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Description of age-related changes in cervical sagittal alignment based on pelvic incidence classification in asymptomatic Chinese population

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Abstract

Purpose

To investigate the pelvic incidence (PI)- and age-related cervical alignment changes of Chinese healthy population.

Methods

Six hundred and twenty-five asymptomatic adult subjects, who underwent the standing whole spinal radiograph, were recruited in this work. The sagittal parameters were measured, including Occipito-C2 angle (O-C2), C2–7 angle (C2–7), cranial arch, caudal arch, T1-slope (T1S), C2–7 sagittal vertical axis (C2–7 SVA), thoracic kyphosis (TK), lumbar lordosis (LL), pelvic tilt (PT), sacral slope (SS), PI, and sagittal vertical axis (SVA). All subjects were stratified into 5 age groups, namely 40–59 years, 60–64 years, 65–69 years, 70–74 years, and 75 years and above, with each age group further divided into 2 subgroups based on PI (deeming PI < 50° as low PI, and PI ≥ 50° as high PI). The correlations between PI or age, and other sagittal parameters were assessed. The age-related changes of sagittal parameters in each PI subgroup were also assessed, followed by one-way analysis of variance analysis for change comparison between age groups.

Results

The average cervical sagittal parameters were as below: 18.2 ± 6.8° for O-C2, 10.4 ± 10.2° for C2–7, 3.9 ± 7.5° for cranial arch, 6.5 ± 7.1° for caudal arch, 23.6 ± 7.3° for T1S, and 21.0 ± 9.7 mm for C2–7 SVA. There was no obvious difference observed between PI and cervical sagittal parameters, excepting for caudal arch. While, C2–7, cranial arch, caudal arch, T1S, and C2–7 SVA increased remarkably with the age. Thereof, C2–7 exhibited great increases at the age of 60–64 years and 70–74 years, respectively, cranial arch increased notably at 60–64 years of age, and caudal arch developed obviously at 70–74 years of age, regardless of PI.

Conclusion

This study showed the PI- and age-related cervical alignment changes of Chinese healthy population. Based on the classification in our study, high or low PI apparently did not correlate with the occurrence of cervical degenerative disease.

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Funding

This study was supported by the National Key Research and Development Program of China (No.2020YFC2004900), National Natural Science Foundation of China (H0608), Natural Science Foundation of China (No.81672201, 81871794), and Beijing Hospitals Authorit’Ascent Plan (No.DFL20190802).

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Author notes

  1. Zheng Wang, Xinli Hu and Peng Cui have contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Changchun Rd. No.45 Changchun Street, Xicheng District, Beijing, 100053, People’s Republic of China

    Zheng Wang, Xinli Hu, Peng Cui, Xu Liu, Weiguo Zhu, Chao Kong, Wei Wang & Shibao Lu

  2. National Clinical Research Center for Geriatric Diseases, Beijing, 100053, People’s Republic of China

    Zheng Wang, Xinli Hu, Peng Cui, Xu Liu, Weiguo Zhu, Chao Kong, Wei Wang & Shibao Lu

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  1. Zheng Wang
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Contributions

SL conceived and designed the study; ZW, XH, PC, and XL collected; ZW, WZ, CK, and WW analyzed and interpreted the data. ZW, XH, and PC wrote the paper. All authors read and approved the final manuscript. The article described has not been submitted elsewhere for publication, in whole or in part. All authors read and approved the final manuscript.

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Correspondence to Wei Wang or Shibao Lu.

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Wang, Z., Hu, X., Cui, P. et al. Description of age-related changes in cervical sagittal alignment based on pelvic incidence classification in asymptomatic Chinese population. Eur Spine J 32, 2402–2414 (2023). https://doi.org/10.1007/s00586-023-07769-3

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