Comparative study of lumbosacral alignment in elderly versus young adults: data on patients with low back pain

Sagittal spinal alignment is an important determinant for proper spinal function. Alterations in spinal alignment may serve as leading factor for diminished body biomechanics. Although increased age is suggested to be associated with changes in lumbosacral alignment, in turn body posture, this is still a current issue in geriatrics which requires further research.

The aim of this study was to compare the spinal alignment of elderly to that of young adults.

A total of 402 (243 female and 159 male) patients with low back pain were included in the study. The mean ages of young adults (n = 205) and elderly (n = 197) were 29.15 ± 6.46 and 71.97 ± 6.48 years, respectively. The electronic medical record database was used to obtain the lumbar radiographs of the individuals retrospectively. Lumbar lordosis angle (LLA), lumbosacral lordosis angle (LSLA), sacral tilt (ST) and lumbosacral angle (LSA) were measured on lateral standing lumbar radiographs.

Lumbar lordosis angle of elderly was significantly smaller than that of young adults (36.22 ± 11.94 and 39.83 ± 10.01 respectively, p = 0.001). When the data was analyzed according to sex, females had wider LLA, ST and LSA than males, whilst males had wider LSLA than females.

This study reflects an age-related loss of lumbar lordosis along with sex-dependent alterations in lumbar sagittal alignment

Aging is related with the loss of lumbar curvature, particularly in men. Longitudinal studies on this issue are needed to confirm the results of this study.