Changes in Lumbar Lordosis Curvature From 2016 to 2024 in Asymptomatic Chinese Populations

A retrospective cross-sectional study was conducted across four centers.

This study seeks to investigate recent trends in lumbar lordosis (LL) curvature over the past eight years and evaluate the influence of contemporary lifestyles on LL.

The significance of lumbar sagittal alignment in clinical practice is gaining increased recognition, owing to its influence on spinal health and its correlation with conditions such as low back pain and facet joint arthritis. Nonetheless, there is a paucity of literature addressing the effects of contemporary lifestyle changes on LL.

A cohort of asymptomatic individuals who had undergone lumbar spine radiography at four hospitals was randomly selected for data comparison between 2016 and 2024. LL curvature was evaluated using four distinct methodologies: the L1-S1 Cobb angle (Cobb A), the L1-L5 Harrison posterior tangent angle (Harrison A), the sacral slope angle (SSA), and the lumbar curve index (LCI). The LL curvature measurements were performed by two authors using a Picture Archiving and Communication System. Participants were categorized into two cohorts: young adults (aged <40 yr) and older adults (aged ≥40 yr).

In both 2016 and 2024 cohorts, age-related differences between genders were insignificant. In 2016, females had higher Harrison A and LCI values than males, while older adults had smaller measurements than younger ones across all assessment methods. By 2024, males and older adults showed increased LL values, except SSA, compared with 2016. There were no significant LL differences for females and younger adults between the two cohorts.

Males and older adults show increased LL curvature, which may impact low back pain prevalence. Further research is needed to understand contributing factors.