The Effect of Aging on Cervical Parameters in a Normative North American Population

Iorio, Justin; Henry, Jensen K.; Lafage, Renaud; Liabaud, Barthélemy; Sides, Brenda; Gupta, Munish C.; Lafage, Virginie; Kim, Hee Jin

doi:10.1016/j.spinee.2016.07.395

Cited by 6 publications

(14 citation statements)

References 12 publications

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“…Iorio et al reported a significant age-related increase in C2–C7 lordosis, C0–C7 lordosis and T1 slope, especially in subjects older than 55 years. [26] Previous research found that the cervical lordosis is related to age. As reported that cervical lordosis becomes most pronounced with the development of the sitting position at age 9 months, [27,28] and that the C3–C7 lordosis angle reach adult like angles at age 14 to 15.…”

Section: Discussionmentioning

confidence: 99%

Correlation between cervical lordosis and cervical disc herniation in young patients with neck pain

et al. 2019

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Abnormal cervical curvature and cervical disc herniation are closely related to neck pain and should be taken into account before any treatment. However, studies have rarely reported on the correlation between cervical lordosis and cervical disc herniation in patients with neck pain. Therefore, in this study, we collect young neck pain patients with abnormal cervical curvature to evaluate the relationship between cervical lordosis and cervical disc herniation. Three hundred patients below 40 years old with neck pain were enrolled. Patient sex, age, apical vertebra, segment of intervertebral disc protrusionl, sagittal diameter of spinal duramater, saggital diameter of spinal canal, height of disc space were recorded, and the cervical curvature, and degree of cervical spinal cord compression (G/F ratio) were calculated. The change of degree of disc herniation and degree of cervical spinal cord compression were analyzed in different cervical curvature groups. Further more, collected these patients who had improved cervical curvature over a period of time, to compare the changes of degree of disc herniation, G/F ratio, and height of disc space. The median age of patients with kyphosis was lower than those with lordosis and straight cervical spine. The degree of disc herniation was higher in the straight and kyphosis groups compared to the lordosis group. Cervical lordosis was inversely correlated with the degree of disc herniation and positively with G/F ratio. Cervical curvature was significantly affected by sex, age, and the degree of disc herniation. With the improvement of cervical lordotic curvature, the degree of disc herniation decreased and height of disc space increased. The degree of disc herniation and cervical spinal cord compression are inversely correlated to cervical lordosis in young neck pain patients, and the degree of disc herniation and height of disc space can recover with the recovery of cervical lordotic curvature. These findings may indicating a link between cervical curvature and degenerative changes which have important clinical implications.

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Section: Discussionmentioning

confidence: 99%

Correlation between cervical lordosis and cervical disc herniation in young patients with neck pain

et al. 2019

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“…This is important, considering the observed change in CL that occurs with longer follow-up times. [20][21][22] In addition, the larger patient sample of our cohort compared with the aforementioned study (308 vs 104) provides superior power for statistical analysis. 19 Our data suggest that correction of cervical sagittal alignment does contribute to improved clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…28,29 Previous studies have established the relationship between these parameters, with cervical sagittal vertical axis inversely correlated with CL and directly correlated with T1 slope. 21,30…”

Section: Discussionmentioning

confidence: 99%

Perioperative Change in Cervical Lordosis and Health-Related Quality-of-Life Outcomes

et al. 2022

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Background: Surgeons have scrutinized spinal alignment and its impact on improving clinical outcomes following anterior cervical discectomy and fusion (ACDF). The primary analysis of this study examines the relationship between change in perioperative cervical lordosis (CL) and health-related quality-of-life (HRQOL) outcomes after ACDF. Secondary analysis evaluates the effects of fusion construct length on outcomes in patients grouped by preoperative cervical alignment.Methods: A retrospective cohort study was performed on an institutional database including patients who underwent 1to 3-level ACDF. C2-C7 CL was measured preoperatively and at final follow-up. For primary analysis, patients were classified based on their perioperative cervical lordotic correction: (1) kyphotic, (2) maintained, and (3) restored. For secondary analysis, patients were categorized based on their preoperative C2-C7 CL: (1) kyphotic, (2) neutral, and (3) lordotic. Demographics and perioperative change in patient-reported outcome measures were compared between groups.Results: A total of 308 patients were included. A significant difference was noted among maintained, restored, and kyphotic groups in terms of delta physical compositeshort form-12 score (ΔPCS-12) (9.0 vs 10.3 vs 1.5; P = 0.04) and delta visual analog scale score (ΔVAS) for arm pain (−0.9 vs −3.8 vs −0.6; P = 0.03). Regression analysis revealed significantly greater improvement of ; P = 0.03) and VAS arm (β: −2.0; P = 0.03) scores in restored patients compared with kyphotic patients. The length of fusion construct in patients grouped by preoperative cervical alignment had no significant impact on the clinical outcomes on regression analysis.Conclusions: Significantly greater PCS-12 and VAS arm improvement were seen in patients whose cervical sagittal alignment was restored to neutral/lordotic compared with those who remained kyphotic. Multivariate analysis demonstrated no association between construct length and perioperative outcomes.Clinical Relevance: The results of this study highlight the importance of sagittal alignment and restoration of CL after short-segment ACDF. Irrespective of preoperative sagittal alignment, the length of ACDF fusion construct does not have a significant impact on clinical outcomes.

