University of Montreal, Montreal, Canada.
Spine (Phila Pa 1976). 2010 Oct 15;35(22):E1193-8. doi: 10.1097/BRS.0b013e3181e50808.
Prospective study of normal sagittal global spinal balance in the Caucasian adult population.
To document values for parameters of global spinal balance in 709 asymptomatic adults without spinal pathology.
Previous studies have investigated sagittal spinal balance in the normal population, but there is still a need for a large prospective database with normative values on the basis of gender and age.
Spinosacral angle (SSA), spinal tilt (ST), and C7 translation ratio were evaluated in 709 asymptomatic adults (354 males and 355 females). Position of C7 plumbline relative to sacrum and hip axis (HA) was also assessed. Comparisons on the basis of gender were performed using analyses of covariance with age as covariate. Relationships between parameters and age were assessed using Spearman's coefficients.
Mean SSA, ST, and C7 translation ratio were respectively 130.4° ± 8.1°, 90.8° ± 3.4°, and 0.1° ± 1.9°. Mean ± 2 standard deviations were respectively 110° to 150° for SSA and 85° to 100° for ST. Mean SSA and ST were higher in females but by less than 2°. C7 plumbline was behind the HA in 86% of subjects. Correlations between global balance and age were small (-0.1 ≤ r ≤ 0.1), with only 1 correlation reaching statistical significance (SSA vs. age; r = -0.1), reflecting a slight tendency for SSA to decrease with age. There was no relationship between ST and age.
Asymptomatic adults tend to stand with a stable global balance and it is expected that 95% of normal adults have an SSA and ST between 110° to 150° and 85° to 100°, respectively. C7 plumbline in front of the HA is not necessarily associated with a spinal pathology. Results suggest that in adults, anterior displacement of C7 plumbline with respect to sacrum cannot be attributed solely to aging and should raise a suspicion for the risk of developing spinal pathology.
高加索成人正常矢状位整体脊柱平衡的前瞻性研究。
记录 709 例无脊柱病变的无症状成年人整体脊柱平衡参数值。
先前的研究已经调查了正常人群的矢状位脊柱平衡，但仍需要一个基于性别和年龄的大型前瞻性数据库，提供规范值。
评估了 709 例无症状成年人（男性 354 例，女性 355 例）的脊柱骶骨角（SSA）、脊柱倾斜度（ST）和 C7 平移比。还评估了 C7 铅垂线相对于骶骨和髋关节轴（HA）的位置。使用协方差分析比较性别差异，以年龄为协变量。使用斯皮尔曼系数评估参数与年龄之间的关系。
平均 SSA、ST 和 C7 平移比分别为 130.4°±8.1°、90.8°±3.4°和 0.1°±1.9°。SSA 的平均值±2 个标准差分别为 110°至 150°，ST 的平均值±2 个标准差分别为 85°至 100°。女性的 SSA 和 ST 平均值较高，但不超过 2°。86%的受试者 C7 铅垂线位于 HA 后方。整体平衡与年龄的相关性较小（-0.1≤r≤0.1），只有 1 个相关性具有统计学意义（SSA 与年龄；r=-0.1），反映出 SSA 随年龄略有下降的趋势。ST 与年龄之间没有关系。
无症状成年人倾向于保持稳定的整体平衡，预计 95%的正常成年人的 SSA 和 ST 分别在 110°至 150°和 85°至 100°之间。HA 前方的 C7 铅垂线不一定与脊柱病变有关。结果表明，在成年人中，C7 铅垂线相对于骶骨的前移位不能仅归因于衰老，应引起对发展为脊柱病变风险的怀疑。
