*Article* **Reference Values for 3D Spinal Posture Based on Videorasterstereographic Analyses of Healthy Adults**

**Janine Huthwelker 1, \*, Jürgen Konradi 1 , Claudia Wolf 1 , Ruben Westphal 2 , Irene Schmidtmann 2 , Philipp Drees <sup>3</sup> and Ulrich Betz 1**


**Abstract:** Visual examinations are commonly used to analyze spinal posture. Even though they are simple and fast, their interrater reliability is poor. Suitable alternatives should be objective, non-invasive, valid and reliable. Videorasterstereography (VRS) is a corresponding method that is increasingly becoming established. However, there is a lack of reference data based on adequate numbers of participants and structured subgroup analyses according to sex and age. We used VRS to capture the spinal posture of 201 healthy participants (aged 18–70 years) divided into three age cohorts. Three-dimensional reference data are presented for the global spine parameters and for every vertebral body individually (C7-L4) (here called the specific spine parameters). The vertebral column was found to be systematically asymmetric in the transverse and the coronal planes. Graphical presentations of the vertebral body posture revealed systematic differences between the subgroups; however, large standard deviations meant that these differences were not significant. In contrast, several global parameters (e.g., thoracic kyphosis and lumbar lordosis) indicated differences between the analyzed subgroups. The findings confirm the importance of presenting reference data not only according to sex but also according to age in order to map physiological posture changes over the life span. The question also arises as to whether therapeutic approximations to an almost symmetrical spine are biomechanically desirable.

**Keywords:** surface topography; rasterstereographic back shape analysis; normative data; healthy adults; posture analysis; spine
