DOI QR코드

DOI QR Code

T1 Slope and Cervical Sagittal Alignment on Cervical CT Radiographs of Asymptomatic Persons

  • Park, Ji Hoon (Department of Neurosurgery, Hallym University College of Medicine, Hallym University Sacred Heart Hospital) ;
  • Cho, Chul Bum (Department of Neurosurgery, Hallym University College of Medicine, Hallym University Sacred Heart Hospital) ;
  • Song, Jun Ho (Department of Neurosurgery, Hallym University College of Medicine, Hallym University Sacred Heart Hospital) ;
  • Kim, Seok Woo (Department of Orthopedics, Hallym University College of Medicine, Hallym University Sacred Heart Hospital) ;
  • Ha, Yoon (Department of Neurosurgery, Yonsei University Health System) ;
  • Oh, Jae Keun (Department of Neurosurgery, Hallym University College of Medicine, Hallym University Sacred Heart Hospital)
  • Received : 2013.01.21
  • Accepted : 2013.06.19
  • Published : 2013.06.28

Abstract

Objective : We performed a retrospective analysis of medical records and radiographic images of patients who never underwent spinal treatment including diagnosis. The objective of this study is to explain the biomechanical and physiologic characteristics of cervical alignment related to thoracic inlet angle including T1 slope changes in each individual. Methods : We reviewed the cervical CT radiographs of 80 patients who visited ENT outpatient clinic without any symptom, diagnosis and treatment of cervical spine from January 2011 to September 2012. All targeted people were randomized without any prejudice. We assessed the data-T1 slope, Cobb's angle C2-7, neck tilt, sagittal vertical axis (SVA) C2-7 and thoracic inlet angle by the CT radiographs. Results : The relationships between each value were analyzed and we concluded that Cobb's angle C2-7 gets higher as the T1 slope gets higher, while the SVA C2-7 value decreases. Conclusion : We propose that the T1 slope is background information in deciding how much angle can be made in the cervical spinal angle of surgical lordotic curvature, especially severe cervical deformity.

Keywords

References

  1. Barrey C, Jund J, Noseda O, Roussouly P : Sagittal balance of the pelvis-spine complex and lumbar degenerative diseases. A comparative study about 85 cases. Eur Spine J 16 : 1459-1467, 2007 https://doi.org/10.1007/s00586-006-0294-6
  2. Berthonnaud E, Dimnet J, Roussouly P, Labelle H : Analysis of the sagittal balance of the spine and pelvis using shape and orientation parameters. J Spinal Disord Tech 18 : 40-47, 2005 https://doi.org/10.1097/01.bsd.0000117542.88865.77
  3. Boulay C, Tardieu C, Hecquet J, Benaim C, Mouilleseaux B, Marty C, et al. : Sagittal alignment of spine and pelvis regulated by pelvic incidence : standard values and prediction of lordosis. Eur Spine J 15 : 415-422, 2006 https://doi.org/10.1007/s00586-005-0984-5
  4. Ferrara LA : The biomechanics of cervical spondylosis. Adv Orthop 2012 : 493605, 2012
  5. Gelb DE, Lenke LG, Bridwell KH, Blanke K, McEnery KW : An analysis of sagittal spinal alignment in 100 asymptomatic middle and older aged volunteers. Spine (Phila Pa 1976) 20 : 1351-1358, 1995
  6. Gore DR, Sepic SB, Gardner GM : Roentgenographic findings of the cervical spine in asymptomatic people. Spine (Phila Pa 1976) 11 : 521-524, 1986 https://doi.org/10.1097/00007632-198607000-00003
  7. Hardacker JW, Shuford RF, Capicotto PN, Pryor PW : Radiographic standing cervical segmental alignment in adult volunteers without neck symptoms. Spine (Phila Pa 1976) 22 : 1472-1478; discussion 1480, 1997 https://doi.org/10.1097/00007632-199707010-00009
  8. Jang JS, Lee SH, Min JH, Kim SK, Han KM, Maeng DH : Surgical treatment of failed back surgery syndrome due to sagittal imbalance. Spine (Phila Pa 1976) 32 : 3081-3087, 2007 https://doi.org/10.1097/BRS.0b013e31815cde71
  9. Knott PT, Mardjetko SM, Techy F : The use of the T1 sagittal angle in predicting overall sagittal balance of the spine. Spine J 10 : 994-998, 2010 https://doi.org/10.1016/j.spinee.2010.08.031
  10. Kuntz C 4th, Levin LS, Ondra SL, Shaffrey CI, Morgan CJ : Neutral upright sagittal spinal alignment from the occiput to the pelvis in asymptomatic adults : a review and resynthesis of the literature. J Neurosurg Spine 6 : 104-112, 2007 https://doi.org/10.3171/spi.2007.6.2.104
  11. Lee CS, Chung SS, Kang KC, Park SJ, Shin SK : Normal patterns of sagittal alignment of the spine in young adults radiological analysis in a Korean population. Spine (Phila Pa 1976) 36 : E1648-E1654, 2011 https://doi.org/10.1097/BRS.0b013e318216b0fd
  12. Lee SH, Kim KT, Seo EM, Suk KS, Kwack YH, Son ES : The influence of thoracic inlet alignment on the craniocervical sagittal balance in asymptomatic adults. J Spinal Disord Tech 25 : E41-E47, 2012 https://doi.org/10.1097/BSD.0b013e3182396301
  13. Silber JS, Lipetz JS, Hayes VM, Lonner BS : Measurement variability in the assessment of sagittal alignment of the cervical spine : a comparison of the gore and cobb methods. J Spinal Disord Tech 17 : 301-305, 2004 https://doi.org/10.1097/01.bsd.0000095824.98982.53
  14. Vialle R, Levassor N, Rillardon L, Templier A, Skalli W, Guigui P : Radiographic analysis of the sagittal alignment and balance of the spine in asymptomatic subjects. J Bone Joint Surg Am 87 : 260-267, 2005 https://doi.org/10.2106/JBJS.D.02043

