Background The understanding of the individual shape and mobility of the
lumbar spine are key factors for the prevention and treatment of low back
pain. The influence of age and sex on the total lumbar lordosis and the range
of motion as well as on different lumbar sub-regions (lower, middle and upper
lordosis) in asymptomatic subjects still merits discussion, since it is
essential for patient-specific treatment and evidence-based distinction
between painful degenerative pathologies and asymptomatic aging. Methods and
Findings A novel non-invasive measuring system was used to assess the total
and local lumbar shape and its mobility of 323 asymptomatic volunteers (age:
20–75 yrs; BMI <26.0 kg/m2; males/females: 139/184). The lumbar lordosis for
standing and the range of motion for maximal upper body flexion (RoF) and
extension (RoE) were determined. The total lordosis was significantly reduced
by approximately 20%, the RoF by 12% and the RoE by 31% in the oldest (>50
yrs) compared to the youngest age cohort (20–29 yrs). Locally, these decreases
mostly occurred in the middle part of the lordosis and less towards the lumbo-
sacral and thoraco-lumbar transitions. The sex only affected the RoE.
Conclusions During aging, the lower lumbar spine retains its lordosis and
mobility, whereas the middle part flattens and becomes less mobile. These
findings lay the ground for a better understanding of the incidence of level-
and age-dependent spinal disorders, and may have important implications for
the clinical long-term success of different surgical interventions
