title: Age-related changes in cervical sagittal range of motion and alignment.
abstract: Study Design Retrospective cohort study. Objective To compare sagittal cervical range of motion (ROM) and alignment in young versus middle-aged adults. Methods One hundred four asymptomatic adults were selected randomly out of 791 subjects who underwent lateral cervical radiographs in neutral, flexion, and extension positions. They were divided into two groups: young (age 20 to 29, 52 people) and middle-aged adults (age 50 to 59, 52 people). We determined the ROMs of upper cervical (occipital-C2 angle), midcervical (C2-C7 angle), and cervicothoracic spine (cervicosternal angle). We compared the alignment differences of the two groups by calculating the distances between C2 and C7 plumb lines, and C2 central-offset distance. Results In neutral position, there was no significant difference between young and middle-aged adults. However, in flexion, C2-C7 angle, distance between C2-C7 plumb lines, and C2 central-offset distance decreased with age. In extension, C2-C7 angle and C2 central-offset distance decreased with age. During flexion and extension, midcervical ROM and the range of C2 central-offset distance decreased in the middle-aged group. However, there was no difference between the two age groups in the ROM of the upper cervical and the cervicothoracic regions during flexion and extension. Conclusion We found that, despite of the presence of age-related cervical alignment changes, the only difference between the two groups was in the sagittal ROM of the midcervical spine during flexion and extension. Only the ROM of the midcervical spine appears to change significantly, consistent with findings that these levels are most likely to develop both symptomatic and asymptomatic degenerative changes.
authors.affiliation: Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University, Gyeonggi-do, Republic of Korea.
authors.forename: Moon Soo
authors.initials: MS
authors.lastname: Park
authors.affiliation: Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Seong-Hwan
authors.initials: SH
authors.lastname: Moon
authors.affiliation: Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hwan-Mo
authors.initials: HM
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University, Gyeonggi-do, Republic of Korea.
authors.forename: Tae-Hwan
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University, Gyeonggi-do, Republic of Korea.
authors.forename: Jae Keun
authors.initials: JK
authors.lastname: Oh
authors.affiliation: Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University, Gyeonggi-do, Republic of Korea.
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Nam
authors.affiliation: Department of Orthopedic Surgery, Washington University School of Medicine, St. Louis, Missouri, United States.
authors.forename: K Daniel
authors.initials: KD
authors.lastname: Riew
keywords: C2; C7 plumb lines; cervical spine; range of motion
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