Cited by

  1. Is It Possible to Evaluate the Parameters of Cervical Sagittal Alignment on Cervical Computed Tomographic Scans? vol.39, pp.10, 2013, https://doi.org/10.1097/brs.0000000000000281
  2. Influence of cervical spine position on the radiographic parameters of the thoracic inlet alignment vol.24, pp.12, 2015, https://doi.org/10.1007/s00586-015-4023-x
  3. Analysis of Cervical Sagittal Balance Parameters in MRIs of Patients with Disc-Degenerative Disease vol.21, pp.None, 2015, https://doi.org/10.12659/msm.893715
  4. The Effect of the Pedicle-Facet Angle on Degenerative Cervical Spondylolisthesis vol.58, pp.4, 2013, https://doi.org/10.3340/jkns.2015.58.4.341
  5. T1 Slope and Degenerative Cervical Spondylolisthesis vol.40, pp.4, 2013, https://doi.org/10.1097/brs.0000000000000722
  6. Cervical Sagittal Alignment in Idiopathic Scoliosis Treated by Posterior Instrumentation and In Situ Bending vol.40, pp.7, 2013, https://doi.org/10.1097/brs.0000000000000767
  7. The Effect of Different Pillow Heights on the Parameters of Cervicothoracic Spine Segments vol.12, pp.3, 2013, https://doi.org/10.14245/kjs.2015.12.3.135
  8. Cervical Sagittal Alignment in Scheuermann Disease vol.40, pp.23, 2013, https://doi.org/10.1097/brs.0000000000001129
  9. Dimensions of the cervical neural foramen in conditions of spinal deformity: an ex vivo biomechanical investigation using specimen-specific CT imaging vol.25, pp.7, 2013, https://doi.org/10.1007/s00586-016-4409-4
  10. Analysis of cervical kyphosis and spinal balance in young idiopathic scoliosis patients classified by the apex of thoracic kyphosis vol.25, pp.10, 2016, https://doi.org/10.1007/s00586-016-4699-6
  11. Influence of T1 Slope on the Cervical Sagittal Balance in Degenerative Cervical Spine : An Analysis Using Kinematic MRI vol.41, pp.3, 2013, https://doi.org/10.1097/brs.0000000000001353
  12. Accessibility of the Cervicothoracic Junction Through an Anterior Approach: An MRI-based Algorithm vol.41, pp.1, 2013, https://doi.org/10.1097/brs.0000000000001155
  13. Analysis of Factors Associated With Sagittal Balance in Normal Asymptomatic Individuals: A Retrospective Study in a Population of East China vol.42, pp.4, 2013, https://doi.org/10.1097/brs.0000000000001782
  14. Cervical Alignment Variations in Different Postures and Predictors of Normal Cervical Kyphosis: A New Understanding vol.42, pp.21, 2017, https://doi.org/10.1097/brs.0000000000002160
  15. Kinematic analysis of the relationship between Modic changes and sagittal balance parameters in the cervical spine vol.96, pp.33, 2017, https://doi.org/10.1097/md.0000000000007699
  16. Magnetic resonance imaging : A possible alternative to a standing lateral radiograph for evaluating cervical sagittal alignment in patients with cervical disc herniation? vol.96, pp.39, 2017, https://doi.org/10.1097/md.0000000000008194
  17. Modic changes of the cervical spine: T1 slope and its impact on axial neck pain vol.10, pp.None, 2013, https://doi.org/10.2147/jpr.s144814
  18. Cervical Spine Deformity-Part 1: Biomechanics, Radiographic Parameters, and Classification vol.81, pp.2, 2013, https://doi.org/10.1093/neuros/nyx249
  19. Risk Factors for Cervical Sagittal Malalignment after Cervical Laminoplasty vol.3, pp.2, 2013, https://doi.org/10.21129/nerve.2017.3.2.38
  20. Cervical kyphosis in patients with Lenke type 1 adolescent idiopathic scoliosis: the prediction of thoracic inlet angle vol.18, pp.None, 2013, https://doi.org/10.1186/s12891-017-1590-5
  21. K-line tilt as a novel radiographic parameter in cervical sagittal alignment vol.27, pp.8, 2018, https://doi.org/10.1007/s00586-018-5634-9
