Abstract
BackgroundThe understanding of the individual shape and mobility of the lumbar spine are key factors for the prevention and treatment of low back pain. The influence of age and sex on the total lumbar lordosis and the range of motion as well as on different lumbar sub-regions (lower, middle and upper lordosis) in asymptomatic subjects still merits discussion, since it is essential for patient-specific treatment and evidence-based distinction between painful degenerative pathologies and asymptomatic aging.Methods and FindingsA novel non-invasive measuring system was used to assess the total and local lumbar shape and its mobility of 323 asymptomatic volunteers (age: 20–75 yrs; BMI <26.0 kg/m2; males/females: 139/184). The lumbar lordosis for standing and the range of motion for maximal upper body flexion (RoF) and extension (RoE) were determined. The total lordosis was significantly reduced by approximately 20%, the RoF by 12% and the RoE by 31% in the oldest (>50 yrs) compared to the youngest age cohort (20–29 yrs). Locally, these decreases mostly occurred in the middle part of the lordosis and less towards the lumbo-sacral and thoraco-lumbar transitions. The sex only affected the RoE.ConclusionsDuring aging, the lower lumbar spine retains its lordosis and mobility, whereas the middle part flattens and becomes less mobile. These findings lay the ground for a better understanding of the incidence of level- and age-dependent spinal disorders, and may have important implications for the clinical long-term success of different surgical interventions.
Highlights
The individual shape of the lumbar spine is an essential predictor for different lumbar degenerative pathologies and for the success of various surgical interventions [1,2,3,4,5]
Two-way analysis of variance (ANOVA) demonstrated that the total lumbar lordosis was only significantly associated with age, but not with sex (Table 2)
This study investigated the effect of age and sex on the lordosis and the range of motion (RoM) of the whole lumbar spine as well as for different lumbar sub-regions in asymptomatic volunteers across the adult lifespan
Summary
The individual shape of the lumbar spine is an essential predictor for different lumbar degenerative pathologies and for the success of various surgical interventions [1,2,3,4,5]. The influence of the factors age and sex on the total lumbar lordosis and the range of motion (RoM) still merits discussion, because it is essential for a patient-specific treatment, for example, with regard to patient age and disease localisation, and evidence-based distinction between painful degenerative pathologies and asymptomatic aging. Despite their influence, the impact of these factors on certain regions of the lumbar spine and its mobility, including upper, middle and lower lumbar spine, remains unknown. These findings lay the ground for a better understanding of the incidence of level- and age-dependent spinal disorders, and may have important implications for the clinical long-term success of different surgical interventions
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