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Factors determining cervical spine sagittal balance in asymptomatic adults: correlation with spinopelvic balance and thoracic inlet alignment

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Author(s)
Sang-Hun LeeEun-Seok SonEun-Min SeoKyung-Soo SukKi-Tack Kim
Keimyung Author(s)
Son, Eun Seok
Department
Dept. of Orthopedic Surgery (정형외과학)
Journal Title
Spine Journal
Issued Date
2015
Volume
15
Issue
4
Keyword
Cervical spine sagittal balanceT1 slopeSpinopelvic balanceThoracic inlet alignment
Abstract
BACKGROUND CONTEXT: Based on the previous studies, cervical lordosis (CL) is a parameter
influenced by thoracic kyphosis (TK); however, the correlations still remain unclear. Few studies
have analyzed the correlations between the cervical spine lordosis and global spinopelvic balance.
To date, there has been no study focused on the factors determining cervical spine sagittal balance.
PATIENT SAMPLE: Seventy-seven asymptomatic volunteers without the history of symptoms
related to whole spine.
OUTCOME MEASURES: Statistical significance of correlations of radiographic parameters on
cervical spine and whole-spine standing lateral radiograph.
PURPOSE: To analyze the factors determining cervical spine sagittal balance, including global
spinopelvic balance and thoracic inlet (TI) alignment in asymptomatic adults.
STUDY DESIGN: A prospective radiographic study.
METHODS: Cervical and whole-spine standing lateral radiographs were taken to analyze the fol-
lowing parameters: spinopelvic parameters pelvic incidence (PI), sacral slope (SS), lumbar lordosis
(LL), and TK; TI parameters thoracic inlet angle (TIA) and T1 slope; and cervical spine parameters
C0–C2, C2–C7, and C0–C7 angles and cervical tilting. Statistical analysis was performed using the
Pearson correlation coefficients and multiple regression analysis.
RESULTS: All the parameters showed a normal distribution. There was a significant sequential
linkage between PI and SS (r50.653), SS and LL (r50.807), LL and TK (r5 0.516), and TK
and C0–C7 angle (r5 0.322). There was a significant relationship between TK and T1 slope
(r50.351) but no significant relationship between TK and TIA. There were significant sequential
relationships between TIA and T1 slope (r50.694), T1 slope and C2–C7 angle (r5 0.624), and
C2–C7 and C0–C2 angles (r5 0.547). T1 slope was the only parameter that demonstrated a signif-
icant correlation with both SP and TI parameters. A linear regression model showed that T1 slope
had a stronger relationship with TIA (r50.694) than TK (r50.351).
CONCLUSIONS: T1 slope was a key factor determining cervical spine sagittal balance. Both spi-
nopelvic balance and TI alignment have a significant influence on cervical spine sagittal balance
via T1 slope, but TIA had a stronger effect than TK. An individual with large T1 slope required large
CL to preserve physiologic sagittal balance of the cervical spine. The results of the present study could
serve as baseline data for further studies on the cervical spine sagittal balance in various clinical con-
ditions including the surgical reconstruction of lordosis. 2015 Elsevier Inc. All rights reserved.
Keywords: Cervical spine sagittal balance; T1 slope; Spinopelvic balance; Thoracic inlet alignment
Keimyung Author(s)(Kor)
손은석
Publisher
School of Medicine
Citation
Sang-Hun Lee et al. (2015). Factors determining cervical spine sagittal balance in asymptomatic adults: correlation with spinopelvic balance and thoracic inlet alignment. Spine Journal, 15(4), 705–712. doi: 10.1016/j.spinee.2013.06.059
Type
Article
ISSN
1529-9430
Source
https://www.sciencedirect.com/science/article/pii/S1529943013007456?via%3Dihub
DOI
10.1016/j.spinee.2013.06.059
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/34646
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학)
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