Changes in correlations between cervical and distal spinal sagittal alignments in asymptomatic population with aging
Background: In recent years, the correlations between spinal sequences and aging have been identified. However, the trends in correlations between cervical and distal spinal alignments with aging in asymptomatic populations remain underexplored.
Aim: This study aimed to compare the correlations between cervical and distal spinal sagittal alignments in different age groups, as well as investigate their trends during the aging process in an asymptomatic population. Methods: A total of 128 asymptomatic healthy volunteers were enrolled and stratified into four groups according to age (Group A: ≤ 20 years; Group B: 21–40 years; Group C: 41–60 years; Group D: > 61 years), with 32 subjects in each group. Then, sagittal spinal parameters, including C0-1 Cobb angle (C0-1 CA), C1-2 Cobb angle (C1-2 CA), C0-2 Cobb angle (C0-2 CA), C2-7 Cobb angle (C2-7 CA), C2-7 sagittal vertical axis (C2-7 SVA), neck tilt (NT), thoracic inlet angle (TIA), T1 slope (TS), thoracic kyphosis (TK), lumbar lordosis (LL), pelvic tilt (PT), sacral slope (SS), pelvic incidence (PI), and C7-S1 sagittal vertical axis (C7-S1 SVA) were measured, and differences in parameters among the four groups were analyzed. Finally, the trends in correlations between the cervical and distal spinal sagittal parameters were investigated in the different age groups.
Results: No significant correlations were detected between upper cervical sagittal parameters (C0-1 CA, C1-2 CA, C0-2 CA) and distal spinal sagittal parameters in the four groups. An increasing trend with aging was discovered in the correlations between subaxial cervical sagittal parameters and distal spinal sagittal parameters. Lastly, significant correlations were observed between TS and TK, as well as between TIA and TK in the four groups.
Conclusions: Subaxial cervical alignments exhibit a close correlation with distal spinal alignments during the aging process in the asymptomatic population. An increasing trend was observed with age in the correlations between C2-7 CA, C2-7 SVA, and distal spinal sagittal parameters.
Relevance for patients: Given the correlations between the cervical and distal spinal alignments, which tend to increase with age, it is crucial to pay special attention to the influence of C2-7 CA and C2-7 SVA on distal spinal alignments prior to spinal surgery for patients.
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