Comparison of Cervical Sagittal Parameters among Patients with Neck Pain and Patients with Cervical Spondylotic Radiculopathy and Cervical Spondylotic Myelopathy

Tao Liu, Shuo Tian, Jianzhou Zhang, Mengzi He, Longlian Deng, Wenyuan Ding, Zheng Wang, Dalong Yang

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Orthopaedic Surgery ›› 2024, Vol. 16 ›› Issue (2) : 329-336. DOI: 10.1111/os.13951
CLINICAL ARTICLE

Comparison of Cervical Sagittal Parameters among Patients with Neck Pain and Patients with Cervical Spondylotic Radiculopathy and Cervical Spondylotic Myelopathy

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Abstract

Objective:: Previous studies have shown that cervical sagittal alignment is strongly associated with cervical deformity, myelopathy, and cervical adjacent-segmental disease, and these cervical sagittal parameters are correlated with health-related quality of life. However, less attention has been paid to cervical sagittal balance in various cervical disorders. This study aimed to compare cervical sagittal parameters between patients with nonspecific neck pain (NS-NP) and patients with cervical spondylotic radiculopathy (CSR) and cervical spondylotic myelopathy (CSM).

Methods:: We retrospectively examined 236 patients from between January 2020 and October 2022. We divided them into three groups (NS-NP, CSR, and CSM) and collected general information and cervical sagittal parameters for these patients. The variation of parameters between the size of these parameters and gender differences was analyzed. Pearson's or Spearman's correlation was applied to analyze the association of cervical sagittal parameters of all patients between the three groups.

Results:: There were significant differences in age and sex among the three groups (p < 0.001), with the NS-NP group being the youngest and NS-NP being more common in women. The parameters of cervical sagittal position significantly differed among the three groups (p < 0.05). Pearson's or Spearman's correlation result showed that the C2–C7 Cobb angle was negatively associated with the C2–C7 sagittal vertical angle (SVA), and the C2–C7 Cobb angle and T1 slope (T1s) were negatively associated with the spino-cranial angle (SCA). There was a positive correlation between the C2–C7 Cobb angle and C7 slope (C7s), C2–C7 SVA and T1s, C2–C7 SVA and SCA, and C7s and T1s.

Conclusion:: This study showed that between the three groups, patients with nonspecific neck pain had smaller SCA, and among patients with NS-NP, women had more significant SCA. The smaller anteroposterior diameter of the thorax in women might explain this difference.

Keywords

Cervical Sagittal Parameters / Cervical Spondylotic Myelopathy / Cervical Spondylotic Radiculopathy / Nonspecific Neck Pain

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Tao Liu, Shuo Tian, Jianzhou Zhang, Mengzi He, Longlian Deng, Wenyuan Ding, Zheng Wang, Dalong Yang. Comparison of Cervical Sagittal Parameters among Patients with Neck Pain and Patients with Cervical Spondylotic Radiculopathy and Cervical Spondylotic Myelopathy. Orthopaedic Surgery, 2024, 16(2): 329‒336 https://doi.org/10.1111/os.13951

