• Zheng Wang, Xinli Hu, Peng Cui, Xu Liu, Weiguo Zhu, Chao Kong, Wei Wang, and Shibao Lu.
• Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Changchun Rd. No.45 Changchun Street, Xicheng District, Beijing, 100053, People's Republic of China.
• Eur Spine J. 2023 Jul 1; 32 (7): 240224142402-2414.

PurposeTo investigate the pelvic incidence (PI)- and age-related cervical alignment changes of Chinese healthy population.MethodsSix hundred and twenty-five asymptomatic adult subjects, who underwent the standing whole spinal radiograph, were recruited in this work. The sagittal parameters were measured, including Occipito-C2 angle (O-C2), C2-7 angle (C2-7), cranial arch, caudal arch, T1-slope (T1S), C2-7 sagittal vertical axis (C2-7 SVA), thoracic kyphosis (TK), lumbar lordosis (LL), pelvic tilt (PT), sacral slope (SS), PI, and sagittal vertical axis (SVA). All subjects were stratified into 5 age groups, namely 40-59 years, 60-64 years, 65-69 years, 70-74 years, and 75 years and above, with each age group further divided into 2 subgroups based on PI (deeming PI < 50° as low PI, and PI ≥ 50° as high PI). The correlations between PI or age, and other sagittal parameters were assessed. The age-related changes of sagittal parameters in each PI subgroup were also assessed, followed by one-way analysis of variance analysis for change comparison between age groups.ResultsThe average cervical sagittal parameters were as below: 18.2 ± 6.8° for O-C2, 10.4 ± 10.2° for C2-7, 3.9 ± 7.5° for cranial arch, 6.5 ± 7.1° for caudal arch, 23.6 ± 7.3° for T1S, and 21.0 ± 9.7 mm for C2-7 SVA. There was no obvious difference observed between PI and cervical sagittal parameters, excepting for caudal arch. While, C2-7, cranial arch, caudal arch, T1S, and C2-7 SVA increased remarkably with the age. Thereof, C2-7 exhibited great increases at the age of 60-64 years and 70-74 years, respectively, cranial arch increased notably at 60-64 years of age, and caudal arch developed obviously at 70-74 years of age, regardless of PI.ConclusionThis study showed the PI- and age-related cervical alignment changes of Chinese healthy population. Based on the classification in our study, high or low PI apparently did not correlate with the occurrence of cervical degenerative disease.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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