Diagnostic Accuracy of Magnetic Resonance Imaging for Sagittal Cervical Spine Alignment: A Retrospective Cohort Study

Oh, Chahyun; Noh, Chan; Lee, Jieun; Lee, Sang‐Min; Hong, Boohwi; Ko, Youngkwon; Lim, Chang Su; Kim, Chongam

doi:10.3390/ijerph182413033

Cited by 4 publications

(2 citation statements)

References 23 publications

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“…Theoretically, an adequate range of motion is achieved at the level of joint replacement, and fixation is achieved at the level of joint fusion [ 20 ]. Cervical sagittal balance is associated with the development of cervical spine-related disorders and a decrease in health-related quality of life [ 21 – 23 ]. Therefore, it has become increasingly important to assess and correct cervical sagittal alignment during surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

Cervical sagittal balance after consecutive three-level hybrid surgery versus anterior cervical discectomy and fusion: radiological results from a single-center experience

et al. 2023

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Introduction According to the different numbers and relative locations of cervical disc replacement (CDR) and anterior cervical discectomy and fusion (ACDF), three-level hybrid surgery (HS) has many constructs. The purpose of this retrospective study was to compare the sagittal alignment parameters of HS and ACDF for cervical degenerative disc disease (CDDD) and the association of the respective parameters. Methods This study involved patients with three-level CDDD who underwent ACDF or HS at our institution between June 2012 and August 2021. This follow-up included one-level CDR and two-level ACDF (type I group), two-level CDR and one-level ACDF (type II group) and three-level ACDF. Cervical sagittal alignment parameters included cervical lordosis (CL), segment alignment (SA), T1 slope (T1S), C2–C7 sagittal vertical axis (SVA), T1S-CL, C2 slope (C2S), occipital to C2 angle (O-C2A) and segment range of motion (ROM). Postoperative complications included adjacent segment degeneration, imbalance, prosthetic subsidence and heterotopic ossification. Results The three groups with a total of 106 patients were better matched in terms of demographics. Patients who underwent HS had significantly higher CL than those who underwent ACDF at 1 week, 6 months, 12 months and the final follow-up after surgery, as well as significantly better SA at 12 months and the final follow-up. There was no significant difference in T1S, SVA, T1S-CL, C2S, O-C2A or segment ROM among the three groups after surgery. The T1S-CL was significantly associated with C2S in the type I and type II groups at the preoperative and final follow-up. There was no significant difference in postoperative complications among the three groups. Conclusions Most improvements in cervical sagittal alignment (CL, SA, T1S, SVA, T1S-CL, C2S, O-C2A, and segmental ROM) were observed in all three groups postoperatively. HS was more advantageous than ACDF in the maintenance of postoperative CL and SA. Thus, three-level HS may be better for maintaining cervical curvature. The number of replacement segments differed in those who underwent HS but did not affect the correlation between T1S-CL and C2S, both of which are well balanced.

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Section: Discussionmentioning

confidence: 99%

Cervical sagittal balance after consecutive three-level hybrid surgery versus anterior cervical discectomy and fusion: radiological results from a single-center experience

et al. 2023

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“…Cervical sagittal alignment is considered a diverse and signi cant component of the overall sagittal alignment. Cervical sagittal balance is associated with the development of cervical spine-related disorders and a decrease in health-related quality of life 25 . Ibrahim et al 26 showed in a 2-year randomized controlled trial that maintaining cervical sagittal balance signi cantly reduced chronic cervicogenic headache in patients.…”

Section: Discussionmentioning

confidence: 99%

Cervical sagittal balance after consecutive three-level hybrid surgery versus anterior cervical discectomy and fusion: radiological results from a single-center experience

