Abstract
Objective. To define the post-mortem cervicothoracic spinal curvature relative to age.
Design. Spinal curvature assessment of lateral cervicothoracic radiographs.
Background. A late consequence of age is the progressive accentuation of spinal curvatures, particularly
the thoracic kyphosis. Little is known about the influence of the kyphosis on the
alignment of the cervical spine.
Method. One hundred and seventy two lateral spinal radiographs (113 males, 59 females) were
analysed using two procedures: (1) sagittal curve deformation angles were derived,
according to the method of Cobb, for thoracic (T1–T12), cervical (C2–C7) and cervicothoracic
junctional regions (C6–T4); and (2) the cervicothoracic curvatures were digitised
(C2–T12), to derive the apex of both curves and the inflexion point.
Results. A significantly increasing thoracic spinal curvature was determined for both genders,
with the mean apex of the kyphosis close to T6. The cervical lordosis tended to flatten
with increasing age, particularly in males, with the cervical apex location shifting
cranially. This association was significant in older males and females. The mean location
of the cervicothoracic curve inflexion point moved from T3 towards C7–T1 with increasing
age.
Conclusion. The cervicothoracic spinal curvature undergoes progressive change through the lifespan
with a subsequent cranial migration of the inflexion point between the thoracic kyphosis
and cervical lordosis, accompanied by a similar shift in the cervical apex.
Relevance Sensitive measures of spinal curvature have utility in determining changes attributed
to age, deformity or trauma on cervicothoracic spinal alignment. The value of assessing
the location of curve inflexion lies in the ability to quantify changes in the relationship
between different regions of the human spine without problems associated with identifying
specific vertebral landmarks.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Clinical BiomechanicsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Increased rates of fibromyalgia following cervical spine injury. A controlled study of 161 cases of traumatic injury.Arthrit. Rheum. 1997; 40: 446-552
- Rheumatologists and neck pain.Scand. J. Rheumat. 2000; 29: 8-12
- Pattern of intervertebral disc degeneration in the cervicothoracic junctional region.Manual Ther. 1998; 3: 72-77
- Thoracic kyphosis and mobility: The effect of age.Physiother. Pract. 1987; 3: 54-62
- A comparison of radiographic and computer-assisted measurements of thoracic and thoracolumbar sagittal curvature.Skeletal Radiol. 1990; 19: 21-26
- Sagittal profiles of the spine.Clin. Orthop. Relat. Res. 1986; 210: 235-242
- Spinal pantograph––a non-invasive technique for describing kyphosis and lordosis in the thoracolumbar spine.Acta Orthop. Scand. 1981; 52: 525-529
- Segmental analysis of the sagittal plane alignment of the normal thoracic and lumbar spines and thoracolumbar junction.Spine. 1984; 14: 717-721
- Thoracic kyphosis: Range in normal subjects.Am. J. Roentgenol. 1980; 134: 979-983
- Age effects in kyphosis and lordosis in adults.Ann. Hum. Biol. 1974; 1: 327-337
- A comparison of three methods for measuring thoracic kyphosis: Implications for clinical studies.Rheumatology. 2000; 39: 310-315
- Computer-assisted curvature assessment and Cobb angle determination of the thoracic kyphosis: An in vivo and in vitro comparison.Spine. 1994; 19: 1381-1386
- Roentgenographic findings of the cervical spine in asymptomatic people.Spine. 1986; 11: 521-524
- Neck pain: A long-term follow up of 205 patients.Spine. 1987; 12: 1-5
- The sagittal alignment of the cervical spine in adolescent idiopathic scoliosis.J. Pediatr. Orthopaed. 1995; 15: 627-632
- The relationship between surface and vertebral body measures of upper spine curvature.Spine. 1994; 19: 2180-2185
- Apophysial joint degeneration, disc degeneration, and sagittal curve of the cervical spine. Can they be measured reliably on radiographs?.Spine. 1997; 22: 859-864
- Radiographic standing cervical segmental alignment in adult volunteers without neck symptoms.Spine. 1997; 22: 1472-1480
- Incidence of common postural abnormalities in the cervical, shoulder and thoracic regions and their association with pain in two age groups of healthy subjects.Phys. Ther. 1992; 72: 425-430
- Kyphosis in older women and its relation to back pain, disability and osteopenia: The study of osteoporotic fractures.Osteoporosis Int. 1994; 4: 55-60
- A clinical profile of back pain and disability in patients with spinal osteoporosis.Bone. 1994; 15: 27-30
- Biomechanical analysis of posture in patients with spinal kyphosis due to ankylosing spondylitis: A pilot study.Rheumatology. 1999; 38: 441-443
- Morphological survey of the cervicothoracic junctional region.Spine. 1996; 21: 544-548
Article info
Publication history
Accepted:
April 17,
2002
Received:
November 26,
2001
Identification
Copyright
© 2002 Elsevier Science Ltd. Published by Elsevier Inc. All rights reserved.
