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Mechanism for worsening of spinal sagittal alignment with age differs between sexes
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Compared with women, elderly men had significantly worse sagittal parameters of the cervical spine and had a greater prevalence of cervical spondylotic myelopathy, according to the results of a study from researchers in Hamamatsu, Japan.
The study included 656 volunteers older than 50 years who participated in the Toei town health screening program in 2012. Researchers used whole spine and pelvic radiographs taken in the standing position to measure 11 parameters, including pelvic tilt, C2-7 sagittal vertical axis (SVA) and sacral slope. Patients were into the following age groups: 36 patients aged 50 to 59 years; 174 patients aged 60 years to 69 years; 311 patients aged 70 years to 79 years; and 135 patients aged 80 years to 89 years.
Researchers found the sacral slope in men and women deteriorated between the ages of 70 years and 80 years. The average T1 slope for each decade was 32°, 31°, 33° and 36° for men, and 28°, 29°, 32° and 37° for women. In addition, the average C2-7 SVA for women by decade was 20 mm, 21 mm, 22 mm and 28 mm. The average C2-7 SVA for men was 25 mm, 28 mm, 34 mm and 35 mm, researchers wrote.
A total of 118 patients exhibited a change in C2-7 SVA of 40° or more. In these patients, the EQ-5D scores were significantly lower when compared with other groups, the researchers wrote.
Researchers also found the initial deterioration in spinal sagittal alignment originated in the pelvis for women and the cervical spine in men. – by Robert Linnehan
Disclosure: The researchers report no relevant financial disclosures.
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