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Relationships and Usefulness of Cervical Lateral Radiographs Compared with Whole-Spine Lateral Radiographs for Evaluating Cervical Sagittal Alignment

  • Journal of Korean Society of Spine Surgery
  • Abbr : J Kor Spine Sur
  • 2020, 27(2), pp.48-54
  • Publisher : Korean Society Of Spine Surgery
  • Research Area : Medicine and Pharmacy > Orthopedic Surgery
  • Received : June 30, 2020
  • Accepted : June 30, 2020
  • Published : June 30, 2020

Byung-Wan Choi 1,  Kyung-Gu Park 2

1인제대학교 해운대백병원 정형외과
2인제대학교 해운대백병원 정형외과학교실

Accredited

ABSTRACT

Study Design: Retrospective analysis. Objectives: This study was conducted to identify the correlations and usefulness of lateral cervical radiographs compared with wholespine sagittal lateral radiographs for evaluating cervical sagittal alignment. Summary of Literature Review: Few reports have compared cervical lateral radiographs with whole-spine sagittal radiographs. Materials and Methods: We retrospectively analyzed 181 patients with both cervical standing lateral radiographs and whole-spine standing lateral radiographs. The radiographs were evaluated using the following sagittal alignment parameters: C2-7 lordosis, C2-7 sagittal vertical axis (SVA), T1 slope, spino-cranial angle (SCA), and whole-spine SVA. We evaluated the relationships between the two radiographs. The patients were divided into four groups according to age and the measured sagittal parameters were compared across groups. An analysis according to clinical symptoms was also done. Results: C2-7 lordosis was 16.86° and 15.76°, C2-7 SVA was 15.76° and 16.86°, T1 slope was 29.03° and 22.49°, and SCA was 74.74° and 74.5°, respectively, on the cervical and whole spine radiographs. The whole-spine SVA was -2.64 mm. Correlation analysis between the two types of radiographs showed significant relationships for each sagittal parameter. The whole-spine SVA was related with wholespine C2-7 lordosis, T1 slope, and SCA. Cervical C2-7 lordosis and the whole-spine SVA increased with age. A decrease of C2-7 lordosis on whole-spine radiographs was shown in patients with neck pain. Conclusions: Cervical SVA and T1 slope were lower on whole-spine standing lateral radiographs than on simple cervical lateral radiographs. The cervical sagittal parameters measured on cervical radiographs were correlated with those measured on whole-spine radiographs. Cervical radiographs can be used to replace whole-spine radiographs with due consideration of these findings.

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