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Huang T, Zhang C, Han Z, Zhong W, Zhao Z, Zhu Y, Luo X, Zhang J. A novel rapid measurement method of cervical sagittal parameters based on the integrated inclinometer of a smartphone: a validity and reliability study. Ann Med 2023; 55:2289590. [PMID: 38065682 PMCID: PMC10836295 DOI: 10.1080/07853890.2023.2289590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 11/26/2023] [Indexed: 12/18/2023] Open
Abstract
Objectives: A new method was introduced using a smartphone's integrated inclinometer for rapid measurement of sagittal cervical parameters. The present study aims to compare the validity and reliability of the proposed method.Methods: We retrospectively reviewed 120 patients with cervical spondylosis treated at our hospital. The C0-2 Cobb angle, C2-7 Cobb angle, T1-slope (T1S), and neck tilt (NT) were selected as representative sagittal angles for this study. Two methods, the smartphone's integrated inclinometer and picture archiving and communication system (PACS), were used to measure these four representative angles. Validity, reliability, and measurement times were recorded and compared.Results: The representative parameters (C0-2 Cobb angle, C2-7 Cobb angle, T1S, and NT), the ICC was 0.957 (0.939-0.970), 0.971 (0.958-0.979), 0.974 (0.963-0.982) and 0.949 (0.927-0.964) for validity respectively. For the aforementioned representative parameters, the ICC values were 0.972 (0.960-0.980), 0.979 (0.969-0.985), 0.972 (0.959-0.980), 0.942 (0.917-0.959) for intraobserver reliability respectively. For the representative parameters mentioned above, the ICC values were 0.947 (0.926-0.963), 0.964 (0.949-0.975), 0.956 (0.938-0.969), 0.916 (0.881-0.940) for interobserver reliability respectively. For the validity of the representative parameters mentioned above, the Bland-Altman plot displayed a mean difference of 0.2, 0.1, 0.1, and 0.4°with a 95% CI of 4.3, 4.5, 3.4, and 4.1°, respectively. The measurement by smartphone's integrated inclinometer (46.31 ± 3.99 s) was significantly quicker than that by PACS (69.48 ± 3.25 s) according to independent-samples T test (p < 0.001).Conclusion: This novel smartphone measurement based on the integrated inclinometer is accurate and reliable for measuring cervical sagittal parameters rapidly and conveniently.
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Affiliation(s)
- Tianji Huang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Orthopedic Laboratory of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Chunyang Zhang
- Department of Orthopedic Surgery, People’s Hospital of Chongqing Banan District, Chongqing, People’s Republic of China
| | - Zhenghan Han
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Orthopedic Laboratory of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Weiyang Zhong
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Orthopedic Laboratory of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Zenghui Zhao
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Orthopedic Laboratory of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Yong Zhu
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Orthopedic Laboratory of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Xiaoji Luo
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Orthopedic Laboratory of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Jie Zhang
- Department of Oncology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
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Sun Y, Ma H, Zhang Z, Tan M. Posterior hybrid surgery for atlantoaxial dislocation coexisting with multilevel cervical spondylotic myelopathy. Front Surg 2023; 10:1164298. [PMID: 37334204 PMCID: PMC10272512 DOI: 10.3389/fsurg.2023.1164298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 05/22/2023] [Indexed: 06/20/2023] Open
Abstract
Background To introduce a hybrid surgery of posterior craniovertebral fusion plus subaxial laminoplasty for atlantoaxial dislocation (AAD) coexisting with multilevel cervical spondylotic myelopathy (CSM). Methods A retrospective study was performed by reviewing data from 23 patients with the coexistence of AAD and CSM who underwent the hybrid technique (n = 23). Clinical outcomes, including visual analogue scale (VAS), Japanese Orthopaedic Association (JOA), and neck disability index (NDI) score, and radiological cervical alignment parameters including C0-2 and C2-7 Cobb angle and range of motion (ROM) were analyzed. The operation time, blood loss, surgical levels, and complications were recorded. Results The included patients were followed up with an average of 20.91 months (range, 12-36 months). Clinical outcomes including JOA, NDI, and VAS scores were significantly improved at different postoperative follow-up points. C0-2 Cobb angle, C2-7 Cobb angle, and ROM showed a stable tendency after 1-year follow-up. No major perioperative complications occurred. Conclusion This study underlined the importance of pathologic condition of AAD coexisting with CSM and presented a novel hybrid approach of posterior craniovertebral fusion plus subaxial laminoplasty. This hybrid surgery was effective in achieving the desired clinical outcomes and better maintaining cervical alignment, proving its value and safety as an alternative technique.
