Department of Orthopaedic Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.
Department of Orthopaedic Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.
Spine J. 2019 Feb;19(2):349-356. doi: 10.1016/j.spinee.2018.06.346. Epub 2018 Jun 26.
It is widely recognized that sagittal spinal alignment changes with age. However, there are presently no clear benchmarks for such values or those for the cervical spine in the general population. Quality epidemiological studies are needed to establish standards for spinal alignment deviation.
In this study of an aged Japanese population, we employed random sampling from the basic resident registry of a rural town for subject selection to determine reference values of sagittal spinal alignment including the cervical spine.
Japanese resident cohort study based on a municipal registry.
A total of 413 aged people randomly sampled from the resident registry of a rural Japanese town.
All subjects underwent a whole spine lateral radiograph for measurement of sagittal spinal alignment parameters.
Registered citizens of 50 to 89 years old were targeted for this survey. We established eight groups based on age (50s, 60s, 70s, and 80s) and gender (male and female) after random sampling from the resident registry of Obuse town in 2014. A total of 413 people (203 males and 210 females) were enrolled. Radiographic parameters of sagittal spinal alignment of the cohort were measured and analyzed. Funding for this study was provided by the Japan Orthopaedics and Traumatology Research Foundation (10,000 USD), the Japanese Orthopaedic Association (5,000 USD), the Japanese Society for Musculoskeletal Medicine (40,000 USD), and the Nakatomi Foundation (15,000 USD).
Global spinal alignments became more misaligned with age for both genders. Sagittal vertical axis (SVA) forward shift was significantly more frequent in 80s males and 70s females, and SVA in 80s females was a mean of 66 mm forward of that of 50s females. Cervical protrusion was markedly greater in 60s males onwards. In women, lumbar lordosis and posterior pelvic inclination were noticeable from a younger age than in men. The amount of pelvic tilt misalignment in female subjects was approximately 10 years earlier than their male counterparts.
This first resident cohort of Japanese individuals determined average spinal alignment parameters by age and gender. Spinal balance generally shifts forward as age increases. A forward shift in the upper cervical spine occurs first in men, whereas lumbopelvic alignment shift occurs first in women.
人们普遍认识到，矢状位脊柱排列会随年龄而变化。然而，目前尚无一般人群颈椎矢状位的明确基准值。需要开展高质量的流行病学研究来建立脊柱排列偏差的标准。
在这项针对日本老年人群的研究中，我们通过随机抽样选择农村城镇的基本居民登记处的受试者，以确定包括颈椎在内的矢状位脊柱排列的参考值。
基于市政登记处的日本居民队列研究。
从农村日本城镇的居民登记处随机抽取的 413 名老年人。
所有受试者均接受全脊柱侧位 X 线片检查，以测量矢状位脊柱排列参数。
该调查以 50 至 89 岁的登记公民为目标。我们在 2014 年从 Obuse 镇的居民登记处随机抽样后，按年龄（50 多岁、60 多岁、70 多岁和 80 多岁）和性别（男性和女性）建立了 8 个组。共纳入 413 人（男性 203 人，女性 210 人）。测量并分析队列的脊柱矢状位排列的放射学参数。这项研究的资金由日本矫形外科和创伤研究基金会（10000 美元）、日本矫形外科学会（5000 美元）、日本肌肉骨骼医学学会（40000 美元）和中谷基金会（15000 美元）共同提供。
两性的整体脊柱排列均随年龄的增长而变得更加错位。80 岁男性和 70 岁女性的矢状垂直轴（SVA）向前移位更为明显，80 岁女性的 SVA 比 50 岁女性向前平均 66 毫米。60 岁以上的男性颈椎前凸明显增加。女性的腰椎前凸和骨盆后倾从更年轻的年龄开始就比男性明显。女性受试者的骨盆倾斜错位量比男性早约 10 年。
这是首例日本人群的居民队列研究，根据年龄和性别确定了平均脊柱排列参数。随着年龄的增长，脊柱平衡总体向前移动。颈椎上段的前移首先发生在男性，而腰骶骨盆排列的移位首先发生在女性。
