Thoracic Curvature Shape and Thoracic Kyphotic Angle In Elder Women without Vertebral Compression Fracture

Area of Science:

• Orthopedics
• Radiology
• Biomedical Engineering

Background:

• Exaggerated thoracic kyphosis increases spinal loading, leading to functional limitations and higher risk of vertebral compression fractures (VCF).
• Understanding thoracic curvature in elder women, a demographic with higher VCF incidence, is crucial for assessing biomechanical implications.

Purpose of the Study:

• To evaluate Thoracic Kyphotic Angle (TKA) and thoracic curvature shapes in elder women without VCF or vertebral deformity.
• To characterize potential biomechanical implications of different thoracic curvature patterns.

Main Methods:

• Assessed TKA using the Cobb angle on digital lateral chest radiographs in 96 elder females without vertebral deformity.
• Classified thoracic curvature into four subgroups: uniform-gentle, focal-upper-thoracic, focal-middle-thoracic, and focal-lower-thoracic.
• Analyzed focal curves for degenerative features and compared TKA across curvature shapes.

Main Results:

• Uniform-gentle curvature was most common (66%), followed by focal-middle (20%), focal-upper (13%), and focal-lower (2%).
• Average TKA was highest in focal-middle-thoracic curvature (48°), with 79% exhibiting hyper-kyphosis.
• Elevated TKA was also observed in uniform-gentle curvature (44°), while focal-upper curvature had a lower TKA (30°).

Conclusions:

• Distinct differences in thoracic curvature shape and TKA exist in elder women without VCF.
• Exaggerated thoracic kyphosis, whether uniform or augmented by focal features (especially mid-thoracic), may increase biomechanical loading on the thoracic spine.