Chen

Deng

Líu

et al. 2022

Preprint

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Introduction: According to the different numbers and relative locations of cervical disc replacement (CDR) and anterior cervical discectomy and fusion (ACDF), three-level hybrid surgery (HS) has many constructs. The purpose of this retrospective study was to compare the sagittal alignment parameters of HS and ACDF for cervical degenerative disc disease (CDDD) and the association of the respective parameters. Methods: This study involved patients with three-level CDDD who underwent ACDF or HS at our institution between June 2012 and August 2021. This follow-up included one-level CDR and two-level ACDF (type I group), two-level CDR and one-level ACDF (type II group) and three-level ACDF. Cervical sagittal alignment parameters included cervical lordosis (CL), segment alignment (SA), T1 slope (T1S), C2-C7 sagittal vertical axis (SVA), T1S-CL, C2 slope (C2S), occipital to C2 angle (O-C2A) and segment range of motion (ROM).Postoperative complications included adjacent segment degeneration (ASD), imbalance, prosthetic subsidence and heterotopic ossification (HO). Results: The three groups with a total of 106 patients were better matched in terms of demographics. Patients who underwent HS had significantly higher CL than those who underwent ACDF at 1 week, 6 months, 12 months and the final follow-up after surgery, as well as significantly better SA at 12 months and the final follow-up. There was no significant difference in T1S, SVA, T1S-CL, C2S, O-C2A or segment ROM among the three groups after surgery. The T1S-CL was significantly associated with C2S in the type I and type II groups at the preoperative and final follow-up. There was no significant difference in postoperative complications among the three groups. Conclusions: Most improvements in cervical sagittal alignment (CL, SA, T1S, SVA, T1S-CL, C2S, O-C2A, and segmental ROM) were observed in all three groups postoperatively. HS was more advantageous than ACDF in the maintenance of postoperative CL and SA. Thus, three-level HS may be better for maintaining cervical curvature. The number of replacement segments differed in those who underwent HS but did not affect the correlation between T1S-CL and C2S, both of which are well balanced.

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Capturing the cervical spine shape: Angular measurements versus geometric morphometric methods

Kedar,

Ezra,

Pelleg‐Kallevag

et al. 2024

Clinical Anatomy

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The cervical spine manifests a wide shape variation. However, the traditional methods to evaluate the cervical spine curve were never tested against its actual shape. The study's main aim was to determine whether the shape classification of the cervical spine, based on traditional angular measurements, coincides with each other and with the shape captured by the 2D landmark‐based geometric morphometric method. The study's second aim was to reveal the associations between the cervical spine shape and the demographic parameters, the head's position, and the spine's sagittal balance. CT scans of the cervical spine of 163 individuals were evaluated to achieve these goals. The shape was assessed by measuring the C2–C7 Cobb angle (CA), the C2–C7 posterior tangent angle (PTA), the curvedness of the arch, and by a 2D landmark‐based geometric morphometric method. The position of the head and the sagittal balance of the spine were evaluated by measuring the foramen magnum‐C2 Cobb angle (FMCA) and the T1 slope angle (T1SA), respectively. Based on the size of the angle measured, each individual was classified into one of the three cervical ‘shape groups’ (lordotic, straight, and kyphotic). We found that cervical lordosis was the dominant shape regardless of the measuring methods utilized (46.6%–54.6%), followed by straight neck (28.2%–30.1%), and kyphosis (15.3%–25.2%); however, about a third of the 163 individuals were classified into a different shape group using the CA and PTA methods. The cervical spine angle was sex‐independent and age‐dependent. The T1SA was significantly correlated with CA and PTA (r = 0.640 and r = 0.585, respectively; p < 0.001). In conclusion, the cervical spine shape evaluation is method‐dependent and varies with age.

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Diagnostic Accuracy of Magnetic Resonance Imaging for Sagittal Cervical Spine Alignment: A Retrospective Cohort Study

Cited by 4 publications

References 23 publications

Cervical sagittal balance after consecutive three-level hybrid surgery versus anterior cervical discectomy and fusion: radiological results from a single-center experience

Cervical sagittal balance after consecutive three-level hybrid surgery versus anterior cervical discectomy and fusion: radiological results from a single-center experience

Cervical sagittal balance after consecutive three-level hybrid surgery versus anterior cervical discectomy and fusion: radiological results from a single-center experience

Capturing the cervical spine shape: Angular measurements versus geometric morphometric methods

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