from 20’ to 70’. A remarkable change of spino-pelvic sagittal alignment was seen from 7th decade to 8th decade in asymptomatic subjects.

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Acknowledgments

This study was supported by institutional funds and by grant research funds, which are intended for promoting hospital functions, of the Japan Labor Health and Welfare Organization (Kawasaki, Japan). No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan

    Yasutsugu Yukawa & Munehito Yoshida

  2. Department of Orthopedic Surgery, Chubu Rosai Hospital, Nagoya, Japan

    Yasutsugu Yukawa & Fumihiko Kato

  3. Department of Orthopedic Surgery, Hokkaido Chuo Rosai Hospital Sekison Center, Bibai, Japan

    Kota Suda

  4. Department of Orthopedic Surgery, Chiba Rosai Hospital, Ichihara, Japan

    Masatsune Yamagata

  5. Department of Orthopedic Surgery, Spinal Injuries Center, Iizuka, Japan

    Takayoshi Ueta

Authors
  1. Yasutsugu Yukawa
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  2. Fumihiko Kato
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  3. Kota Suda
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  4. Masatsune Yamagata
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  5. Takayoshi Ueta
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  6. Munehito Yoshida
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Correspondence to Yasutsugu Yukawa.

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Yukawa, Y., Kato, F., Suda, K. et al. Normative data for parameters of sagittal spinal alignment in healthy subjects: an analysis of gender specific differences and changes with aging in 626 asymptomatic individuals. Eur Spine J 27, 426–432 (2018). https://doi.org/10.1007/s00586-016-4807-7

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  • DOI: https://doi.org/10.1007/s00586-016-4807-7

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