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Age-related changes in cervical sagittal alignment: based on 625 Chinese asymptomatic subjects.
Eur Spine J. 2023 05; 32(5):1607-1615.ES

Abstract

PURPOSE

This work aimed to provide a comprehensive description of cervical alignment including cranial arch and caudal arch according to age, thus offering a reference database for cervical deformity treatment.

METHODS

Total 150 males and 475 females aged at 48-88 were enrolled from August 2021 to May 2022. Radiographic parameters were measured, including Occipito-C2 angle (O-C2), C2-7 angle (C2-7), cranial arch, caudal arch, T1-slope (T1s), and C2-7 sagittal vertical axis (C2-7 SVA). Pearson correlation coefficient was employed in analyzing associations among sagittal parameters and between age and each parameter. Five groups were set according to different age stages, namely group with age 40-59 (N = 77), group with age 60-64 (N = 189), group with age 65-69 (N = 214), group with age 70-74 (N = 97), and group with age exceeding 75 (N = 48). An analysis of variance (ANOVA) test was applied to compare multi-sets of cervical sagittal parameters (CSPs). Chi-square test or Fisher's exact test was used in assessing the relationships of various cervical alignment patterns with age groups.

RESULTS

T1s exhibited the strongest correlation with C2-7 (r = 0.655) and caudal arch (r = 0.561), and moderately correlated with cranial arch (r = 0.355). The positive correlations between age and C2-7 angle (r = 0.189, P < 0.001), cranial arch (r = 0.150, P < 0.001), caudal arch (r = 0.112, P = 0.005), T1s (r = 0.250, P < 0.001), as well as C2-7 SVA (r = 0.090, P = 0.024) were observed. Moreover, two progressive growths of C2-7 were shown after 60-64 and 70-74 years old, respectively. Thereof, cranial arch increased greatly after the age of 60-64, followed by a relative stability in the degeneration. The notable growth of caudal arch was observed after the age of 70-74, and the growth remained stable when exceeding the age of 75. The difference between cervical alignment patterns and age groups was obvious (Fisher's exact test P < 0.001).

CONCLUSION

This work explored in detail the normal reference values of cervical sagittal alignment including cranial arch and caudal arch under different age groups. Age-related changes in cervical alignment depended on the increase in the cranial and caudal arches in different proportions with age.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Wang Z
Department of Orthopedics, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Changchun Rd. 45, Xicheng District, Beijing, 100053, China. National Clinical Research Center for Geriatric Diseases, Changchun Rd. 45, Beijing, 100053, China.
Liu X
Department of Orthopedics, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Changchun Rd. 45, Xicheng District, Beijing, 100053, China. National Clinical Research Center for Geriatric Diseases, Changchun Rd. 45, Beijing, 100053, China.
Hu X
Department of Orthopedics, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Changchun Rd. 45, Xicheng District, Beijing, 100053, China. National Clinical Research Center for Geriatric Diseases, Changchun Rd. 45, Beijing, 100053, China.
Cui P
Department of Orthopedics, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Changchun Rd. 45, Xicheng District, Beijing, 100053, China. National Clinical Research Center for Geriatric Diseases, Changchun Rd. 45, Beijing, 100053, China.
Wang W
Department of Orthopedics, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Changchun Rd. 45, Xicheng District, Beijing, 100053, China. National Clinical Research Center for Geriatric Diseases, Changchun Rd. 45, Beijing, 100053, China.
Kong C
Department of Orthopedics, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Changchun Rd. 45, Xicheng District, Beijing, 100053, China. kong988500@163.com. National Clinical Research Center for Geriatric Diseases, Changchun Rd. 45, Beijing, 100053, China. kong988500@163.com.
Lu S
Department of Orthopedics, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Changchun Rd. 45, Xicheng District, Beijing, 100053, China. spinelu@163.com. National Clinical Research Center for Geriatric Diseases, Changchun Rd. 45, Beijing, 100053, China. spinelu@163.com.

