The ratio of cervical lordosis to C7 slope represents the reciprocal change between cervical sagittal alignment and global spinal alignment

Journal of Orthopaedic Surgery and Research

Research Article

Bin Shi¹  Cheng-Xin Liu¹  Shi-Bao Lu¹  Chao Kong¹  Dong-Fan Wang¹  Xiang-Yu Li¹ 

[1] Department of Orthopedics, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Xicheng District, 100053, Beijing, China;National Clinical Research Center for Geriatric Diseases, No.45 Changchun Street, Xicheng District, Beijing, China;Beijing Clinical Research Center for Geriatric Diseases, No.45 Changchun Street, Xicheng District, Beijing, China;

关键词: Cervical alignment;    Global sagittal alignment;    Cervical spine;    Sagittal balance;   

DOI  :  10.1186/s13018-023-03602-1

 received in 2022-06-18, accepted in 2023-02-10,  发布年份 2023

来源: Springer

【 摘 要 】

PurposeThis retrospective cross-sectional study investigated variations in the ratio of cervical lordosis to C7 slope (CL/C7S) at different stages of global sagittal balance to better understand how global sagittal alignment affects cervical alignment.MethodsA total of 255 patients with the degenerative lumbar disease were retrospectively studied within a single medical center. Whole spine radiographs were used to evaluate sagittal parameters, mainly including occiput-C2 lordosis (OC2), cervical lordosis (CL), C7 slope (C7S), the ratio of cervical lordosis to C7 slope (CL/C7S), cervical sagittal vertical axis (CSVA), thoracic kyphosis (TK), lumbar lordosis (LL), pelvic tilt (PT), pelvic incidence (PI), PI minus LL mismatch (PI–LL), and sagittal vertical axis (SVA). Patients were divided into the balance group (SVA < 50 mm, PI–LL ≤ 10°), hidden imbalance group (SVA < 50 mm, PI–LL > 10°), and imbalance group (SVA > 50 mm).ResultsSignificant correlations were found between CL/C7S and OC2 (r = − 0.334), CSVA (r = − 0.504), PI–LL (r = 0.189), and SVA (r = 0.309). Multivariable linear regression analysis indicated that patients in the hidden imbalance group had lower CL/C7S than those in the balance group (B = − 0.234, P < 0.001), whereas the value of CL/C7S in patients with imbalanced sagittal alignment was higher than those with balanced alignment (B = 0.164, P = 0.011). The mean value of CL/C7S was 0.71, 0.51, and 0.97 in the balance, hidden imbalance, and imbalance groups, respectively. The global spine tended to tilt forward as the LL decreased, while TK, PT, PI–LL, and SVA increased (all, P < 0.001) from the balance stage to the imbalance stage.ConclusionsCL/C7S tended to be lower when the thoracic extension increased to maintain global sagittal balance at the hidden imbalance stage. Inversely, CL/C7S increased significantly when the global spine showed severe anterior malalignment.

【 授权许可】

CC BY   
© The Author(s) 2023

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