Age-related changes in osseous anatomy, alignment, and range of motion of the cervical spine. Part I: Radiographic data from over 1,200 asymptomatic subjects

Abstract

Purpose This study aimed to establish radiographic standard values for cervical spine morphometry, alignment, and range of motion (ROM) in both male and female in each decade of life between the 3rd and 8th and to elucidate these age-related changes. Methods A total of 1,230 asymptomatic volunteers underwent anteroposterior (AP), lateral, flexion, and extension radiography of the cervical spine. There were at least 100 men and 100 women in each decade of life between the 3rd and 8th. AP diameter of the spinal canal, vertebral body, and disc were measured at each level from the 2nd to 7th cervical vertebra (C2-C7). C2-C7 sagittal alignment and ROM during flexion and extension were calculated using a computer digitizer. Results The AP diameter of the spinal canal was 15.8 ± 1.5 [mean ± standard deviation (SD)] mm at the mid-C5 level, and 15.5 ± 2.0 mm at the C5/6 disc level. The disc height was 5.8 ± 1.3 mm at the C5/6 level, which was the minimum height, and the maximum height was at the C6/7 level. Both the AP diameter of the spinal canal and disc height decreased gradually with increasing age. The C2-C7 sagittal alignment and total ROM were 13.9 ± 12.3°in lordosis and 55.3 ± 16.0°, respectively. The C2-C7 lordotic angle was 8.0 ± 11.8°in the 3rd decade and increased to 19.7 ± 11.3 in the 8th decade, whereas the C2-C7 ROM was 67.7 ± 17.0°in the 3rd decade and decreased to 45.0 ± 12.5 in the 8th decade. The extension ROM decreased more than the flexion ROM, and lordotic alignment progressed with increasing age. There was a significant difference in C2-C7 alignment and ROM between men and women. Conclusions The standard values and age-related changes in cervical anatomy, alignment, and ROM for males and females in each decade between the 3rd and 8th were established. Cervical lordosis in the neutral position develops with aging, while extension ROM decreases gradually. These data will be useful as normal values for the sake of comparison in clinical practice.

Correlation Between Cervical Sagittal Alignment and Functional Capacity in Cervical Spondylosis

“…2,13 The correlation between the TS and the CL, showing that the amount of CL is influenced by the inclination of the upper plateau of T1 (TS), has been published in the literature 21,29,30 and was also evident in our study. A significant correlation between the TS and the cSVA was also confirmed, which indicates the important role of the inclination of T1 for all cervical sagittal alignment, as previously demonstrated in the literature.…”

“…A significant correlation between the TS and the cSVA was also confirmed, which indicates the important role of the inclination of T1 for all cervical sagittal alignment, as previously demonstrated in the literature. 2,29,30 This study also showed the effect of aging on cervical sagittal alignment. As seen in the results obtained, the TS, the CL, and the cSVA tend to increase with age.…”

“…As seen in the results obtained, the TS, the CL, and the cSVA tend to increase with age. Yukawa et al 30 published similar results and argued that with age the spine tends to assume positive sagittal alignment, increasing the TS. In order to maintain the ability to look forward, the cervical spine has an increase in the value of cervical lordosis.…”

The evaluation of cervical spinal angle in patients with acute and chronic neck pain

“…In their study of 1230 healthy volunteers, Yukawa et al (21) showed that the lordosis angle increased with age. Grob et al (5) determined that the cervical curvature angle increased with age in females rather than males.…”

Does the backrest shape of the wheelchair influence the asymmetric posture of patients with hemiparesis? A single institution pilot study

“…This mass generates a forward torque because of the structural incompatibility between the natural thoracic curvature and the flat supporting surface of the T-WC backrest. Furthermore, elderly patients with stroke tend to take a forward head posture [51,52]. The burden on the musculoskeletal system decreases as the head and neck approaches the neutral position, and a neutral head position contributes to postural adjustment against gravity [53,54].…”