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Affiliation(s)
- Yan Sun
- Department of Orthopaedic Surgery, Guang’an Men Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- College of Basic Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Haoning Ma
- Department of Orthopaedic Surgery, China-Japan Friendship Hospital, Beijing, China
| | - Zhihai Zhang
- Department of Orthopaedic Surgery, Guang’an Men Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Mingsheng Tan
- College of Basic Medicine, Beijing University of Chinese Medicine, Beijing, China
- Department of Orthopaedic Surgery, China-Japan Friendship Hospital, Beijing, China
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Zhou X, Xia B, Chen F, Zhu J, Lu X, Ni B, Guo Q. C2 Dome-Like Expansive Laminoplasty Versus C2 Open-Door Laminoplasty for Treating Multilevel Cervical Ossification of the Posterior Longitudinal Ligament Involving C2. Oper Neurosurg (Hagerstown) 2023; 24:168-174. [PMID: 36637301 DOI: 10.1227/ons.0000000000000485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/06/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND There are controversies over the treatment of cervical ossification of the posterior longitudinal ligament (OPLL) involving C2. OBJECTIVE To compare the outcomes of C2 dome-like expansive laminoplasty (C2DL) and C2 open-door laminoplasty (C2OL) for treating cervical OPLL involving C2. METHODS The data of 36 patients undergoing C2OL and 40 patients treated with C2DL because of cervical OPLL involving C2 were retrospectively analyzed. The functional outcomes of the Japanese Orthopedic Association score, Neck Disability Index, 36-Item Short Form Health Survey score, and visual analog scale score for neck pain were compared between the 2 groups. The C2-C7 Cobb angle, cervical range of motion (ROM), and space available for the spinal cord at C2 were measured. RESULTS At the final follow-up, the Japanese Orthopedic Association score, Neck Disability Index, and 36-Item Short Form Health Survey score significantly improved in both groups (all P < .05), but with no significant intergroup differences (all P > .05). The visual analog scale score for neck pain reduced significantly in both groups (P < .05), but the patients in the C2OL group experienced more severe neck axial pain (P < .05). The C2-C7 Cobb angle and cervical ROM reduced greatly in both groups (P < .05), but those in the C2OL group decreased more (P < .05). The spinal cord at C2 significantly improved in both groups (P < .05), with no significant intergroup differences (P > .05). CONCLUSION C2DL was superior to C2OL in maintaining the cervical alignment and ROM and reducing neck axial pain for treating OPLL involving C2.
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Affiliation(s)
- Xin Zhou
- Department of Orthopedics, Changzheng Hospital, Naval Medical University, Shanghai, People's Republic of China
| | - Bo Xia
- Department of Emergency Trauma Surgery, Jining No. 1 People's Hospital, Jining, Shandong, People's Republic of China
| | - Fei Chen
- Department of Orthopedics, Changzheng Hospital, Naval Medical University, Shanghai, People's Republic of China
| | - Jingyu Zhu
- Department of Orthopedics, Changzheng Hospital, Naval Medical University, Shanghai, People's Republic of China
| | - Xuhua Lu
- Department of Orthopedics, Changzheng Hospital, Naval Medical University, Shanghai, People's Republic of China
| | - Bin Ni
- Department of Orthopedics, Changzheng Hospital, Naval Medical University, Shanghai, People's Republic of China
| | - Qunfeng Guo
- Department of Orthopedics, Changzheng Hospital, Naval Medical University, Shanghai, People's Republic of China
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Wang W, Xue C, Ma X, Feng H, Ma Z, Guan X, Chen X, Zhang X. Extension of decompression to C2 doesn't affect the spinal sagittal parameters compared with standard open-door laminoplasty. Medicine (Baltimore) 2022; 101:e32532. [PMID: 36595870 PMCID: PMC9794331 DOI: 10.1097/md.0000000000032532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
We modified and extended laminoplasty to the upper cervical spine on patients with canal stenosis associated with upper cervical spinal ossified lesions. However, whether the extended decompression range of laminoplasty can cause further effects on cervical stability is rarely studied at present. A retrospective study to analyze the relationship between the surgical levels and cervical sagittal parameters effects was performed in patients with cervical spondylosis myelopathy who had undergone posterior cervical expansive open-door laminoplasty with/without extending to C2. In total, 64 patients were divided into 2 groups according to the surgical levels. Radiologic outcomes of occipito-cervical angle (C0-2 Cobb angle), CL C27 Cobb angle, cervical sagittal vertical alignment, T1-Slope (T1S), T1S minus CL (T1S-CL), spino-cranial angle and center of the sella turcica-C7 SVA (St-SVA) were evaluated on lateral X-rays of the cervical spine at pre-operation, post-operation, and 2-year follow-up. The patient's health-related quality of life was obtained including neck disability index, Japanese orthopaedic association scores, and visual analog scale. Changes in sagittal parameters were observed in both groups after surgery. T1S, cervical sagittal vertical alignment, and T1S-CL significantly increased and CL decreased in 2 groups of patients postoperative. After a 2-year follow-up period, the C0-2 Cobb angle was found to increase compared to preoperative records. In addition, there were no significant differences in spino-cranial angle and st-SVA between preoperative and 2 years follow-up measurements. Health-related quality of life was improved in both groups and was not significantly different. Herein, the parameters indicated a tilting forward of the lower cervical spine and a more lordotic upper cervical spine to maintain a horizontal gaze in patients. However, C2 to 7 laminoplasty was performed to achieve satisfactory clinical results without significantly changing the spinal sagittal parameters.
