{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T18:05:57Z","timestamp":1777658757600,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2018,3,27]],"date-time":"2018-03-27T00:00:00Z","timestamp":1522108800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To investigate age-based changes in cervical alignment parameters in an asymptomatic population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Retrospective review of a prospective study of 118 asymptomatic subjects who underwent biplanar imaging with 3-dimensional capabilities. Demographic and health-related quality of life data was collected prior to imaging. Patients were stratified into 5 age groups: &lt;35 years, 35-44 years, 45-54 years, 55-64 years, and \u226565 years. Radiographic measurements of the cervical spine and spinopelvic parameters were compared between age groups. The normal distribution of parameters was assessed followed by analysis of variance for comparison of variance between age groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>C2-C7 lordosis, C0-C7 lordosis, and T1 slope demonstrated significant increases with age. C0-C7 lordosis was significantly less in subjects &lt;35 years compared with \u226555 years. Significant differences in T1 slope were identified in patients &lt;35 versus \u226565, 35-44 versus \u226565, and 45-54 versus \u226565 years. T1 slope demonstrated a positive correlation with age. Horizontal gaze parameters did not change linearly with age and mean averages of all age groups were within 10\u00b0 of one another. Cervical kyphosis was present in approximately half of subjects who were &lt;55 compared with approximately 10% of subjects \u226555 years. Differences in pelvic tilt, pelvic incidence-lumbar lordosis, and C7-S1 sagittal vertical axis were identified with age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>C0-C7 lordosis, C2-C7 lordosis, and T1 slope demonstrate age-based changes while other cervical and horizontal gaze parameters remain relatively constant with age.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2192568218765400","type":"journal-article","created":{"date-parts":[[2018,3,28]],"date-time":"2018-03-28T00:27:28Z","timestamp":1522196848000},"page":"709-715","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":43,"title":["The Effect of Aging on Cervical Parameters in a Normative North American Population"],"prefix":"10.1177","volume":"8","author":[{"given":"Justin","family":"Iorio","sequence":"first","affiliation":[{"name":"Hospital for Special Surgery, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virginie","family":"Lafage","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renaud","family":"Lafage","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jensen K.","family":"Henry","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Stein","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence G.","family":"Lenke","sequence":"additional","affiliation":[{"name":"Columbia University Medical Center, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Munish","family":"Gupta","sequence":"additional","affiliation":[{"name":"Washington University, St Louis, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael P.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Washington University, St Louis, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brenda","family":"Sides","sequence":"additional","affiliation":[{"name":"Washington University, St Louis, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Han Jo","family":"Kim","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,3,27]]},"reference":[{"key":"bibr1-2192568218765400","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000254120.25411.ae"},{"key":"bibr2-2192568218765400","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31828802c2"},{"key":"bibr3-2192568218765400","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-012-2167-5"},{"key":"bibr4-2192568218765400","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199707010-00009"},{"key":"bibr5-2192568218765400","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0b013e31826100c9"},{"key":"bibr6-2192568218765400","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-011-1265-x"},{"key":"bibr7-2192568218765400","doi-asserted-by":"publisher","DOI":"10.3171\/2014.11.SPINE14368"},{"key":"bibr8-2192568218765400","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-014-3632-0"},{"key":"bibr9-2192568218765400","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181bb4f96"},{"key":"bibr10-2192568218765400","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3182444402"},{"key":"bibr11-2192568218765400","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0b013e31820b51f3"},{"key":"bibr12-2192568218765400","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000001171"},{"key":"bibr13-2192568218765400","volume-title":"Paper 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