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10.06.2024 | Original Article

Sex-dependent evolution of whole-body postural alignment with age

verfasst von: Marc Khalifé, Wafa Skalli, Ayman Assi, Pierre Guigui, Valérie Attali, Rémi Valentin, Olivier Gille, Virginie Lafage, Han-Jo Kim, Emmanuelle Ferrero, Claudio Vergari

Erschienen in: European Spine Journal

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Abstract

Purpose

The goal of this study was to explore sex-related variations of global alignment parameters and their distinct evolution patterns across age groups.

Methods

This multicentric retrospective study included healthy volunteers with full-body biplanar radiographs in free-standing position. All radiographic data were collected from 3D reconstructions: global and lower limb parameters, pelvic incidence (PI) and sacral slope (SS). Lumbar lordosis (LL), thoracic kyphosis (TK) and cervical lordosis (CL) were also assessed as well as the lumbar and thoracic apex, and thoracolumbar inflexion point. The population was divided into five 5 age groups: Children, Adolescents, Young, Middle-Aged and Seniors.

Results

This study included 861 subjects (53% females) with a mean age of 34 ± 17 years. Mean PI was 49.6 ± 11.1 and mean LL was − 57.1 ± 11.6°. Females demonstrated a PI increase between Young and Middle-Aged groups (49 ± 11° vs. 55 ± 12°, p < 0.001) while it remained stable in males. SS and LL increased with age in females while remaining constant in males between Children and Middle-aged and then significantly decreased for both sexes between Middle-Aged and Seniors. On average, lumbar apex, inflexion point, and thoracic apex were located one vertebra higher in females (p < 0.001). After skeletal maturity, males had greater TK than females (64 ± 11° vs. 60 ± 12°, p = 0.04), with significantly larger CL (-13 ± 10° vs. -8 ± 10°, p = 0.03). All global spinal parameters indicated more anterior alignment in males.

Conclusion

Males present more anteriorly tilted spine with age mainly explained by a PI increase in females between Young and Middle-Aged, which may be attributed to childbirth. Consequently, SS and LL increased before decreasing at senior age.

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Titel: Sex-dependent evolution of whole-body postural alignment with age
verfasst von: Marc Khalifé
Wafa Skalli
Ayman Assi
Pierre Guigui
Valérie Attali
Rémi Valentin
Olivier Gille
Virginie Lafage
Han-Jo Kim
Emmanuelle Ferrero
Claudio Vergari
Publikationsdatum: 10.06.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: European Spine Journal
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-024-08323-5

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