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Affiliation(s)
- Wenxuan Wang
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
| | - Chenhui Xue
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
| | - Xun Ma
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
- Department of Orthopedics, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
- * Correspondence: Xun Ma, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, China (e-mail: )
| | - Haoyu Feng
- Department of Orthopedics, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Zhuo Ma
- Department of Orthopedics, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Xiaoming Guan
- Department of Orthopedics, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Xu Chen
- Department of Orthopedics, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Xin Zhang
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
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Zhang J, Zhang C, Zhong W, Zhao Z, Han F, Han Z, Zhang H, Huang T, Luo X. Validity and reliability of a novel iPhone method to rapidly measure cervical sagittal parameters. Sci Rep 2022; 12:19579. [PMID: 36380107 PMCID: PMC9666521 DOI: 10.1038/s41598-022-21660-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 09/29/2022] [Indexed: 11/16/2022] Open
Abstract
We introduced a novel method based on the iPhone's intrinsic photo edit function to measure sagittal parameters of the cervical spine. This study aimed to assess the validity of this new method compared with the picture archiving and communication system (PACS) method (the gold standard) and to test the reliability of this novel technique. One hundred consecutive patients admitted to our hospital diagnosed with cervical spondylotic myelopathy or cervical spondylotic radiculopathy were retrospectively reviewed. Four angles, including the C0-2 Cobb angle, C2-7 Cobb angle, T1S and neck tilt (NT), were assessed by iPhone and PACS. The validity and reliability were evaluated, and the time taken by both methods was compared. The ICCs of the validity of the C0-2 Cobb angle, C2-7 Cobb angle, T1S and NT were 0.960, 0.976, 0.980 and 0.946, respectively. The ICCs of the intraobserver reliability of the C0-2 Cobb angle, C2-7 Cobb angle, T1S and NT were 0.966, 0.983, 0.971 and 0.951, respectively. The ICCs of the interobserver reliability of the C0-2 Cobb angle, C2-7 Cobb angle, T1S and NT were 0.953, 0.972, 0.957 and 0.929, respectively. The Bland‒Altman plot of validity of the four angles revealed mean differences of 0.3, 0.2, 0.1, and 0.1 degrees with 95% CIs of 4.1, 4.1, 2.9, and 4.3 degrees, respectively. The iPhone measurement time (58.55 ± 4.17 s) was significantly less than that by the PACS (70.40 ± 2.92 s) when compared by the independent-samples T test (P < 0.001). This novel method using the iPhone's intrinsic photo edit function is accurate, reliable, fast and convenient when measuring cervical sagittal parameters.
