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Spinous process morphology: the effect of ageing through adulthood on spinous process size and relationship to sagittal alignment

European Spine Journal volume 21, pages 1007–1012 (2012)Cite this article

Abstract

Study design

Blinded radiographic analysis of CT scans reformatted for precise lumbar spinous process (LSP) measurement.

Objective

To investigate the effect of ageing on LSP morphology and influence of LSP morphology on lumbar spine sagittal alignment.

Summary of background data

There is little data reporting the influence of ageing on spinous process size. There is data describing the increase in size of other body parts with age, such as the femur, ears, vertebral body, and nose. Several old cadaveric and radiographic studies have reported the formation of osseous spurs within the supraspinous and interspinous ligaments.

Method

200 abdominal CT scans taken for trauma and vascular investigation were reformatted to allow precise bony measurement of the lumbar spine. Two observers were blinded from the age and demographics of the patients. Sagittal and coronal plane projections were used to measure the height and width of the spinous processes (L1–L5), respectively. The relationship between spinous process size, age, and supine lordosis was investigated.

Results

LSP height increases by 0.03–0.07 mm/year (p < 10−3 to 10−8) and width by 0.05–0.06 mm/year (p < 10−11 to 10−15). Lumbar lordosis decreases with increasing LSP height (p < 0.0004) but is not related to increasing LSP width (p = 0.195). Supine lordosis increases by 0.1°/year (p = 0.004).

Conclusions

This study demonstrates that the dimensions of the LSP change with age. Increases in LSP height and even more impressive increases in LSP width occur with advancing age. There is an inverse relationship between lumbar lordosis and LSP height.

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Conflict of interest

No funds were received in support of this work. 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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Affiliations

  1. Department of Orthopaedics, Auckland City Hospital, Level 7, Auckland, New Zealand

    Caspar Edward William Aylott, Rupesh Puna & Peter Alexander Robertson

  2. Department of Engineering Science, The University of Auckland, Auckland, New Zealand

    Cameron Walker

  3. The Orthopaedic Clinic, Mercy Specialist Centre, 100 Mountain Road, Epsom, Auckland, 1023, New Zealand

    Peter Alexander Robertson

  4. Department of Orthopaedics, Gloucestershire Royal Hospital, Level 2 Tower Block, Great Western Road, Gloucestershire, GL1 3NN, UK

    Caspar Edward William Aylott

Authors
  1. Caspar Edward William Aylott
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  2. Rupesh Puna
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  3. Peter Alexander Robertson
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  4. Cameron Walker
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Corresponding authors

Correspondence to Caspar Edward William Aylott or Peter Alexander Robertson.

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Aylott, C.E.W., Puna, R., Robertson, P.A. et al. Spinous process morphology: the effect of ageing through adulthood on spinous process size and relationship to sagittal alignment. Eur Spine J 21, 1007–1012 (2012). https://doi.org/10.1007/s00586-011-2029-6

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  • DOI: https://doi.org/10.1007/s00586-011-2029-6

Keywords

  • Spinous process
  • Ageing
  • Sagittal alignment
  • Lumbar lordosis