References

[1]
Cohen SP, Hooten WM. Advances in the diagnosis and management of neck pain. BMJ. 2017;358:j3221.
CrossRef Google scholar
[2]
Ling FP, Chevillotte T, Leglise A, Thompson W, Bouthors C, Le Huec J. Which parameters are relevant in sagittal balance analysis of the cervical spine? A literature review. Eur Spine J. 2018;27:8–15.
CrossRef Google scholar
[3]
Scheer JK, Tang JA, Smith JS, Acosta FL, Protopsaltis TS, Blondel B, et al. Cervical spine alignment, sagittal deformity, and clinical implications: a review. J Neurosurg Spine. 2013;19:141–159.
CrossRef Google scholar
[4]
Lee SH, Hyun SJ, Jain A. Cervical sagittal alignment: literature review and future directions. Neurospine. 2020;17:478–496.
CrossRef Google scholar
[5]
Kaka B, Ogwumike OO, Adeniyi AF, Maharaj SS, Ogunlade SO, Bello B. Effectiveness of neck stabilisation and dynamic exercises on pain intensity, depression and anxiety among patients with non-specific neck pain: a randomised controlled trial. Scand J Pain. 2018;18:321–331.
CrossRef Google scholar
[6]
Ortego G, Lluch E, Herrero P, Boudreau SA, Domenech-Garcia V. Profiling and association over time between disability and pain features in patients with chronic nonspecific neck pain: a longitudinal study. J Clin Med. 2022;11(5):1346.
CrossRef Google scholar
[7]
Gore DR. Roentgenographic findings in the cervical spine in asymptomatic persons: a ten-year follow-up. Spine. 2001;26(22):2463–2466.
CrossRef Google scholar
[8]
Moon BJ, Choi KH, Yun C, Ha Y. Cross-sectional study of neck pain and cervical sagittal alignment in air force pilots. Aerosp Med Hum Perform. 2015;86:445–451.
CrossRef Google scholar
[9]
Jouibari MF, Le Huec JC, Ranjbar HM, et al. Comparison of cervical sagittal parameters among patients with neck pain and healthy controls: a comparative cross-sectional study. Eur Spine J. 2019;28:2319–2324.
CrossRef Google scholar
[10]
Grob D, Frauenfelder H, Mannion AF. The association between cervical spine curvature and neck pain. Eur Spine J. 2007;16:669–678.
CrossRef Google scholar
[11]
Kim JH, Kim JH, Kim JH, Kwon TH, Park YK, Moon HJ. The relationship between neck pain and cervical alignment in young female nursing staff. J Korean Neurosurg Soc. 2015;58:231–235.
CrossRef Google scholar
[12]
Fujiwara H, Oda T, Makino T, Moriguchi Y, Yonenobu K, Kaito T. Impact of cervical sagittal alignment on axial neck pain and health-related quality of life after cervical laminoplasty in patients with cervical spondylotic myelopathy or ossification of the posterior longitudinal ligament: a prospective comparative study. Clin Spine Surg. 2018;31:E245–E251.
CrossRef Google scholar
[13]
Le Huec JC, Saddiki R, Franke J, Rigal J, Aunoble S. Equilibrium of the human body and the gravity line: the basics. Eur Spine J. 2011;20:558–563.
CrossRef Google scholar
[14]
Wang Z, Wang Z, Fan X, Gao X, Ding W, Yang D. Assessment of spino cranial angle of cervical spine sagittal balance system after multi-level anterior cervical discectomy and fusion. J Orthop Surg Res. 2021;16:194.
CrossRef Google scholar
[15]
Wang Z, Wang Z, Fan X, et al. Influence of SCA on clinical outcomes and cervical alignment after laminoplasty in patients with multilevel cervical spondylotic myelopathy. J Orthop Surg Res. 2021;16:49.
CrossRef Google scholar
[16]
Wang Z, Xu J, Liu Z, Wang Z, Ding W, Yang D. Spino cranial angle and degenerative cervical spondylolisthesis. World Neurosurg. 2021;151:e517–e522.
CrossRef Google scholar
[17]
Wang Z, Xu J, Liu Z, et al. Spino cranial angle as a predictor of loss of cervical lordosis after laminoplasty in patients with cervical myelopathy. BMC Surg. 2021;21:291.
CrossRef Google scholar
[18]
Xing R, Liu W, Li X, Jiang L, Yishakea M, Dong J. Characteristics of cervical sagittal parameters in healthy cervical spine adults and patients with cervical disc degeneration. BMC Musculoskelet Disord. 2018;19:37.
