ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2022
Variation of cervical sagittal alignment parameters according to gender, pelvic incidence and age.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 24 citations in OpenAlex.
- A comprehensive analysis of the association of psychological profiling and sagittal balance parameters with neck pain in a non-deformity cervical spondylosis population: A prospective two-centers cross-sectional study.Neurosurgical review · 2026Article
- Can pelvic incidence be used to analyse the sagittal profile in adolescent idiopathic scoliosis? A retrospective analysis of 100 patients.Spine deformity · 2026Article
- Comparison of cervical sagittal alignment in normal subjects and adolescents and young adults with idiopathic scoliosis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- The Longitudinal Changes of Cervical Sagittal Alignment in a Non-surgical Cohort: A 12-Year Longitudinal Study.Global spine journal · 2026Article
- Sex-dependent evolution of whole-body postural alignment with age.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Increased Cervical Disc Height and Decreased Neck Pain and Disability Following Improvement in Cervical Lordosis and Posture Using Chiropractic BioPhysics.Bioengineering (Basel, Switzerland) · 2026Article
- Association between Cervical Posterior Spondylolisthesis and Cervical Sagittal Alignment: The Role of T1 Slope in Pathophysiology.Spine surgery and related research · 2025Article
- Laminectomy and fusion better maintains horizontal gaze than laminoplasty in cervical spondylotic myelopathy.North American Spine Society journal · 2025Article
- Can C7 Slope Accurately Substitute for an Invisible T1 Slope According to Age and Cervical Morphology in Cervical Lateral Radiographs?Global spine journal · 2025Article
- Influence of subaxial cervical spine surgery on the sagittal alignment of the cervical and global spine. A prospective observational study.Brain & spine · 2025Article
- Machine learning identifies clusters of the normal adolescent spine based on sagittal balance.Spine deformity · 2025Article
- C4 constant vertebra: a novel benchmark of physiological cervical sagittal alignment.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Article
- Coronal alignment in normal individuals and moderate scoliosis: Normative values, variation with age and comparison with sagittal alignment.Brain & spine · 2024Article
- Age-related changes in cervical sagittal alignment: based on 625 Chinese asymptomatic subjects.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2023Article
- Association between Sagittal Cervical Spinal Alignment and Degenerative Cervical Spondylosis: A Retrospective Study Using a New Scoring System.Journal of clinical medicine · 2022Article
Corrections and comments
- Erratum issued
Authors and funding
26 authors at 11 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe aim was to describe radiographic cervical sagittal alignment variations according to age, gender and pelvic incidence (PI) and to investigate relationships with thoracic alignment.
methodsA total of 2599 individuals (5-93 years) without spinal deformity were studied. Cranial cervical parameters were: McGregor slope, occipita-C2 angle, McGregor-C2 lordosis and C1-C2 lordosis. Caudal cervical parameters were: C2-C7, cranial arch and caudal arch lordosis and C7- and T1-slope. A Bayesian inference compared parameter distributions. Correlations with spinopelvic and global alignment parameters were investigated.
resultsAmong cranial cervical parameters, variations of McGregor slope were non-significant. McGregor-C2 lordosis and C1-C2 lordosis were smaller in males and increased significantly during growth, whereas the occipito-C2 angle decreased (Pr > 0.95). The occipito-C2 angle was larger and McGregor-C2 lordosis was smaller in low PI (Pr > 0.95). Among caudal cervical parameters, C2-C7 lordosis and C7- and T1-slope were larger in males and increased after 50 years (Pr > 0.95). Lordosis changes were non-significant in the cranial arch, whereas values increased in the caudal arch after 35 years (Pr > 0.95). Caudal parameter differences were non-significant between PI groups. Strong correlations existed between C2-C7, caudal arch lordosis, C7-slope, T1-slope and thoracic kyphosis. The sagittal vertical axis C2 correlated with caudal arch lordosis and T1-slope (ρ > 0.5; Pr > 0.95).
conclusionCervical alignment parameters vary according to age, gender and PI. In the cranial cervical spine, changes occur mainly during growth. In the caudal cervical spine, lordosis increases in the caudal arch, which is related to thoracic kyphosis increase with age. The caudal cervical arch acts as a compensatory segment by progressive extension, allowing horizontal gaze.
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