Thoracic Inlet Parameters for Degenerative Cervical Spondylolisthesis Imaging Measurement

Wang, Quanbing; Wang, Xiaotao; Zhu, Lei; Wei, Yiran

doi:10.12659/msm.907073

Cited by 9 publications

(5 citation statements)

References 22 publications

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“…Pan et al 121 (2017) reported similar changes of thoracic inlet alignment after the correction of posttuberculosis cervical kyphosis. Wang et al 122 (2018) presented higher T1S and TIA in cervical spondylolisthesis group than nonspondylolisthesis group but the NT was unchanged. Song et al 123 (2020) reported stable NT values and TIA after correction of kyphotic deformities in patients with Hirayama disease.…”

Section: "Where" To Go In the Future? 1 Thoracic Inlet Alignment Stumentioning

confidence: 97%

Cervical Sagittal Alignment: Literature Review and Future Directions

Hyun

Jain

2020

Neurospine

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Cervical alignment as a concept has come to the forefront for spine deformity research in the last decade. Studies on cervical sagittal alignment started from normative data, and expanded into correlation with global sagittal balance, prognosis of various conditions, outcomes of surgery, definition and classification of cervical deformity, and prediction of targets for ideal cervical reconstruction. Despite the recent robust research efforts, the definition of normal cervical sagittal alignment and cervical spine deformity continues to elude us. Further, many studies continue to view cervical alignment as a continuation of thoracolumbar deformity and do not take into account biomechanical features unique to the cervical spine that may influence cervical alignment, such as the importance of musculature connecting cranium-cervical-thoracic spine and upper extremities. In this article, we aim to summarize the relevant literature on cervical sagittal alignment, discuss key results, and list potential future direction for research using the '5W1H' framework; "WHO" are related?,

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Section: "Where" To Go In the Future? 1 Thoracic Inlet Alignment Stumentioning

confidence: 97%

Cervical Sagittal Alignment: Literature Review and Future Directions

Hyun

Jain

2020

Neurospine

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“…Recently, after the concepts of the thoracic inlet angle (simihttps://doi.org/10.3340/jkns.2021.0011 lar to pelvic incidence in the thoracolumbar spine) and T1 slope (T1s) had been established, another derived factor (T1s minus cervical lordosis [CL]) has also been viewed as an essential parameter 15,25,26) . Although the usefulness of the above radiological parameters has been proven in many previous reports, the accurate measurement of T1s is not usually easy for many patients, due to their short necks or obstruction of shoulder shading 22) .…”

Section: Introductionmentioning

confidence: 99%

Analyzing the Significance of T1 Slope minus Cervical Lordosis in Patients with Anterior Cervical Discectomy and Fusion Surgery

Lee

You

Sung

et al. 2021

J Korean Neurosurg Soc

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Objective : Accurate measurement of T1 slope (a component of T1s minus cervical lordosis [CL]) is often constrained by anatomical limitations. In this situation, efforts should be made to find the exact meaning of T1s-CL and whether there are any alternatives to it.Methods : We enrolled 117 patients who received two-level anterior cervical discectomy and fusion (ACDF). Occipital slope, C2 slope (C2s), C7 slope (C7s), T1, O-C2 angle (O-C2A), C2-7 angle (C2-7A), O-C7 angle (O-C7A), T1s-CL, C7-T1 angle (C7-T1A), and C2-7 sagittal vertical axis were measured. We determined 16° (T1s-CL) as the reference point for dividing subjects into the mismatch group and the balance group, and a comparative analysis was performed.Results : The mean value of C7-T1A was constantly maintained within 2.6° peri-operatively. In addition, C2s and T1s-CL showed the same absolute change (Δ|0.8|°). The mean values of T1s-CL of the mismatch and balance groups were 23.0° and 7.6°, respectively. The five factors with the largest differences between the two groups were as follows : C2s (Δ13.3°), T1s-CL (Δ15.4°), O-C2A (Δ8.7°), C2-7A (Δ14.7°), and segmental angle (Δ7.9°) before surgery. Only four factors showed statistically significant change between the two groups after ACDF : T1s-CL (Δ4.0° vs. Δ0.2°), C2s (Δ3.2° vs. Δ0.7°), O-C2A (Δ2.6° vs. Δ1.3°), C2-7A (Δ6.3° vs. Δ1.3°). A very strong correlation between T1s-CL and C2s was also found (r=|0.88–0.96|).Conclusion : C2s itself may be the essential key to represent T1s-CL. The amounts and directions of change of these two factors (T1s-CL and C2s) were also almost identical. The above phenomenon was re-confirmed once again through the correlation analysis.