MeSH

FemaleHumansMaleCervical VertebraeDatabases, FactualEast Asian PeopleLordosisNeckRetrospective StudiesAge FactorsAsymptomatic DiseasesMiddle AgedAgedAged, 80 and over

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

36897429

Citation

Wang, Zheng, et al. "Age-related Changes in Cervical Sagittal Alignment: Based On 625 Chinese Asymptomatic Subjects." European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, vol. 32, no. 5, 2023, pp. 1607-1615.
Wang Z, Liu X, Hu X, et al. Age-related changes in cervical sagittal alignment: based on 625 Chinese asymptomatic subjects. Eur Spine J. 2023;32(5):1607-1615.
Wang, Z., Liu, X., Hu, X., Cui, P., Wang, W., Kong, C., & Lu, S. (2023). Age-related changes in cervical sagittal alignment: based on 625 Chinese asymptomatic subjects. European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 32(5), 1607-1615. https://doi.org/10.1007/s00586-023-07632-5
Wang Z, et al. Age-related Changes in Cervical Sagittal Alignment: Based On 625 Chinese Asymptomatic Subjects. Eur Spine J. 2023;32(5):1607-1615. PubMed PMID: 36897429.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Age-related changes in cervical sagittal alignment: based on 625 Chinese asymptomatic subjects. AU - Wang,Zheng, AU - Liu,Xu, AU - Hu,Xinli, AU - Cui,Peng, AU - Wang,Wei, AU - Kong,Chao, AU - Lu,Shibao, Y1 - 2023/03/10/ PY - 2023/01/02/received PY - 2023/02/28/accepted PY - 2023/01/02/revised PY - 2023/5/24/medline PY - 2023/3/11/pubmed PY - 2023/3/10/entrez KW - Age KW - Caudal arch KW - Cervical spine KW - Cranial arch KW - Sagittal alignment SP - 1607 EP - 1615 JF - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society JO - Eur Spine J VL - 32 IS - 5 N2 - PURPOSE: This work aimed to provide a comprehensive description of cervical alignment including cranial arch and caudal arch according to age, thus offering a reference database for cervical deformity treatment. METHODS: Total 150 males and 475 females aged at 48-88 were enrolled from August 2021 to May 2022. Radiographic parameters were measured, including Occipito-C2 angle (O-C2), C2-7 angle (C2-7), cranial arch, caudal arch, T1-slope (T1s), and C2-7 sagittal vertical axis (C2-7 SVA). Pearson correlation coefficient was employed in analyzing associations among sagittal parameters and between age and each parameter. Five groups were set according to different age stages, namely group with age 40-59 (N = 77), group with age 60-64 (N = 189), group with age 65-69 (N = 214), group with age 70-74 (N = 97), and group with age exceeding 75 (N = 48). An analysis of variance (ANOVA) test was applied to compare multi-sets of cervical sagittal parameters (CSPs). Chi-square test or Fisher's exact test was used in assessing the relationships of various cervical alignment patterns with age groups. RESULTS: T1s exhibited the strongest correlation with C2-7 (r = 0.655) and caudal arch (r = 0.561), and moderately correlated with cranial arch (r = 0.355). The positive correlations between age and C2-7 angle (r = 0.189, P < 0.001), cranial arch (r = 0.150, P < 0.001), caudal arch (r = 0.112, P = 0.005), T1s (r = 0.250, P < 0.001), as well as C2-7 SVA (r = 0.090, P = 0.024) were observed. Moreover, two progressive growths of C2-7 were shown after 60-64 and 70-74 years old, respectively. Thereof, cranial arch increased greatly after the age of 60-64, followed by a relative stability in the degeneration. The notable growth of caudal arch was observed after the age of 70-74, and the growth remained stable when exceeding the age of 75. The difference between cervical alignment patterns and age groups was obvious (Fisher's exact test P < 0.001). CONCLUSION: This work explored in detail the normal reference values of cervical sagittal alignment including cranial arch and caudal arch under different age groups. Age-related changes in cervical alignment depended on the increase in the cranial and caudal arches in different proportions with age. SN - 1432-0932 UR - https://www.unboundmedicine.com/medline/citation/36897429/Age_related_changes_in_cervical_sagittal_alignment:_based_on_625_Chinese_asymptomatic_subjects_ DB - PRIME DP - Unbound Medicine ER -