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“…without kyphosis or lordosis). 13 Ames et al proposed that we should keep the T1S-Cl < 15 , C2-7 SVA < 40 mm 1 . Tundo et al suggested that cervical lordosis or neutral alignment should be restored.…”

Section: Introductionmentioning

confidence: 99%

The Difference of Sagittal Correction of Adult Subaxial Cervical Spine Surgery According to Age: A Retrospective Study

Guo

Yang

et al. 2022

Orthopaedic Surgery

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Objective At present, the true sagittal alignment of the cervical spine is uncertain, resulting in no standard reference for subaxial cervical surgery. So, we aimed to explore the age difference of normal cervical sagittal alignment and to further investigate the mid‐and long‐term changes of sagittal alignment after subaxial cervical spine surgery. Materials and Methods This was a retrospective study and 1223 asymptomatic volunteers and 79 patients undergoing subaxial cervical spine surgery were retrospectively reviewed in total. Asymptomatic volunteers and patients were divided into six subgroups: 20–29, 30–39, 40–49, 50–59, 60–69 and ≥70 groups. The age difference and trend with age of cervical sagittal parameters of asymptomatic volunteers were assessed by cervical lateral radiography and analyzed by ANOVA test, and the regression equation of C2‐7 Cobb was established via multiple linear regression. Based on the C2‐7 Cobb regression equations of different ages, the theoretical value, deviation value, loss value of the C2‐7 Cobb, and JOA recovery rate of patients were calculated, and the correlation among the loss value, deviation value of the C2‐7 Cobb, and JOA recovery rate of the 79 patients was evaluated by Pearson correlation analysis. Results For the asymptomatic volunteers, the C0‐2 Cobb decreased gradually with increasing age. The C2‐7 Cobb, C2‐7 SVA, T1S, NT, and TIA increased gradually with increasing age. The CBVA fluctuated with increasing age. T1S demonstrated a moderate correlation with C2‐7 Cobb ( r = 0.60, p < 0.01); C0‐2 Cobb, C2‐7 SVA, CBVA, and TIA demonstrated a fair correlation with C2‐7 Cobb ( r = −0.30, −0.33, 0.41, 0.40, p < 0.01); age demonstrated a poor correlation with C2‐7 Cobb ( r = 0.19, p < 0.01). The regression equations of C2‐7 Cobb were established using C0‐2 Cobb, C2‐7 SVA, CBVA, and T1S. For the patients with subaxial cervical spine surgery, the loss of C2‐7 Cobb was moderately correlated with the deviation of C2‐7 Cobb ( r = 0.33, p < 0.01). Conclusion The age difference of cervical sagittal alignment was obvious, and the C2‐7 Cobb increased with age especially. The closer the postoperative C2‐7 Cobb was to the theoretical value of corresponding age, the smaller the loss of correction angle was, and the better the mid‐ and long‐term outcomes. The personalized sagittal reconstruction should be performed according to age difference for subaxial cervical spine surgery.

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The Effect of Aging on Cervical Parameters in a Normative North American Population

Cited by 6 publications

References 12 publications

Correlation between cervical lordosis and cervical disc herniation in young patients with neck pain

Correlation between cervical lordosis and cervical disc herniation in young patients with neck pain

Perioperative Change in Cervical Lordosis and Health-Related Quality-of-Life Outcomes

The Difference of Sagittal Correction of Adult Subaxial Cervical Spine Surgery According to Age: A Retrospective Study

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