CrossRef Google scholar
[19]
Iyer S, Nemani VM, Nguyen J, Elysee J, Burapachaisri A, Ames CP, et al. Impact of cervical sagittal alignment parameters on neck disability. Spine. 2016;41(5):371–377.
CrossRef Google scholar
[20]
Johnston V, Jull G, Souvlis T, Jimmieson NL. Neck movement and muscle activity characteristics in female office workers with neck pain. Spine. 2008;33(5):555–563.
CrossRef Google scholar
[21]
Tsunoda D, Iizuka Y, Iizuka H, Nishinome M, Kobayashi R, Ara T, et al. Associations between neck and shoulder pain (called katakori in Japanese) and sagittal spinal alignment parameters among the general population. J Orthop Sci. 2013;18:216–219.
CrossRef Google scholar
[22]
Kumagai G, Ono A, Numasawa T, Wada K, Inoue R, Iwasaki H, et al. Association between roentgenographic findings of the cervical spine and neck symptoms in a Japanese community population. J Orthop Sci. 2014;19:390–397.
CrossRef Google scholar
[23]
Seong HY, Lee MK, Jeon SR, Roh SW, Rhim SC, Park JH. Prognostic factor analysis for Management of Chronic Neck Pain: can we predict the severity of neck pain with lateral cervical curvature? J Korean Neurosurg Soc. 2017;60:456–464.
CrossRef Google scholar
[24]
Guo GM, Li J, Diao QX, Zhu TH, Song ZX, Guo YY, et al. Cervical lordosis in asymptomatic individuals: a meta-analysis. J Orthop Surg Res. 2018;13:147.
CrossRef Google scholar
[25]
Ferrara LA. The biomechanics of cervical spondylosis. Adv Orthop. 2012;2012:493605.
CrossRef Google scholar
[26]
Le Huec JC, Thompson W, Mohsinaly Y, Barrey C, Faundez A. Sagittal balance of the spine. Eur Spine J. 2019;28:1889–1905.
CrossRef Google scholar
[27]
Inoue T, Ando K, Kobayashi K, Nakashima H, Ito K, Katayama Y, et al. Age-related changes in T1 and C7 slope and the correlation between them in more than 300 asymptomatic subjects. Spine. 2021;46(8):E474–E481.
CrossRef Google scholar
[28]
Weng C, Wang J, Tuchman A, Wang J, Fu C, Hsieh PC, et al. Influence of T1 slope on the cervical sagittal balance in degenerative cervical spine. Spine. 2016;41(3):185–190.
CrossRef Google scholar
[29]
Zhu Y, Zhang X, Fan Y, Zhou Z, Gu G, Wang C, et al. Sagittal alignment of the cervical spine: radiographic analysis of 111 asymptomatic adolescents, a retrospective observational study. BMC Musculoskelet Disord. 2022;23(1):840.
CrossRef Google scholar
[30]
Hey H, Tan KA, Chin BZ, Liu G, Wong HK. Comparison of whole body sagittal alignment during directed vs natural, relaxed standing postures in young, healthy adults. Spine J. 2019;19:1832–1839.
CrossRef Google scholar
[31]
Iorio J, Lafage V, Lafage R, Henry JK, Stein D, Lenke LG, et al. The effect of aging on cervical parameters in a normative north American population. Global Spine J. 2018;8:709–715.
CrossRef Google scholar
[32]
Xu Y, Liu S, Wang F, Wu X. Cervical sagittal parameters were closely related to neck disability index score after anterior cervical decompression and fusion. J Orthop Surg Res. 2020;15(1):325.
CrossRef Google scholar
[33]
Kim B, Cho S, Hur JW, Cha J, Kim S. Kinematics after cervical laminoplasty: risk factors for cervical kyphotic deformity after laminoplasty. Spine J. 2021;21:1822–1829.
CrossRef Google scholar
[34]
Xu C, Zhang Y, Dong M, Wu H, Yu W, Tian Y, et al. The relationship between preoperative cervical sagittal balance and clinical outcome of laminoplasty treated cervical ossification of the posterior longitudinal ligament patients. Spine J. 2020;20:1422–1429.
CrossRef Google scholar
[35]
Lee JH, Park YK, Kim JH. Chronic neck pain in young adults: perspectives on anatomic differences. Spine J. 2014;14:2628–2638.
CrossRef Google scholar

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