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“…Lee found no direct correlation between pelvic parameters and thoracic or cervical spine alignment [12]. Kim found no statistically significant correlations were found among cervical kyphosis and the global spine parameters [4].…”

Section: Discussionmentioning

confidence: 83%

“…Usually, we use the C2-C7 angle to represent cervical lordosis(CL), but the relationship between cervical degeneration and cervical lordosis has been controversial. Wang observed no significant difference in the C2-7 angle between the normal group and the degenerative cervical spondylolisthesis group [12]. Generally speaking, the presence of a kyphotic cervical alignment may indicate substantial deformity and be linked to poor clinical outcomes.…”

Section: Discussionmentioning

confidence: 92%

Analysis of global spine sagittal parameters in cervical spondylotic patients and asymptomatic subjects

Zhu

Shen

et al. 2020

Preprint

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Background: Degenerative changes associated with cervical spondylotic can result in a change of normal sagittal alignment, and this may be the initial change of kyphosis and sagittal imbalance. Few studies have analyzed the correlations between the cervical spine lordosis and global spine balance in patients with cervical spondylotic. This study is applied to investigate the characteristics and relationships of cervical and global sagittal parameters in normal adults and cervical spondylotic patients. Methods: We reviewed 46 asymptomatic control subjects (normal group, NG) and 48 cervical spondylotic patients (cervical spondylotic group, CSG), who had both cervical MRI and global radiographs obtained together, between January 2016 and September 2018. Data includes C1-2 angle, C2–7 lordosis (CL), T1 slope (T1S), thoracic inlet angle (TIA), C2–7 sagittal vertical axis (CSVA), sagittal vertical axis(SVA), thoracic-kyphosis(TK), thoracic-lumbar lordosis(TL), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS). The values were presented as the mean ± standard deviation. Student t-test and Pearson’s correlation coefﬁcient were used for statistical analysis. Probability values less than 0.05 were considered statistically signiﬁcant. Results: 1.Comparison of global sagittal parameters between the normal group and cervical spondylosis group. A total of 48 cervical spondylotic patients with an average age of 57.91±9.58 and 46 healthy people with an average age of 28.00±8.09 were recruited in our study. CL in the NG was significantly lower than CSG (P<0.05), while TK and TL were significantly lower than in the CSG(P< 0.01). However, a comparison of the NG and CSG yielded no significant differences in C1-2, TIA, TIS, LL, PT, PI, SS, CSVA, and SVA. 2.The relationship between cervical and global sagittal alignment. CL positively correlated with T1S (r=0.433) and TK (r=0.335) while negatively correlated with CSVA (r=-0.309) in cervical spondylosis group. TIA has positively correlated with T1S (r=0.376 in NG and r=0.416 in CSG) and no correlated with other parameters in both groups. Conclusions Cervical spondylosis causes changes in sagittal parameters of the cervical and thoracic spine but does not affect on lumbar and pelvic parameters. TIA is a relative constant parameter, not affected by cervical spondylotic.

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Thoracic Inlet Parameters for Degenerative Cervical Spondylolisthesis Imaging Measurement

Cited by 9 publications

References 22 publications

Cervical Sagittal Alignment: Literature Review and Future Directions

Cervical Sagittal Alignment: Literature Review and Future Directions

Analyzing the Significance of T1 Slope minus Cervical Lordosis in Patients with Anterior Cervical Discectomy and Fusion Surgery

Analysis of global spine sagittal parameters in cervical spondylotic patients and asymptomatic subjects

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