Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2023 Feb;32(2):562-570.
doi: 10.1007/s00586-022-07445-y. Epub 2022 Nov 15.

The age-specific normative values of standing whole-body sagittal alignment parameters in healthy adults: based on international multicenter data

Jun Ouchida  1 , Hiroaki Nakashima  2 , Tokumi Kanemura  3 , Masashi Okamoto  4 , Shun Hatsushikano  4 , Shiro Imagama  1 , Jean Charles Le Huec  5 , Kazuhiro Hasegawa  4
Affiliations
Free article
Multicenter Study

The age-specific normative values of standing whole-body sagittal alignment parameters in healthy adults: based on international multicenter data

Jun Ouchida et al. Eur Spine J. 2023 Feb.
Free article

Abstract

Purpose: To investigate the age-specific normative values of whole-body sagittal alignment (WBSA) including global balance parameters in healthy adults and to clarify the correlations among parameters based on the data from three international multicenter.

Methods: Three hundred and seventeen healthy subjects (range: 20-84 y.o., mean: 43.8 ± 14.7 y.o.) were included and underwent whole-body biplanar X-ray imaging system. Spinopelvic parameters and knee flexion (KF), the center of acoustic meatus (CAM)-hip axis (HA), and C2 dentiform apophyse (OD)-HA, the cranial center (Cr)-HA were evaluated radiologically. Sub-analysis for correlation analysis between age and parameters and among parameters was performed to investigate age-specific change and compensatory mechanisms.

Results: For age-related change, C2-7 angle (r = .326 for male/.355 for female), KF (r = .427/.429), and SVA (r = .234/.507) increased with age in both male and female group. For global parameters related to the center of the gravity, correlations with age were not significant (r = .120/.161 for OD-HA, r = .163/.275 for Cr-HA, r = .149/.262 for CAM-HA). Knee flexion (KF) has correlation with global parameters (i.e., SVA, OD-HA, Cr-HA, CAM-HA) and does not have correlations with local spinopelvic alignment.

Conclusion: While several local alignment changes with age were found, changes in global parameters related to the center of gravity were kept relatively mild by the chain of compensation mechanisms including the lower limbs. We showed the normative values for a comprehensive WBSA in standing posture from large international healthy subjects' database.

Keywords: Global balance; Healthy subjects; Normative values; Sagittal balance; Whole-body alignment.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Hasegawa K, Okamoto M, Hatsushikano S, Shimoda H, Ono M, Watanabe K (2016) Normative values of spino-pelvic sagittal alignment, balance, age, and health-related quality of life in a cohort of healthy adult subjects. Eur Spine J 25:3675–3686. https://doi.org/10.1007/s00586-016-4702-2 - DOI
    1. Protopsaltis T, Schwab F, Bronsard N, Smith JS, Klineberg E, Mundis G, Ryan DJ, Hostin R, Hart R, Burton D (2014) The T1 pelvic angle, a novel radiographic measure of global sagittal deformity, accounts for both spinal inclination and pelvic tilt and correlates with health-related quality of life. JBJS 96:1631–1640 - DOI
    1. Kim YC, Lenke LG, Lee SJ, Gum JL, Wilartratsami S, Blanke KM (2017) The cranial sagittal vertical axis (CrSVA) is a better radiographic measure to predict clinical outcomes in adult spinal deformity surgery than the C7 SVA: a monocentric study. Eur Spine J 26:2167–2175. https://doi.org/10.1007/s00586-016-4757-0 - DOI
    1. Le Huec JC, Faundez A, Dominguez D, Hoffmeyer P, Aunoble S (2015) Evidence showing the relationship between sagittal balance and clinical outcomes in surgical treatment of degenerative spinal diseases: a literature review. Int Orthop 39:87–95. https://doi.org/10.1007/s00264-014-2516-6 - DOI
    1. Hasegawa K, Okamoto M, Hatsushikano S, Watanabe K, Ohashi M, Vital J-M, Dubousset J (2020) Compensation for standing posture by whole-body sagittal alignment in relation to health-related quality of life. Bone Joint J 102:1359–1367 - DOI

Publication types