Evidence map›Paper›PMID 38858268›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026

Sex-dependent evolution of whole-body postural alignment with age.

Marc Khalifé, Wafa Skalli, Ayman Assi, Pierre Guigui, Valérie Attali, Rémi Valentin, Olivier Gille, Virginie Lafage, Han-Jo Kim, Emmanuelle Ferrero and 1 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

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, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Kyphosis, lordosis and height velocity. What is the effect of rate of growth on the development of the sagittal parameters of the spine in normal children?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 · 2026
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Marc KhaliféOrthopaedic Surgery Department, Spine Unit, Hôpital Européen Georges Pompidou, 20 rue Leblanc, Paris, 75015, France. marckhalife@icloud.com.ORCID 0000-0001-9022-3336
Wafa SkalliArts et Métiers Institute of Technology, Université Sorbonne Paris Nord, IBHGC - Institut de Biomécanique Humaine Georges Charpak, HESAM Université, Paris, 75013, France.
Ayman AssiFaculty of Medicine, Saint-Joseph University, Beirut, Lebanon.
Pierre GuiguiOrthopaedic Surgery Department, Spine Unit, Hôpital Européen Georges Pompidou, 20 rue Leblanc, Paris, 75015, France.
Valérie AttaliArts et Métiers Institute of Technology, Université Sorbonne Paris Nord, IBHGC - Institut de Biomécanique Humaine Georges Charpak, HESAM Université, Paris, 75013, France.
Rémi ValentinArts et Métiers Institute of Technology, Université Sorbonne Paris Nord, IBHGC - Institut de Biomécanique Humaine Georges Charpak, HESAM Université, Paris, 75013, France.
Olivier GilleOrthopaedic Surgery Department, Spine Unit, Pellegrin University Hospital, pl. Amélie Raba Léon, Bordeaux, 33000, France.
Virginie LafageDepartment of Orthopedics, Lenox Hill Hospital, Northwell Health, New York City, NY, USA.
Han-Jo KimDepartment of orthopaedics, Hospital for Special Surgery, New York City, NY, USA.
Emmanuelle FerreroOrthopaedic Surgery Department, Spine Unit, Hôpital Européen Georges Pompidou, 20 rue Leblanc, Paris, 75015, France.
Claudio VergariArts et Métiers Institute of Technology, Université Sorbonne Paris Nord, IBHGC - Institut de Biomécanique Humaine Georges Charpak, HESAM Université, Paris, 75013, France.

Funding

Société Française de Chirurgie Orthopédique et Traumatologique 22.000€
6 · The paper itself

Abstract

purposeThe goal of this study was to explore sex-related variations of global alignment parameters and their distinct evolution patterns across age groups.

methodsThis multicentric retrospective study included healthy volunteers with full-body biplanar radiographs in free-standing position. All radiographic data were collected from 3D reconstructions: global and lower limb parameters, pelvic incidence (PI) and sacral slope (SS). Lumbar lordosis (LL), thoracic kyphosis (TK) and cervical lordosis (CL) were also assessed as well as the lumbar and thoracic apex, and thoracolumbar inflexion point. The population was divided into five 5 age groups: Children, Adolescents, Young, Middle-Aged and Seniors.

resultsThis study included 861 subjects (53% females) with a mean age of 34 ± 17 years. Mean PI was 49.6 ± 11.1 and mean LL was - 57.1 ± 11.6°. Females demonstrated a PI increase between Young and Middle-Aged groups (49 ± 11° vs. 55 ± 12°, p < 0.001) while it remained stable in males. SS and LL increased with age in females while remaining constant in males between Children and Middle-aged and then significantly decreased for both sexes between Middle-Aged and Seniors. On average, lumbar apex, inflexion point, and thoracic apex were located one vertebra higher in females (p < 0.001). After skeletal maturity, males had greater TK than females (64 ± 11° vs. 60 ± 12°, p = 0.04), with significantly larger CL (-13 ± 10° vs. -8 ± 10°, p = 0.03). All global spinal parameters indicated more anterior alignment in males.

conclusionMales present more anteriorly tilted spine with age mainly explained by a PI increase in females between Young and Middle-Aged, which may be attributed to childbirth. Consequently, SS and LL increased before decreasing at senior age.

Indexed as

AgingPostureAdolescentAdultAgedAge FactorsChildFemaleHumansKyphosisLordosisMaleMiddle AgedRadiographyRetrospective StudiesSex CharacteristicsAgeLumbar lordosisPelvic incidenceSagittal alignmentSexThoracic kyphosis

Identifiers

PMID38858268

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.