• Cervical region. Cervical lordosis (occiput-C7) averages 40°, with the majority of cervical lordosis occurring at the C1-C2 motion segment.
• Thoracic region. Normal kyphosis (T1-T12) in young adults ranges from 20° to 50° with a tendency to increase slightly with age. The kyphosis in the thoracic region usually starts at T1-T2 and gradually increases at each level toward the apex (T6-T7 disc). Below the thoracic apex, segmental kyphosis gradually decreases until the thoraco-lumbar junction is reached.
• Thoracolumbar region. The thoracolumbar junction (T12-L1) is essentially straight with respect to the sagittal plane. It serves as the transition area between the relatively stiff kyphotic thoracic region and the relatively mobile lordotic lumbar region.
• Lumbar region. Normal lumbar lordosis (L1-S1) ranges from 30° to 80° with a mean lordosis of 60°. Lumbar lordosis generally begins at L1-L2 and gradually increases at each distal level toward the sacrum. The apex of lumbar lordosis is normally located at the L3-L4 disc space. (Fig. 10-13)
Figure 10-13. The sagittal curves of the spine. (From DeWald RL. Revision surgery for spinal deformity. In: Eilert RE, editor: Instructional Course Lectures. vol. 41, Rosemont, IL: American Academy of Orthopaedic Surgeons; 1992. p. 241, with permission.)
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