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Affiliation(s)
- Jie Zhang
- grid.452206.70000 0004 1758 417XDepartment of Oncology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016 People’s Republic of China
| | - Chunyang Zhang
- Department of Orthopedic Surgery, People’s Hospital of Chongqing Banan District, Chongqing, 401320 People’s Republic of China
| | - Weiyang Zhong
- grid.452206.70000 0004 1758 417XDepartment of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016 People’s Republic of China ,grid.203458.80000 0000 8653 0555Orthopedic Laboratory of Chongqing Medical University, Chongqing, 400016 People’s Republic of China
| | - Zenghui Zhao
- grid.452206.70000 0004 1758 417XDepartment of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016 People’s Republic of China ,grid.203458.80000 0000 8653 0555Orthopedic Laboratory of Chongqing Medical University, Chongqing, 400016 People’s Republic of China
| | - Fei Han
- grid.452206.70000 0004 1758 417XDepartment of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016 People’s Republic of China ,grid.203458.80000 0000 8653 0555Orthopedic Laboratory of Chongqing Medical University, Chongqing, 400016 People’s Republic of China
| | - Zhenghan Han
- grid.452206.70000 0004 1758 417XDepartment of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016 People’s Republic of China ,grid.203458.80000 0000 8653 0555Orthopedic Laboratory of Chongqing Medical University, Chongqing, 400016 People’s Republic of China
| | - Hang Zhang
- grid.452206.70000 0004 1758 417XDepartment of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016 People’s Republic of China ,grid.203458.80000 0000 8653 0555Orthopedic Laboratory of Chongqing Medical University, Chongqing, 400016 People’s Republic of China
| | - Tianji Huang
- grid.452206.70000 0004 1758 417XDepartment of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016 People’s Republic of China ,grid.203458.80000 0000 8653 0555Orthopedic Laboratory of Chongqing Medical University, Chongqing, 400016 People’s Republic of China
| | - Xiaoji Luo
- grid.452206.70000 0004 1758 417XDepartment of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016 People’s Republic of China ,grid.203458.80000 0000 8653 0555Orthopedic Laboratory of Chongqing Medical University, Chongqing, 400016 People’s Republic of China
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Asif H, Tohidi M, Hopman W, Yen D. Association between pre-operative sagittal alignment and radiographic measures of decompression following cervical laminectomy: a retrospective cohort study. JOURNAL OF SPINE SURGERY 2021; 7:376-384. [PMID: 34734142 DOI: 10.21037/jss-21-41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 08/06/2021] [Indexed: 11/06/2022]
Abstract
Background The primary purpose of this study was to determine the association between pre-operative cervical sagittal alignment and the extent of cord decompression in the form of increased spinal cord width and cerebrospinal fluid (CSF) space in front of and behind the cord in patients undergoing laminectomy for cervical spondylotic myelopathy (CSM). Secondary objectives included an assessment of the correlation between increasing numbers of levels decompressed and the post-operative cervical spine sagittal alignment, the effect of laminectomy on the change in alignment, as well as effect of laminectomy on pre-existing spinal cord signal abnormality. Methods This retrospective cohort study included patients who underwent cervical laminectomies, without fusion, between 2015 and 2020. Chart review was used to collect baseline variables. Cervical sagittal alignment, width of the spinal cord, and the CSF space in-front and behind the cord was measured pre-operatively and post-operatively using magnetic resonance imaging (MRI) scans for each patient. The correlation between change in measured parameters and pre-operative cervical sagittal alignment was assessed using Spearman's correlation. Results Thirty-five patients were included. Average age was 65.29±10.98 years old. The majority of patients (80%) underwent laminectomies at 3-4 levels. Average pre-operative sagittal alignment determined by the Cobb angle was 6.05°±14.17°, while the average post-operative Cobb angle was 3.15°±16.64°. The change in Cobb angle was not statistically significant (P=0.998). Eleven patients (32%) had pre-operative kyphotic sagittal alignment. The average time from surgery to post-operative MRI scan was 20.44±13.18 months (range, 3-39; median, 18.5; IQR, 23.5). There was no statistically significant association between increasing levels of decompression and change in alignment (P=0.546). Cord signal abnormality persisted after decompression. There was a moderate correlation between lordotic pre-operative cervical sagittal alignment and change in space in-front of the cord (correlation coefficient 0.337, P=0.048) and change in cord width (correlation coefficient 0.388, P=0.021). Conclusions Severity of pre-operative kyphotic sagittal alignment is associated with decreased spinal cord drift and extent of decompression. The pre-operative sagittal alignment is not significantly associated with the change in post-operative alignment. Increasing number of levels decompressed does not worsen a kyphotic cervical spine sagittal alignment.
