The impact of cervical sagittal parameters on axial neck pain in patients with cervical kyphosis

Abstract

Background:Cervical sagittal alignment is closely related with cervical disc degeneration and impacts the spinal function and quality of life, especially for cervical kyphosis (CK). The purpose of this study was to evaluate the influence of cervical sagittal parameters on the axial neck pain (ANP) in patients with CK.Methods: A retrospective analysis was performed of data from 263 patients who underwent to the authors' department of this institution between January 2012 and December 2018. Radiographic evaluations were performed at authors' department, including CK types, C2-7 sagittal vertical axis (SVA), thoracic inlet angle (TIA), T1 slope, neck tilt (NT), cranial tilt and cervical tilt. Sagittal alignment of the cervical spine was classified into 2 types: global and regional type. Multivariate logistic regression analysis was performed to evaluate these parameters as the risk factors for ANP.Results: Patients in this study were divided into 2 groups according to ANP. There were 92 patients in ANP group and 171 patients in Non-ANP group. There was no significant difference in age (P=0.196), gender (P=0.516), TIA(P=0.139), NT (P=0.676), CK types (P=0.533), cranial tilt (P=0.332), cervical tilt (P=0.585) and cervical disc degeneration (P=0.695) between the two groups. T1 slope, C2-7 SVA in the ANP group was significantly higher than in the Non-ANP group (P < 0.05). After multivariate logistic regression analysis, C2-7 SVA (P=0.003, OR 2.318, 95% CI 1.373-4.651) and T1 slope (P=0.028, OR 2.563, 95% CI 1.186-4.669) were the two risk factors for the ANP.Conclusions: Based on this study, cervical sagittal parameters have a significant effect on the happening of axial neck pain in patients with CK. A higher T1 slope and larger C2-7 SVA are closely lead to the development of neck pain. BackgroundCervical sagittal imbalance is the one of the main reasons for decreased intervertebral disc height, further leads to the cervical degenerative disease [1, 2] . The misalignment exacerbates more distribution of the load on the intervertebral disc and posterior joints, accelerates the progression of spinal degenerative diseases during the range of motion. However, there is limited data exploring the relationship between cervical sagittal alignment and axial neck pain(ANP). JL carried out the manuscript preparation and experimental design, DZ conducted patient visits and statistical analysis of the data. JL and DZ carried out the statistical analysis of the data.YS revised the manuscript critically for important intellectual content and gave final approval of the version to be published.All authors read and approved the final version of this manuscript. Authors' information