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Physiological variations in the sagittal spine alignment in an asymptomatic elderly population
Tito Bassani1, Fabio Galbusera1, Andrea Luca2
1IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. LABS - Laboratory of Biological Structures Mechanics.
Summary
Sagittal spine alignment parameters differ in asymptomatic elderly Caucasians compared to younger adults. These findings are crucial for spine surgeons planning deformity correction in older populations.
Area of Science:
- Orthopedics and Spine Surgery
- Radiology and Imaging
- Geriatric Medicine
Background:
- Sagittal plane alignment is critical for spinal deformity treatment planning.
- Normative sagittal alignment parameters are well-documented for young and middle-aged Caucasians.
- Limited data exists for asymptomatic elderly individuals (>60 years), especially with small sample sizes.
Purpose of the Study:
- To establish normative sagittal spine and pelvic alignment parameter ranges in a large cohort of asymptomatic elderly Caucasian subjects.
Main Methods:
- Monocentric, prospective, cross-sectional study involving 160 asymptomatic elderly volunteers (>60 years).
- EOS low-dose system used for full-spine and pelvic radiographic scans in standing position.
- Key parameters measured: thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), sagittal vertical axis (SVA), T1 pelvic angle (TPA), and Roussouly classification.
Main Results:
- Average values: TK 55±14°, LL 57±12°, PI 55±11°, SS 38±10°, PT 16±7°, PI-LL -3±11°, SVA 25±32 mm, TPA 14.6±7.4°.
- TK, TPA, and SVA showed an increase with age.
- Asymptomatic scoliosis (27%) and limitations in Roussouly classification (16% excluded) were noted.
Conclusions:
- The study provides essential normative sagittal alignment data for asymptomatic elderly Caucasians.
- Age-related changes in TK, TPA, and SVA, along with asymptomatic scoliosis, must be considered in surgical planning.
- Findings offer a valuable resource for spine surgeons treating spinal deformities in the elderly.
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