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Affiliation(s)
- Hamza Asif
- Department of Surgery, Queen's University, Kingston, ON, Canada.,School of Medicine, Queen's University, Kingston, ON, Canada
| | - Mina Tohidi
- Department of Surgery, Queen's University, Kingston, ON, Canada.,Kingston Health Sciences Centre, Kingston, ON, Canada
| | - Wilma Hopman
- Department of Surgery, Queen's University, Kingston, ON, Canada.,Kingston Health Sciences Centre, Kingston, ON, Canada
| | - David Yen
- Department of Surgery, Queen's University, Kingston, ON, Canada.,Kingston Health Sciences Centre, Kingston, ON, Canada
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Sagittal balance of the cervical spine: a systematic review and meta-analysis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 30:1411-1439. [PMID: 33772659 DOI: 10.1007/s00586-021-06825-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 09/26/2020] [Accepted: 03/20/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The purpose of this systematic review and meta-analysis was to compare the cervical sagittal parameters between patients with cervical spine disorder and asymptomatic controls. METHODS Two independent authors systematically searched online databases including Pubmed, Scopus, Cochrane library, and Web of Science up to June 2020. Cervical sagittal balance parameters, such as T1 slope, cervical SVA (cSVA), and spine cranial angle (SCA), were compared between the cervical spine in healthy, symptomatic, and pre-operative participants. Where possible, we pooled data using random-effects meta-analysis, by CMA software. Heterogeneity and publication bias were assessed using the I-squared statistic and funnel plots, respectively. RESULTS A total of 102 studies, comprising 13,802 cases (52.7% female), were included in this meta-analysis. We used the Newcastle-Ottawa Scale (NOS) to evaluate the quality of studies included in this review. Funnel plot and Begg's test did not indicate obvious publication bias. The pooled analysis reveals that the mean (SD) values were: T1 slope (degree), 24.5 (0.98), 25.7 (0.99), 25.4 (0.34); cSVA (mm), 18.7 (1.76), 22.7 (0.66), 22.4 (0.68) for healthy population, symptomatic, and pre-operative assessment, respectively. The mean value of the SCA (degree) was 79.5 (3.55) and 75.6 (10.3) for healthy and symptomatic groups, respectively. Statistical differences were observed between the groups (all P values < 0.001). CONCLUSION The findings showed that the T1 slope and the cSVA were significantly lower among patients with cervical spine disorder compared to controls and higher for the SCA. Further well-conducted studies are needed to complement our findings.
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Rao H, Chen Y, Xu W, Zhou Z. Clinical Effects of Preoperative K-Line Tilt on Patient Outcomes After Laminoplasty for Cervical Ossification of the Posterior Longitudinal Ligament. World Neurosurg 2021; 150:e639-e644. [PMID: 33757888 DOI: 10.1016/j.wneu.2021.03.071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/14/2021] [Accepted: 03/15/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE We sought to clarify the effects of the preoperative K-line tilt on cervical sagittal balance and patient outcomes after laminoplasty for cervical ossification of the posterior longitudinal ligament (OPLL). METHODS A retrospective analysis of 45 patients with OPLL treated by laminoplasty from January 2013 to December 2018 was performed. The radiological parameters included the K-line tilt, C2-C7 sagittal vertical axis, C2-C7 lordosis, T1 slope, and T1 slope minus C2-C7 lordosis. The patient quality of life outcomes were assessed using the neck disability index, Japanese Orthopaedic Association disability scale, and visual analog scale. The patients were classified into 2 groups according to the median preoperative K-line tilt angle (14.1°): the high K-line tilt group (n = 23) and the low K-line tilt group (n = 22). The postoperative cervical alignment changes and patient outcomes were compared and analyzed. RESULTS The clinical outcomes demonstrated overall improvement at the final follow-up. The C2-C7 lordosis had significantly decreased from 13.5° ± 9.5° preoperatively to 10.2° ± 9.7°. The C2-C7 lordosis was less in the high K-line tilt group than that in the low K-line tilt group. In addition, the high K-line tilt group revealed significantly greater kyphotic changes and a greater loss of cervical lordosis compared with the low K-line tilt group. Finally, the quality of life outcomes and postoperative visual analog scale scores were higher in the high K-line tilt group. CONCLUSIONS The results of the present study have shown that the parameter K-line tilt is an ideal radiological parameter for predicting the outcomes and determining the need for laminoplasty for cervical ossification of the OPLL. Patients with a higher K-line tilt preoperatively experienced more kyphotic alignment changes and neck pain after laminoplasty.
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Affiliation(s)
- Hongming Rao
- Department of Orthopaedic Surgery, Fuzhou Second Hospital affiliated to Xiamen University, Fuzhou, China
| | - Yufan Chen
- Department of Spine Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Weihong Xu
- Department of Spine Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Zhangyan Zhou
- Department of Orthopaedic Surgery, Sanming First Hospital Affiliated to Fujian Medical University, Sanming, China.
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