Purpose: Previous studies have shown that cervical sagittal alignment is strongly associated with cervical deformity, myelopathy,and cervical adjacent-segmental disease, and those cervical sagittal parameters are correlated with health-related quality of life, while less attention has been paid to cervical sagittal balance in various cervical disorders. This study aimed to compare cervical sagittal parameters between patients with nonspecific neck pain(NS-NP) and patients with cervical spondylotic radiculopathy(CSR) and cervical spondylotic myelopathy(CSM). Methods: We retrospectively included 236 patients divided into three groups, NS-NP, CSR, and CSM, and collected general information and cervical sagittal parameters of such kind patients. The variation of parameters between the size of these parameters and gender differences were analyzed. Pearson’s or Spearman’s correlation was applied to analyzethe association of cervical sagittal parameters of all patients between the three groups. Results: There were significant differences in age and sex among the three groups (P<0.001), among which the NS-NP group was the youngest, and NS-NP was more common in women. The parameters of cervical sagittal position were significantly different among the three groups (P<0.05). Pearson’s or Spearman’s correlation result showed that the C2-C7 Cobb angle was negatively associated with C2-C7 SVA, and the C2-C7 Cobb angle, T1 slope (T1s) were negatively associated with the spino-cranial angle (SCA). There was a positive correlation between the C2-C7 Cobb angle and C7 slope (C7s), C2-C7 SVA and T1s, C2-C7 SVA and SCA, and C7s and T1s. Conclusion: This study showed that between the three groups, patients with non-specific neck pain had larger C7s, T1s, and C2-C7 Cobb angle and smaller SCA and C2-C7 SVA; and among patients with NS-NP, women had larger SCA and smaller C7s and T1s. The smaller anteroposterior (AP) diameter of the thoraxin women might be the possible explanation for this difference.

Purpose: To compare the variation characteristics of cervical sagittal position parameters and the correlation among nonspecific neck pain(NS-NP), cervical spondylotic radiculopathy (CSR), and cervical spondylotic myelopathy (CSM). Methods: We retrospectively included 236 patients divided into three groups, NS-NP, CSR and CSM, and collected general information and cervical sagittal parameters of such kind patients. The characteristics of the variation of parameters between the size of these parameters and gender differences were analyzed. Pearson’s or Spearman’s correlation was applied to analyze the association of cervical sagittal parameters of all patients between the three groups. Results: There exist obvious differences in age and sex among the three groups (P<0.001), among which the NS-NP group was the youngest, and NS-NP was more common in women. The parameters of cervical sagittal position were obviously different among the three groups (P<0.05). Pearson’s or Spearman’s correlation result showed that the C2-C7 Cobb angle was negatively associated with C2-C7 SVA, and the C2-C7 Cobb angle, T1s were negatively associated with the SCA angle. There was a positive correlation between the C2-C7 Cobb angle and C7s, C2-C7 SVA and T1s, C2-C7 SVA and SCA, and C7s and T1s. Conclusion: This study found that patients with CSR and CSM had higher SCA and C2-C7 SVA, and smaller C7s, T1s, and C2-C7 Cobb angles than patients with NS-NP; however, there has no obvious difference in sagittal parameters between the two types of cervical spondylosis. The SCA, C2-C7 SVA, C7s, T1s, and C2-C7 Cobb angles all had a strong correlation. Women were more common and had greater SCA than men in NS-NP patients, and women had smaller C7s and T1s than men.

PURPOSE Our research was designed to analyse the postoperative clinical results of patients suffering from single-segment thoracic ossification of the ligamentum flavum (TOLF) combined with dural ossification (DO) who underwent posterior laminar decompression and internal fixation.METHODS This retrospective research included thirty-two patients who underwent surgery for ossifying the ligamentum flavum in the thoracic spine between January 2016 and January 2020. Patients were fallen into one group included patients with evidence of DO during surgery, and the other group included patients without evidence of DO. We assessed and compared general clinical characteristics and health-related outcomes before surgery and during follow-up.RESULTS The DO group had a longer operation duration, more blood loss, and longer hospital stay (operation time: 94.75±6.78 min vs. 80.00±10.13 min, p<0.001; blood loss: 331.67±50.06 ml vs. 253.00±48.24 ml, p<0.001; length of hospital stay: 13.83±2.76 days vs. 10.05±2.33 days, p<0.001). Complications: There were 12 cases of cerebrospinal fluid leakage and 1 case of superficial wound infection in the DO group. However, the neurological recovery and health-associated quality of life (HRQOL) scores showed no statistically significant changes between the DO and non-DO groups (p>0.05).CONCLUSIONS Thoracic myelopathy because of ossifying a single thoracic ligamentum flavum is uncommon. Posterior laminectomy and internal fixation combined with intraoperative resection of the ossified ligamentum flavum and dura is an efficient and relatively safe method for treating TOLF with DO, which can provide satisfactory results. Moreover, DO had no significant effect on postoperative neurological recovery and health-related quality of life scores.

Purpose This study aimed to compare cervical sagittal parameters and clinical outcomes between patients undergoing cervical laminoplasty(CL) and those undergoing lateral mass screw fixation(LMS). Methods We retrospectively studied 67 patients with multilevel ossification of the posterior longitudinal ligament (OPLL) of the cervical spine who underwent lateral mass screw fixation (LMS = 36) and cervical laminoplasty (CL = 31). We analyzed cervical sagittal parameters (C2-7 sagittal vertical axis (C2-7 SVA), C0-2 Cobb angle, C2-7 Cobb angle, C7 slope (C7s), T1 slope (T1s), and spino-cranial angle (SCA)) and clinical outcomes (visual analog scale [VAS], neck disability index [NDI], Japanese Orthopaedic Association [JOA] scores, recovery rate (RR), and minimum clinically significant difference [MCID]). The cervical sagittal parameters at the last follow-up were analyzed by binary logistic regression. Finally, we analyzed the correlation between the cervical sagittal parameters and each clinical outcome at the last follow-up after surgery in both groups. Results At the follow-up after posterior decompression in both groups, the mean values of C2-C7 SVA, C7s, and T1s in the LMS group were larger than those in the CL group (P ≤ 0.05). Compared with the preoperative period, C2-C7 SVA, T1s, and SCA gradually increased, and the C2-C7 Cobb angle gradually decreased after surgery (P < 0.05). The improvement in the JOA score and the recovery rate was similar between the two groups, while the improvement in the VAS-N score and NDI score was more significant in the CL group (P = 0.001; P = 0.043). More patients reached MCID in the CL group than in the LMS group (P = 0.036). Binary logistic regression analysis showed that SCA was independently associated with whether patients reached MCID at NDI postoperatively. SCA was positively correlated with cervical NDI and negatively correlated with cervical JOA score at postoperative follow-up in both groups (P < 0.05); C2-7 Cobb angle was negatively correlated with cervical JOA score at postoperative follow-up (P < 0.05). Conclusion CL may be superior to LMS in treating cervical spondylotic myelopathy caused by OPLL. Cervical SCA after posterior decompression can be used as a predictor of postoperative clinical outcome.