The relative contribution of disc and vertebral morphometry to the angle of kyphosis in asymptomatic subjects

Manns, R.A.; Haddaway, M.J.; McCall, Iain W.; Pullicino, V. Cassar; Davie, M.W.J.

doi:10.1016/s0009-9260(96)80342-4

Cited by 48 publications

(39 citation statements)

References 22 publications

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“…For instance, the study of vertebral fracture etiology requires a model representative of an older adult population. Other factors that vary between individuals and likely influence in vivo loads, such as spine curvature [63][64][65] and rib cage size and shape [17,66,67], can also easily be incorporated in future versions of the model to provide an even better subject-specific model.…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of a Musculoskeletal Model of the Fully Articulated Thoracolumbar Spine and Rib Cage

Bruno

Bouxsein

Anderson

2015

Journal of Biomechanical Engineering

163

168

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We developed and validated a fully articulated model of the thoracolumbar spine in OPENSIM that includes the individual vertebrae, ribs, and sternum. To ensure trunk muscles in the model accurately represent muscles in vivo, we used a novel approach to adjust muscle cross-sectional area (CSA) and position using computed tomography (CT) scans of the trunk sampled from a community-based cohort. Model predictions of vertebral compressive loading and trunk muscle tension were highly correlated to previous in vivo measures of intradiscal pressure (IDP), vertebral loading from telemeterized implants and trunk muscle myoelectric activity recorded by electromyography (EMG).

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Section: Discussionmentioning

confidence: 99%

Development and Validation of a Musculoskeletal Model of the Fully Articulated Thoracolumbar Spine and Rib Cage

Bruno

Bouxsein

Anderson

2015

Journal of Biomechanical Engineering

163

168

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“…The Willner and Johnson's series [6], using a pantograph, showed a general tendency for thoracic kyphosis to increase with age; however, for the ages between 10 and 12 years, they found a constant decrease. Age-related increases in thoracic kyphosis can be attributed to overloading of spinal soft tissue, particularly to the intervertebral disk with ageing [19], or secondary to extreme physical activities, during the growth period [20]. Revel et al [21] found destructive changes at the spinal growth plate in rats that were submitted to repetitive physical activity under weight overloading conditions.…”

Section: Discussionmentioning

confidence: 99%

Development and evaluation of thoracic kyphosis and lumbar lordosis during growth

Giglio

Volpon

2007

Journal of Children's Orthopaedics

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Purpose The aim of this study was to establish ranges of angular variation in lordotic and kyphotic curves in normal male and female children and adolescents. Methods We developed a pantograph to measure dorsal curves. It consisted of a tripod-supported vertical strut to which an articulated bar was fixed and which had an arm that was able to follow the dorsal surface while moving up and down. This arm was positioned over the C7 spinous process and followed spinous processes to L5 at constant speed. A laser beam was used to ensure the proper positioning of the pantograph and the subject. The motion was recorded using software so that the dorsal outline was represented on a computer screen, and lordotic and kyphotic curves were automatically measured. Before performing the population study, the pantograph was validated in 20 normal subjects by comparing the pantograph measurements with lateral spine radiographs. There were no statistically significant differences in the measurements. There were 718 subjects with no race selection, of whom 350 were males and 368 females ranging in age from 5 to 20 years and presenting normal weight and height. Individuals with generalized ligament laxity, trunk asymmetry, muscle retraction, or any orthopedic anomaly were excluded from the study. Data were analyzed according to age and gender. Student's t tests and regression analysis were performed. Results Kyphotic curves increased linearly from 25°at 7 years of age to 38°at 19 years of age (kyphotic angle = 25°+ 0.58 · age). Lordotic curves increased linearly from 22°at 5 years of age to 32°at 20 years of age (lordotic angle = 24°+ 0.51 · age). There were no differences between males and females. Conclusions The pantograph that was developed for this study was successfully used to establish the normal ranges and progression of thoracic kyphosis and lumbar lordosis in the studied population. Both curves increased linearly with age, with no differences between males and females.

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“…Estimates of hyperkyphosis in community-dwelling older adults vary by measurement method but are thought to be as high as 40% [7,8]. There are a variety of known and hypothesized causes, including vertebral fractures, vertebral disc deformities, degenerative disc disease, spinal muscle weakness, and low paraspinal muscle density, among others [9][10][11][12][13][14][15]. Sequelae include impaired pulmonary function, decreased physical function, elevated fracture risk, and an increased risk of mortality [7,8,[16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Kyphosis and incident falls among community-dwelling older adults

et al. 2017

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Summary Hyperkyphosis commonly affects older persons and is associated with morbidity and mortality. Many have hypothesized that hyperkyphosis increases fall risk. Within this prospective study of older adults, kyphosis was significantly associated with incident falls over 1 year. Measures of hyperkyphosis could enhance falls risk assessments during primary care office visits. Introduction To determine the association between four measures of kyphosis and incident and injurious falls in older persons. Methods Community-dwelling adults aged 65 and older (n = 72) residing in southern California were invited to participate in a prospective cohort study. Participants had kyphosis assessed four ways. Two standing measures included a flexicurve ruler placed against the back to derive a kyphotic index and the Debrunner kyphometer, a protractor used to measure the kyphotic angle in degrees. Two lying measures included the blocks method (number of 1.7 cm blocks needed to achieve a neutral head position while lying supine) and traditional Cobb angle calculation derived from DXA based lateral vertebral assessment. Baseline demographic, clinical, and other health information (including a timed up and go (TUG) test) were assessed at a clinic visit. Participants were followed monthly through email or postcard for 1 year, with falls outcomes confirmed through telephone interview. Results Mean age was 77.8 (± 7.1) among the 52 women and 20 men. Over 12 months, 64% of participants experienced at least one incident fall and 35% experienced an injurious fall. Each standard deviation increase in kyphosis resulted in more than doubling the adjusted odds of an incident fall, even after adjusting for TUG. Odds of injurious falls were less consistent across measures; after adjusting for TUG, only the blocks method was associated with injurious falls. Conclusions Each kyphosis measure was independently associated with incident falls. Findings were inconsistent for injurious falls; the blocks measure suggested the strongest association. If these findings are replicated, the blocks measure could be incorporated into office visits as a quick and efficient tool to identify patients at increased fall risk.

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The relative contribution of disc and vertebral morphometry to the angle of kyphosis in asymptomatic subjects

Cited by 48 publications

References 22 publications

Development and Validation of a Musculoskeletal Model of the Fully Articulated Thoracolumbar Spine and Rib Cage

Development and Validation of a Musculoskeletal Model of the Fully Articulated Thoracolumbar Spine and Rib Cage

Development and evaluation of thoracic kyphosis and lumbar lordosis during growth

Kyphosis and incident falls among community-dwelling older adults

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