{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T16:18:34Z","timestamp":1783613914308,"version":"3.55.0"},"reference-count":46,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Anatomy"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The acquisition of habitual bipedal posture required substantial reorganization of the human spine and pelvis, including the development of lumbar lordosis. While global lumbar alignment has been extensively studied, the anatomical relationship between regional lumbar lordosis and pelvic incidence in healthy adults remains incompletely understood. In this cross\u2010sectional study, 154 rigorously screened healthy adults aged 20\u201376\u2009years underwent standing whole\u2010body EOS imaging, simultaneous force plate balance assessment, and body composition analysis. Sagittal alignment parameters, including segmental lumbar lordosis, pelvic incidence, balance metrics, and body composition variables, were analyzed for distributional characteristics and age\u2010 and sex\u2010related associations. Segmental lumbar lordosis parameters, including lower lumbar lordosis (LL4\u2013S1), demonstrated approximately normal and unimodal distributions with preserved central tendencies across adulthood. Pelvic incidence showed a consistent positive association with upper lumbar lordosis (LL1\u20134), whereas its relationship with lower lumbar lordosis (LL4\u2013S1) was weak or absent in pooled analyses and emerged only in sex\u2010stratified analyses, particularly among males. In contrast to sagittal alignment parameters, balance and body composition variables demonstrated greater variability and clearer age\u2010 and sex\u2010related modulation. These findings support the concept that the lumbar spine is regionally differentiated rather than functionally uniform. Lower lumbar alignment demonstrated weaker and, in pooled analyses, often absent associations with pelvic incidence than the upper lumbar spine, suggesting differential biomechanical regulation of the lumbosacral junction. Although broader evolutionary implications remain speculative, the present findings provide an anatomical and biomechanical framework for future investigations of human upright posture and lumbosacral disorders.<\/jats:p>","DOI":"10.1111\/joa.70202","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T16:07:40Z","timestamp":1783613260000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Regional lumbar alignment, physiological variation, and pelvic incidence in healthy adults: Emphasis on the lumbosacral junction"],"prefix":"10.1111","author":[{"given":"Kazuhiro","family":"Hasegawa","sequence":"first","affiliation":[{"name":"Niigata Spine Surgery Center  Niigata City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Niigata Spine Surgery Center  Niigata City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Kameda Daiichi Hospital  Niigata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun","family":"Hatsushikano","sequence":"additional","affiliation":[{"name":"Kameda Daiichi Hospital  Niigata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruka","family":"Shimoda","sequence":"additional","affiliation":[{"name":"Niigata Spine Surgery Center  Niigata City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayuki","family":"Ohashi","sequence":"additional","affiliation":[{"name":"Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine Niigata University Graduate School of Medical and Dental Sciences  Niigata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"66","volume-title":"The Biomechanics of Back Pain","author":"Adams M.","year":"2002"},{"issue":"1","key":"e_1_2_7_3_1","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1097\/00007632-200301010-00015","article-title":"The reliability and concurrent validity of the Scoliosis Research Society\u201022 patient questionnaire for idiopathic scoliosis","volume":"28","author":"Asher M.","year":"2003","journal-title":"Spine"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.4236\/aa.2013.33018"},{"key":"e_1_2_7_5_1","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1097\/00007632-198907000-00012","article-title":"Segmental analysis of the sagittal plane alignment of the normal thoracic and lumbar spines and thoracolumbar junction","volume":"14","author":"Bernhardt M.","year":"1989","journal-title":"Spine"},{"key":"e_1_2_7_6_1","first-page":"403","article-title":"Abnormal magnetic\u2010resonance scans of the lumbar spine in asymptomatic subjects. 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