ArticleFrontiers in neuroscience2026
Age-associated differences in cervical sagittal alignment parameters among asymptomatic adults: a cross-sectional reference study.
Article in Frontiers in neuroscience, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: While age-adjusted alignment goals are established for the lumbar spine, analogous clinically actionable tools are lacking for cervical sagittal assessment. This study aimed to derive and internally assess simple, age- and sex-specific formulas for key cervical parameters-thoracic inlet angle minus cervical lordosis (TIA-CL), neck tilt (NT), and cervical sagittal vertical axis (cSVA)-in asymptomatic adults. Methods: This retrospective cross-sectional study analyzed 632 rigorously screened asymptomatic adults (268 males, 364 females; mean age 54.8 ± 16.6 years) who underwent neutral lateral cervical radiography. Radiographic parameters (TIA, C2-C7 lordosis, NT, cSVA) were measured using a validated protocol. All angular parameters (TIA, CL, TIA-CL, and NT) are reported in degrees (°), whereas cSVA is reported in millimeters (mm). Sex-stratified linear regression models quantified age-related associations for TIA-CL, NT, and cSVA, with internal resampling via 1,000-iteration bootstrap resampling (CI width < 0.15 indicating good stability). Results: All three parameters showed significant positive associations with age (all Conclusion: We provide age- and sex-specific reference formulas for NT and cSVA, and an age-specific formula for TIA-CL. These intuitive equations offer a practical reference for comparing an individual's alignment against age-associated population estimates.
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