The Assessment of Upright Cervical Spinal Alignment Using Supine MRI Studies

Karabağ, Hamza; İplikçioğlu, A. Celal

doi:10.1097/bsd.0000000000000495

Cited by 11 publications

(7 citation statements)

References 6 publications

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“…A previous prospective observational study also found similar correlations between radiography and MRI measurements of cervical alignment, with correlation coefficients for the C2-7 Cobb angle and the ARA being 0.55 and 0.48, respectively [ 15 ]. That study, however, used different cut-off values for determining cervical alignment.…”

Section: Discussionsupporting

confidence: 59%

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

Noh

Lee

et al. 2021

IJERPH

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(1) Background: Although radiography performed on the subject in an upright position is considered the standard method for assessing sagittal cervical alignment, it is frequently determined, or reported, based on MRI performed on the subject in a supine position. (2) Methods: Cervical alignment observed in both imaging modalities was assessed using four methods: the C2-7 Cobb angle, the absolute rotation angle (ARA), Borden’s method, and the sagittal vertical axis (SVA). Cervical alignment was determined (lordosis, kyphosis, and straight) based on radiography. Then, the diagnostic cut-off values for the MRI images and their corresponding diagnostic accuracies were assessed. (3) Results: The analysis included 142 outpatients. The determined diagnostic cut-off values for lordosis, using three measurements (Cobb angle, ARA, and Borden’s method), were −8.5°, −12.5°, and 3.5 mm, respectively, and the cut-off values for kyphosis were −4.5°, 0.5°, and −1.5 mm, respectively. The cut-off value for SVA > 40 mm was 19.5 mm. The Cobb angle, ARA, and Borden’s method, on MRI, showed high negative predictive values for determining kyphosis. The SVA on MRI measurements also showed high negative predictive values for determining >40 mm. (4) Conclusions: MRI measurements may be predictive of cervical alignment, especially for the exclusion of kyphosis and SVA > 40 mm. However, caution is needed in the other determinations using MRI, as their accuracies are limited.

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Section: Discussionsupporting

confidence: 59%

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

Noh

Lee

et al. 2021

IJERPH

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“…46 The change of spinal alignment might also be associated with the differences. 11 , 41 In the supine posture, kyphosis of the thoracic spine decreases, and the scapulae are retracted. 4 , 14 , 21 Another factor might be gravity.…”

Section: Discussionmentioning

confidence: 99%

Comparing in vivo three-dimensional shoulder elevation kinematics between standing and supine postures

Sugi¹,

Matsuki²,

Fukushi³

et al. 2021

JSES International

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Background It is often assumed that body posture, standing vs. supine, changes shoulder muscle activation and range of motion, but these altered shoulder mechanics have not been objectively assessed. We expected the supine posture might facilitate scapular rotation and change subacromial pressure. The purpose of this study is to evaluate the influence of body posture on shoulder kinematics during arm elevation. Methods Ten males and eight females with a mean age of 33 years participated in this study. Shoulder kinematics were assessed during scapular plane elevation in the standing and supine postures by using single-plane fluoroscopic images. Kinematics were measured using 3-dimensional to 2-dimensional model-image registration techniques: matching the 3-dimensional bone model derived from computed tomography onto each fluoroscopic image. Glenohumeral superior/inferior translation, acromiohumeral distance, and scapular rotations were compared between the postures. The effect of sex also was evaluated. Results With the arm at the side position, the humeral head in the supine posture was located 0.5 mm superior compared to the standing posture ( P < .001). During humeral elevation, the humeral head significantly shifted more inferiorly in the supine posture than in standing; the biggest mean difference was 0.6 mm, P = .003. But acromiohumeral distance during elevation was not significantly affected by the body posture ( P = .05). Scapular upward rotation and posterior tilt were significantly different between the postures ( P < .001). Sex had statistically significant, but quantitatively small, effects on shoulder kinematics. Conclusions Body postures affect shoulder kinematics during humeral elevation. This knowledge will be useful to optimize rehabilitation exercises and for diagnostic insight.

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“…On average, the C0-1 segment is kyphotic. [23][24][25][26][27][28] The loss of subaxial lordosis has been reported in CVJ fixation in which excessive hyperlordosis is created at the C0-2 segment (Fig. 1B).…”

Section: A B Cmentioning

confidence: 99%

Evaluation and Surgical Planning for Craniovertebral Junction Deformity

et al. 2020

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Craniovertebral junction (CVJ) deformity is a challenging pathology that can result in progressive deformity, myelopathy, severe neck pain, and functional disability, such as difficulty swallowing. Surgical management of CVJ deformity is complex for anatomical reasons; given the discreet relationships involved in the surrounding neurovascular structures and intricate biochemical issues, access to this region is relatively difficult. Evaluation of the reducibility, CVJ alignment, and direction of the mechanical compression may determine surgical strategy. If CVJ deformity is reducible, posterior in situ fixation may be a viable solution. If the deformity is rigid and the C1-2 facet is fixed, osteotomy may be necessary to make the C1-2 facet joint reducible. C1-2 facet release with vertical reduction technique could be useful, especially when the C1-2 facet joint is the primary pathology of CVJ kyphotic deformity or basilar invagination. The indications for transoral surgery are becoming as narrow as a treatment for CVJ deformity. In this article, we will discuss CVJ alignment and various strategies for the management of CVJ deformity and possible ways to prevent complications and improve surgical outcomes.

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The Assessment of Upright Cervical Spinal Alignment Using Supine MRI Studies

Abstract: It is possible to estimate the spinal alignment in standing position with the measurements of cervical spinal alignment in the MRI at supine position. And this may render having cervical graphy in standing position unnecessary.

Cited by 11 publications

References 6 publications

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

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

Comparing in vivo three-dimensional shoulder elevation kinematics between standing and supine postures

Evaluation and Surgical Planning for Craniovertebral Junction Deformity

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