From the Research
Sagittal balance of the spine naturally changes throughout the aging process, with older adults typically developing a more forward-leaning posture, and maintaining good spinal sagittal alignment, muscle strength, and physical ability is crucial to reduce the risk of falls and improve quality of life. As we age, several degenerative changes occur that affect this balance: intervertebral discs lose height and hydration, vertebral bodies may develop wedging from osteoporosis, and paraspinal muscles weaken 1. These changes typically result in increased thoracic kyphosis (forward curvature in the upper back), decreased lumbar lordosis (flattening of the lower back curve), and an anterior shift in the center of gravity, which can be compensated by pelvic retroversion, hip extension, and knee flexion to maintain balance 2. Some key points to consider in the context of sagittal balance and aging include:
- The importance of evaluating and managing sagittal plane imbalance, which can be caused by de novo scoliosis or iatrogenic flat back deformity 3
- The need to consider spinal sagittal alignment, body balance, muscle strength, and physical ability when assessing the risk of falls in older adults 4
- The role of regular exercise, including core and back muscle strengthening, in maintaining bone density and practicing good posture to minimize age-related changes in sagittal alignment 1 It is essential to prioritize maintaining good spinal sagittal alignment, muscle strength, and physical ability to reduce the risk of falls and improve quality of life, especially in older adults, as supported by the most recent and highest quality study 2.