The most appropriate cervical vertebra for the measurement of occipitocervical inclination parameter: a validation study of C3, C4, and C5 levels using multi-positional magnetic resonance imaging

European spine journal

article

Permsak Paholpak¹  Blake Formanek¹  Andrew Vega¹  Koji Tamai¹  Zorica Buser¹  Jeffrey C. Wang¹ 

[1] Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California;Department of Orthopaedics, Faculty of Medicine, Khon Kaen University;Department of Orthopaedics, Faculty of Medicine, Osaka City University

关键词: Occipitocervical;    Occipitocervical alignment;    Occipitocervical parameters;    Occipitocervical inclination;    Occipitocervical angle;   

DOI  :  10.1007/s00586-019-06028-8

来源: Springer

【 摘 要 】

To evaluate which cervical level is the most appropriate level to measure occipitocervical inclination (OCI). Sixty-two patients with multi-positional MRI: 24 males and 38 females, who had cervical lordosis and had a disk degeneration grade of 3 or less were included. We measured patient’s OCI at C3, C4, and C5, occipitocervical angle (OCA), occipitocervical distance (OCD), C2–7 angle, and cervical sagittal vertical axis (cSVA) in neutral, flexion, and extension position. The correlation between OCI and OCA, OCD, C2–7 angle, and cSVA on each cervical level in all three positions was tested using Pearson’s correlation coefficient test. The difference between OCIs at each cervical level was tested by Wilcoxon signed-rank test. p value of less than 0.05 was set as a statistically significant level. C5 OCI showed statistically significant correlation with OCA, OCD, C2–7 angle, and cSVA in all three positions (p < 0.05, r = 0.214–0.525). C3 OCI in flexion (p = 0.393, r = 0.081) and C4 OCI in neutral and flexion (neutral p = 0.275, r 0.104; flexion p = 0.987, r = 0.002) did not show significant correlation with C2–7 angle. There was a statistically significant difference between C3, C4, and C5 OCIs in neutral and extension position (p < 0.05). At the same time, OCI showed statistically strong correlation between adjacent cervical levels (p < 0.001, r = 0.627–0.822). C5 cervical level is the most appropriate level for OCI measurement. OCI should be measured at the same cervical level at all time. C4 OCI can reliably substitute C5 OCI in case C5 which is invisible on radiographic image. These slides can be retrieved under Electronic Supplementary Material.

【 授权许可】

Unknown