  22. Are There Age- and Sex-related Differences in Spinal Sagittal Alignment and Balance Among Taiwanese Asymptomatic Adults? vol.476, pp.5, 2018, https://doi.org/10.1007/s11999.0000000000000140
  23. Thoracic Inlet Parameters for Degenerative Cervical Spondylolisthesis Imaging Measurement vol.24, pp.None, 2013, https://doi.org/10.12659/msm.907073
  24. Cervical sagittal balance parameters after single-level anterior cervical discectomy and fusion: Correlations with clinical and functional outcomes vol.9, pp.1, 2013, https://doi.org/10.4103/jcvjs.jcvjs_9_18
  25. Can C7 Slope Substitute the T1 slope?: An Analysis Using Cervical Radiographs and Kinematic MRIs vol.43, pp.7, 2013, https://doi.org/10.1097/brs.0000000000002371
  26. MRI kinematic analysis of T1 sagittal motion between cervical flexion and extension positions in 145 patients vol.27, pp.5, 2013, https://doi.org/10.1007/s00586-017-5385-z
  27. Surgical Treatment of Cervical Spondylotic Myelopathy in the Elderly: Outcomes in Patients Aged 80 Years or Older vol.43, pp.24, 2018, https://doi.org/10.1097/brs.0000000000002751
  28. Correlation of cervical and thoracic inlet sagittal parameters by MRI and radiography in patients with cervical spondylosis vol.98, pp.7, 2013, https://doi.org/10.1097/md.0000000000014393
  29. Anterior cervical corpectomy and fusion : Spinal cord compression caused by buckled ligamentum flavum vol.48, pp.2, 2013, https://doi.org/10.1007/s00132-018-3633-5
  30. Age-related Changes in Cervical Sagittal Alignment : A Radiographic Analysis vol.44, pp.19, 2013, https://doi.org/10.1097/brs.0000000000003082
  31. 목 안정화 운동이 경추성두통 환자의 근육특성과 근활성도 및 자세에 미치는 영향 vol.7, pp.4, 2019, https://doi.org/10.15268/ksim.2019.7.4.301
  32. The Importance of C2 Slope, a Singular Marker of Cervical Deformity, Correlates With Patient-reported Outcomes vol.45, pp.3, 2013, https://doi.org/10.1097/brs.0000000000003214
  33. Can C7 Slope Be Used as a Substitute for T1 Slope? A Radiographic Analysis vol.10, pp.2, 2020, https://doi.org/10.1177/2192568219846909
  34. Association of cervical sagittal alignment with adjacent segment degeneration and heterotopic ossification following cervical disc replacement with Prestige-LP disc vol.28, pp.3, 2013, https://doi.org/10.1177/2309499020968295
  35. The effect of posterior tethers on the biomechanics of proximal junctional kyphosis: The whole human finite element model analysis vol.10, pp.None, 2020, https://doi.org/10.1038/s41598-020-59179-w
  36. Understanding “Kyphosis” and “Lordosis” for Sagittal Balancing in Two Common Standing Postures vol.46, pp.23, 2013, https://doi.org/10.1097/brs.0000000000004106
  37. Cervical spine lateral radiograph versus whole spine lateral radiograph : A retrospective comparative study to identify a better modality to assess cervical sagittal alignment vol.100, pp.21, 2013, https://doi.org/10.1097/md.0000000000025987
  38. Degenerative Cervical Myelopathy: Insights into Its Pathobiology and Molecular Mechanisms vol.10, pp.6, 2013, https://doi.org/10.3390/jcm10061214
  39. The Changes in Cervical Biomechanics After CTDR and Its Association With Heterotopic Ossification: A Systematic Review and Meta-analysis vol.11, pp.4, 2013, https://doi.org/10.1177/2192568220922949
  40. Spino Cranial Angle and Degenerative Cervical Spondylolisthesis vol.151, pp.None, 2013, https://doi.org/10.1016/j.wneu.2021.04.071
  41. Physiologic Cervical Alignment Change between Cervical Spine X-ray and Computed Tomography vol.64, pp.5, 2021, https://doi.org/10.3340/jkns.2020.0320
  42. Diagnostic Accuracy of Magnetic Resonance Imaging for Sagittal Cervical Spine Alignment: A Retrospective Cohort Study vol.18, pp.24, 2021, https://doi.org/10.3390/ijerph182413033