Study Design: A radiological analysis of the sagittal balance in younger and older aged volunteers.
Object:´ves: To determine the normal range of the sagittal spinal alignment, and define significant spinopelvic compensations over tl to hip axis for the sagittal balance with. aging.
Summary of Literature Review: Normative data of the sagittal spinal alignment has wide variation and limited clinical usefulness. 1. t addition, the extent to which the "normal" sagittal spinal contour changes with aging remains unknown.
Mater.als and Methods: Inclusion criteria were an age between 20 and 29 years (n=50), group A, and between 55 and 65 years (n=50 group B, for the asymptomatic subjects. Measurements made on the standing lateral radiographs included the following: thorac is kyphosis, lumbar lordosis and sagittal vertical axis. In addition, measurements of the sacropelvic translation, spinopelvic balance, pelvic incidence, pelvic tilting and sacral slope were made.
Resull s: The average thoracic kyphosis was .24, ranging from 3 to 42, in group A, and 33", ranging from 9 to 53, in group B (p&,001). The average lumbar lordosis was -47, ranging from -65 to -23, and -51, ranging from -69 to -33, in groups A an: B, respectively (p>0.05). The C7 plumb line, on average, fell 15.4 mm more anteriorly to the posterosuperior corner of St in grout; B than in group A (p<0.05). The anterior positioning of the C7 was also positively correlated with decreasing lordosis (p<0.001). The average sacropelvic translation was -41mm, ranging from -76 to 20 mm, and -48 mm, ranging from -76 to -17 mm, i 1 groups A and B, respectively (p<0.05). The average spinopelvic balance was -57 mm, ranging from -104 to -4 mm, and -49 r im, ranging from -101 to -3 mm, in. groups A and B, respectively. The C7 plumb line fell posterior to the hip axis in all cases. The average pelvic incidence was 46c´, ranging from 30 to 61, and 54, ranging from 28 to 76, in groups A and B, respe tively (p<0.05). The average pelvic tilt was 14, ranging from 4 to 33, and 19, ranging from 3 to 37, in groups A and B
rc 3pectively (p<0.05). The average sacral slope was 32, ranging from 17 to 47, and 35, ranging from 25 to 50, in groups A ai A B, respectively (p<0.05). There was significant correlation between pelvic incidence and lumbar lordosis (p<0.001). Conclusions: The sagittal spinal balance is maintained by spinopelvic compensations over the hip axis with aging, and sacrop lvic parameters over the hip axis are important for the evaluation of the sagittal spinal balance.
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