Clinical implications of alignment of upper and lower cervical spine

Sherekar, Snehal; Yadav, Yad Ram; Basoor, Abhijeet; Baghel, Arvind; Aj, Nelson

doi:10.4103/0028-3886.27149

Cited by 51 publications

(16 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It might be explained by the fact that the radiographs were taken differently than those in the current study. In that study, all individuals underwent cervical lateral radiograph while sitting on a stool with film-tube distance set at 1.5 m,9 10 cervical lateral radiograph while standing with film-tube distance set at 1.5 m,7 or whole-spine standing radiographs,15 but in the current study, the subjects underwent cervical lateral radiograph while standing and film-tube distance was set at 1.8 m.…”

Section: Discussionmentioning

confidence: 95%

“…It might be explained by the fact that their studies included participants of different ages than the current study. They included people between 12 and 80 years of age in their studies,7 9 11 and we randomly selected people in their 20s and 50s. In addition, radiographs were taken differently in their studies.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, radiographs were taken differently in their studies. The individuals underwent cervical lateral radiograph while sitting on a stool with film-tube distance of 1.5 m9 10 or standing with film-tube distance of 1.5 m,7 and the subjects underwent cervical lateral radiograph while standing and film-tube distance was set at 1.8 m in the current study. In another study of 100 healthy unoperated adults who were free of spinal problems and underwent whole-spine standing radiographs, the subjects consisted of two groups divided by age: those in their 20s and those above 60 15.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Age-Related Changes in Cervical Sagittal Range of Motion and Alignment

Park

Moon

Lee

et al. 2014

Global Spine Journal

View full text Add to dashboard Cite

Study Design Retrospective cohort study. Objective To compare sagittal cervical range of motion (ROM) and alignment in young versus middle-aged adults. Methods One hundred four asymptomatic adults were selected randomly out of 791 subjects who underwent lateral cervical radiographs in neutral, flexion, and extension positions. They were divided into two groups: young (age 20 to 29, 52 people) and middle-aged adults (age 50 to 59, 52 people). We determined the ROMs of upper cervical (occipital–C2 angle), midcervical (C2–C7 angle), and cervicothoracic spine (cervicosternal angle). We compared the alignment differences of the two groups by calculating the distances between C2 and C7 plumb lines, and C2 central-offset distance. Results In neutral position, there was no significant difference between young and middle-aged adults. However, in flexion, C2–C7 angle, distance between C2–C7 plumb lines, and C2 central-offset distance decreased with age. In extension, C2–C7 angle and C2 central-offset distance decreased with age. During flexion and extension, midcervical ROM and the range of C2 central-offset distance decreased in the middle-aged group. However, there was no difference between the two age groups in the ROM of the upper cervical and the cervicothoracic regions during flexion and extension. Conclusion We found that, despite of the presence of age-related cervical alignment changes, the only difference between the two groups was in the sagittal ROM of the midcervical spine during flexion and extension. Only the ROM of the midcervical spine appears to change significantly, consistent with findings that these levels are most likely to develop both symptomatic and asymptomatic degenerative changes.

show abstract

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Age-Related Changes in Cervical Sagittal Range of Motion and Alignment

Park

Moon

Lee

et al. 2014

Global Spine Journal

View full text Add to dashboard Cite

show abstract

“…As the preoperative Oc–C2 angle was −7.5°, some degree of reduction of the alignment was deemed necessary because the mean angle in male subjects should approximately be 14.6°. 9) Toyama and Koyanagi warned that straight, kyphotic, and swan neck deformities occurred after insufficient reduction of C1–C2 angle, and recommended that the optimum postoperative C1–C2 angle should be 20°. 11) Nevertheless, overreduction of the C1–C2 angle induces a loss of lordosis and kyphotic deformity in the lower cervical spine, resulting in a possibility of myelopathy with progressive subaxial subluxation.…”

Section: Discussionmentioning

confidence: 99%

Posterior Fixation for Atlantoaxial Subluxation in a Case With Complex Anomaly of Persistent First Intersegmental Artery and Assimilation in the C1 Vertebra

Umebayashi

Hara

Nakajima

et al. 2013

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

We report a very rare case of atlantoaxial subluxation (AAS) with persistent first intersegmental artery (PFIA) and assimilation in the atlas (C1) vertebra. This case demonstrates the difficulty of deciding on a surgical strategy for complex anomalies. A 63-year-old man presented with gait disturbance, neck pain, and severe dysesthesia in his left arm. Past history included a whiplash injury. Dynamic X-ray studies demonstrated an irreducible AAS and assimilation of C1. This subluxation was slightly deteriorated in an extended position. A three-dimensional computed tomography angiography (3DCTA) indicated that the PFIA was located on the left side. We performed a C1 posterior arch resection and C1 lateral mass–axis pedicle screw (C1LM–C2PS) fixation using the modified technique of skewering the occipital condyle and C1 lateral mass. The patient had no postoperative morbidity and his symptoms disappeared immediately after operation. Complex anomalies cause difficulty in determining surgical strategy although several surgical methods for simple craniovertebral junction anomaly have been reported. To avoid significant morbidities associated with vertebral artery injury, surgical strategies for these complex conditions are discussed. The modified technique of a C1 lateral mass screw penetrating the occipital condyle is a viable treatment option.

show abstract

“…Detecting FCV in the early stages can help in documenting any further change due to injury, ageing or progression of a degenerative process and also motivates the patients to change their lifestyle to lead a normal life. 3 Management includes lifestyle changes to prevent and delay aggravation or the use of nonoperative measures such as cervical collars and traction. Surgical intervention has a high risk of morbidity and mortality.…”

Section: Descriptionmentioning

confidence: 99%