Abstract
The relationship between spinal posture and quality of life has garnered considerable attention with the increase in older community-dwelling residents. However, details of this association remain insufficient. A recent Japanese population cohort epidemiological locomotion survey (the Obuse study) revealed that the C2–C7 cervical sagittal vertical axis (CSVA) began to increase in males from their 60s, but not in females. This study aimed to clarify the pathology of these cervical spondylotic changes. A total of 411 participants (202 male and 209 female) aged between 50 and 89 years were selected by random sampling from a cooperating town’s resident registry. All participants underwent lateral X-ray photography in a standing position for the measurement of several sagittal spinal alignment parameters, including CSVA, C2–C7 cervical lordosis (CL), T1 slope (T1S), and sagittal vertical axis (SVA). The presence of cervical spondylotic changes was also recorded. Associations of cervical sagittal spinal alignment with cervical spondylosis and between cervical and total sagittal spinal alignment were examined. The prevalence of cervical spondylosis was significantly higher in males (81%) than in females (70%) (p = 0.01). CL was significantly smaller in cervical spondylosis subjects when adjusted by age (3.4 degrees less; p = 0.01). T1S minus CL displayed a moderate positive correlation with CSVA in both males and females (r = 0.49 and 0.48, respectively, both p < 0.01). In males only, CSVA and CL showed weak positive correlations with SVA (r = 0.31 and 0.22, respectively, both p < 0.01) independently of age. Cervical spinal misalignment was more clearly associated with diminished SF-8TM scores in females than in males. In community-dwelling elderly residents, cervical sagittal spinal alignment change accompanying cervical spondylosis manifested as hypofunction to compensate for whole-spine imbalance.
Highlights
Overall cervical sagittal vertical axis (CSVA) and T1 slope (T1S) were significantly larger in males, with no remarkable gender differences for cervical lordosis (CL) or sagittal vertical axis (SVA) (p = 0.54 and p = 0.96, respectively)
Cervical sagittal spinal alignment changes accompanying spondylosis in the general elderly population manifested as hypofunction to compensate for whole-spine imbalance
Men have a higher prevalence of cervical spondylosis, and their inflexible cervical spine has difficulty compensating for subcervical alignment deterioration
Summary
Sagittal spinal alignment deteriorates with age in community-dwelling older people [2,3,4]. Age-related changes in lumbopelvic condition are known to affect sagittal spinal alignment. Two epidemiological studies conducted in different regions corroborated the finding of a characteristic gender difference in the process of spinal alignment change with aging. Alignment changes over time in males were prominent in the cervical spine region, while females predominantly displayed changes in the lumbo-pelvic area [3,4]. Spinal alignment can be affected by a variety of factors, including activity level and profession. Age-related cervical spondylosis may contribute to poor alignment of the cervical spine [6]. This study aimed to clarify the pathomechanism of sagittal cervical alignment changes in community-dwelling older residents
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