Age-related trend of spine changes

Introduction. The increase in the number of elderly and senile people is recognized as a global problem, therefore, the development of new indicators that objectively reflect the aging of the human body is an urgent and significant task. However, the available quantitative indicators and methods used in the field of aging, according to WHO estimates, are limited and do not provide a deep understanding of the key aspects of healthy aging. This article offers information about the possibilities of studying the panoramic X-ray image of the entire spine for developing some new indicators and evaluating the age-related changes observed.The purpose of the work: to investigate the age-related spine changes on the basis of previously developed criteria for quantitative and qualitative assessment of the shape and position of the spine structures.Materials and methods. X-ray images of all spine parts were examined in the sagittal projection for 141 patients, 57 men and 84 women with dorsopathies. The selection of patients was carried out randomly. The cohort of patients was divided into 4 groups: 1st — 21–44 years (average age 32,7 years) — 31 people, 2st — 45–59 years (average age 52,6 years) — 39 people, 3st — 60–74 years (average age 66,8 years) — 50 people and 4st — 75–88 years (average age — 81,1 years) — 21 people. The study was carried out on a personal computer screen, without the participation and additional irradiation of patients. A digital X-ray image of the whole spine in the sagittal plane was obtained for each patient. On the combined digital radiograph the occipital vertical was drown starting from the outer hillock of the occipital bone along all spine parts. The anteroposterior axes of CV–TV vertebrae (r axes) were drawn and the tangent line segments were applied on the contours of the base and dorsal planes of the sacral image. The angles were measured between the occipital vertical and the perpendiculars restored to these lines at the points of their intersection with the occipital vertical. Statistical processing of the data obtained was carried out.Results. In the course of statistical processing on the basis of the data obtained, some distinctive features of the studied structures were identified, methods of their quantitative assessment were proposed and boundaries of the proposed indicator registration were determined. The peculiarities of changes in the position of the spine depending on age are revealed: for people over 70 years, the occipital vertical most often passes anteriorly from the anterior contours of the bodies or crosses the bodies of the thoracic vertebrae; for people over 60 years, the cervical-thoracic transition at the CVII–TIII  level more often has the form of enhanced kyphosis («Bear withers» or «Buffalo hump» type), and the head is in a forward position (FHP); for people over 70 years, the sacrum more often has an upright position.Conclusion. The proposed diagnostic method made it possible to determine position type of the spine structures and to characterize the age-related spine changes.