Acta Neurochirurgica

, Volume 159, Issue 6, pp 1119–1128 | Cite as

Sagittal spinal alignment in asymptomatic patients over 30 years old in the Korean population

  • Seil Sohn
  • Chun Kee ChungEmail author
  • Yongjung Jay Kim
  • Inbo Han
  • Su Min Kang
  • Ji Won Yoon
  • Hyejin Kim
Original Article - Spine



We aim to provide sagittal and pelvic parameters according to different age groups in an asymptomatic population all over 30 years old and to investigate the possible causes of changes in these parameters.


Whole-spine, standing lateral radiographs were taken in 128 asymptomatic Korean people over 30 years old. The spinal parameters (the total thoracic kyphosis (TTK), maximal lumbar lordosis (MLL), total lumbar lordosis (TLL), lower lumbar lordosis (LLL), thoracolumbar junctional angle (TLJA), and lumbar inclination (LI)), pelvic parameters (pelvic incidence (PI), sacral slope (SS), and pelvic tilt (PT)), and spinal balance parameters (spinal balance, sacropelvic balance, and spinopelvic balance) were measured. The body mass index, body protein mass, waist line, skeletal muscle mass, and body fat mass were also measured for potential causes.


TTK and TLJA were significantly increased in the group over 70 years of age compared to the other age groups (p = 0.0002, <0.001). TLL was significantly decreased in the group over 70 years of age (p = 0.002), whereas the PI values were similar to PI even in over 70-year age group. LLL did not differ in the group over 70 years of age (p = 0.29), gradually increasing with an increase in age. SS was significantly decreased and PT was significantly increased in the group over 70 years of age as compared to the other age groups (p = 0.049, 0.049, respectively). PI was similar in all age groups (p = 0.75). Spinal balance was significantly decreased in the group over 70 years of age (p = <0.0001). PT was significantly associated with body protein mass and skeletal muscle mass (p = 0.01, 0.001, respectively). Body protein mass and skeletal muscle mass were significantly lower in the group over 70 years of age (p = 0.02, 0.02) and were possible causes.


Several sagittal and pelvic parameters are different in asymptomatic adults over 70 years of age. Decreased body protein mass and skeletal muscle mass are possible causes of these changes.


Sagittal balance Spinal alignment Sacral slope Adult spine Normal patterns 


Compliance with ethical standards


The authors have no personal financial or institutional interest in any of the drugs, materials, or devices described in this article.


The Ministry of Health & Welfare, Republic of Korea provided financial support in the form of a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI) (grant number: HI16C1559). The sponsor had no role in the design or conduct of this research.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.


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Copyright information

© Springer-Verlag Wien 2017

Authors and Affiliations

  1. 1.Department of NeurosurgerySeoul National University College of MedicineJongno-guSouth Korea
  2. 2.Neuroscience Research InstituteSeoul National University Medical Research CenterSeoulSouth Korea
  3. 3.Clinical Research InstituteSeoul National University HospitalSeoulSouth Korea
  4. 4.Department of Neurosurgery, CHA Bundang Medical CenterCHA UniversityGyeonggidoSouth Korea
  5. 5.Department of Brain and Cognitive SciencesSeoul National University College of Natural SciencesSeoulSouth Korea
  6. 6.Department of Orthopedics, College of Physicians and SurgeonsColumbia UniversityNew YorkUSA
  7. 7.Department of Radiology, Healthcare Research Institute, Healthcare System Gangnam CenterSeoul National University HospitalSeoulSouth Korea
  8. 8.Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam CenterSeoul National University HospitalSeoulSouth Korea
  9. 9.Seoul National University Bundang HospitalGyeonggidoSouth Korea

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