Sagittal wedging of intervertebral discs and vertebral bodies in the cervical spine and their associations with age, sex and cervical lordosis: A large‐scale morphological study

Objective Developing and validating a novel parameter, the modified C2–C7 Cobb angle, as a feasible substitute for the traditional method in assessing cervical sagittal alignment, and exploring its reference range through a large-scale retrospective study. Methods The visibility of the C6, C7 upper, and C7 lower endplates was graded and compared. Baseline data such as height, weight, body mass index (BMI), age, and gender were analyzed for their impact on the visibility of the C7 lower endplate. Values of C2-6 Cobb angle, C2-7 Cobb angle, and modified C2–C7 Cobb angle were measured. The intra- and interobserver reliability, differences, and efficacy of evaluation on cervical lordosis of the parameters were compared, and the correlations among the parameters were analyzed. Furthermore, reference ranges for the modified C2–C7 Cobb angle were established based on lateral cervical spine X-rays of 825 asymptomatic Chinese adults across different age groups and genders. Results The visibility of the C7 lower endplates was significantly reduced compared to the C6 lower and C7 upper endplates. Age, weight, BMI, and male gender were identified as factors negatively influencing the visibility of the C7 lower endplate. Both intra-observer and inter-observer reliability demonstrated excellence for all tested parameters. The linear regression model unveiled a stronger association of the modified C2–C7 Cobb angle with the C2-7 Cobb angle compared to the C2-6 Cobb angle. Furthermore, the modified C2-7 Cobb angle exhibited excellent efficacy in evaluating cervical lordosis. Age displayed a positive correlation with the modified C2–C7 Cobb angle, and across every age bracket from 20 to 69 years, males exhibited a higher mean modified C2-7 Cobb angle compared to females. Conclusion The visibility of the C7 lower endplate diminishes with increasing age, weight, BMI, and male gender. In cases where the C7 lower endplate is unclear, the modified C2–C7 Cobb angle emerges as a reliable method for estimating cervical sagittal morphology. Reference ranges for the modified C2–C7 Cobb angle were established across various age groups and genders among asymptomatic Chinese adults, offering a valuable resource to guide therapeutic interventions for cervical spine disorders and deformities.

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Clinical and morphometric features in cervical spine pathology in humans and animals

Andreeva,

Stoyanov,

Mirdjuraev

et al. 2024

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Background. The neck, its bone-cartilaginous and muscle apparatus, etc. high activity is well known. Cervical spine degenerative-dystrophic processes are considered to be an urgent problem. The purpose of the study was to determine the clinical and morphometric changes of the cervical spine in humans and animals with neck pain based on a clinical and neurological examination, determination of the vertebral body density, their configuration, and ratio for timely correction and prognosis of this pathology. Materials and methods. Pain intensity was studied in humans and animals using the adapted visual-analogue scale. The indexes of computer tomography with measurement of vertebral body density, and morphometric indexes with an emphasis on C5-C7 level were also studied. All studies were conducted following existing bioethical standards. Results. The pathology of spine configuration was registered in 84.6 % of the examined patients in the form of angular kyphosis or straightened lordosis, more often in women. It was observed in 34.7 % of cases in dogs and cats. The normal configuration is more common: in cats — 78.6 % and in dogs of small breeds — 78.5 %, in large breed dogs — only 26.3 %, and deformations were more frequent than in cats and small dogs (2.7 times more). The cervical vertebrae bodies density in all groups decreased toward the caudal direction with a difference of 18.1 % in humans. In cats — 2.7 %, in dogs of small breeds, it was higher (7.5 %), and in large breed dogs, it reached 14.3 %. The maximum deviations of the studied indicators were found in humans and maximally coincided with those in dogs of large breeds. Conclusions. Thus, animals, especially dogs of large breeds, can serve as a model for studying etiopathogenetic factors, the course, prognosis of degeneration of the bone-cartilage apparatus.

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Sagittal wedging of intervertebral discs and vertebral bodies in the cervical spine and their associations with age, sex and cervical lordosis: A large‐scale morphological study

Cited by 4 publications

References 54 publications

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Unveiling a Modified Approach to Assess Cervical Sagittal Alignment: Findings from a Large-Scale Retrospective Analysis

Clinical and morphometric features in cervical spine pathology in humans and animals

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