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C7 sagittal vertical axis is the determinant of the C5-C7 angle in cervical sagittal alignment.
Spine J. 2017 05; 17(5):622-626.SJ

Abstract

BACKGROUND CONTEXT

Previous studies have indicated that the T1 slope correlates with cervical lordosis. In contrast, the specific impact of the C7 sagittal vertical axis (C7SVA) on cervical lordosis remains unknown.

PURPOSE

This study aimed to investigate the specific role of C7SVA in cervical lordosis.

STUDY DESIGN/SETTING

This was a retrospective radiographic study.

PATIENT SAMPLE

Forty-eight consecutive patients who underwent lateral standing radiography of the entire spine were retrospectively reviewed.

OUTCOME MEASURES

Radiographic parameters included occipito (Oc)-C7, Oc-C2, C2-C7, C2-C4, and C5-C7 angles; T1 slope; C7SVA; T1 pelvic angle (TPA); pelvic incidence; pelvic tilt; and sacral slope.

METHODS

The radiographs of 96 consecutive patients who underwent lateral standing radiography of the entire spine in June 2015 in our hospital were retrospectively reviewed. Patients having cervical deformities, having undergone cervical fusion, and under 18 years of age were excluded. A total of 48 Asian patients (14 men and 34 women; mean age, 54.6 years) were eligible. Pathologies included scoliosis, myelopathy, thoracolumbar deformity, and spondylosis. Spearman rank correlation coefficients were used to examine correlations between the parameters. The relationship between C5-C7 lordosis and the radiographic parameters was calculated using the forward stepwise multivariate regression analysis. The authors do not have financial associations relevant to this article.

RESULTS

C7SVA correlated with the Oc-C7 (r=0.42) and C2-C7 (r=0.50) angles. However, the correlation coefficient was smaller than that between the T1 slope and Oc-C7 (r=0.83) or C2-C7 (r=0.76) angles. When the C2-C7 angle was divided into C2-C4 and C5-C7 angles, C7SVA correlated with the C5-C7 (r=0.63) angle but not with the C2-C4 angle. The correlation coefficient between the C5-C7 angle and C7SVA was higher than that between the C5-C7 angle and T1 slope (r=0.53) or the C5-C7 angle and TPA (r=0.60). Using radiographic parameters and age, multiple regression analysis revealed that only C7SVA affected the C5-C7 angle.

CONCLUSIONS

C7SVA was the only radiographic parameter that affected the C5-C7 angle. Both T1 slope and C7SVA are key to the shape of the cervical sagittal alignment. The results of this study can be a starting point to improve our understanding of cervical sagittal alignment.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. Electronic address: ymatsubayashi-tky@umin.ac.jp.

Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.

Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.

Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.

Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.

Department of Orthopaedic Surgery, Gunma Spine Center (Harunaso Hospital), 828-1, Kamitoyooka, Takasaki, Gunma, 370-0871, Japan.

Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.

MeSH

AdolescentAdultAgedAged, 80 and overCervical VertebraeFemaleHumansLordosisMaleMiddle AgedPostureRadiography

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27871819

Citation

Matsubayashi, Yoshitaka, et al. "C7 Sagittal Vertical Axis Is the Determinant of the C5-C7 Angle in Cervical Sagittal Alignment." The Spine Journal : Official Journal of the North American Spine Society, vol. 17, no. 5, 2017, pp. 622-626.

Matsubayashi Y, Chikuda H, Oshima Y, et al. C7 sagittal vertical axis is the determinant of the C5-C7 angle in cervical sagittal alignment. Spine J. 2017;17(5):622-626.

Matsubayashi, Y., Chikuda, H., Oshima, Y., Taniguchi, Y., Fujimoto, Y., Shimizu, T., & Tanaka, S. (2017). C7 sagittal vertical axis is the determinant of the C5-C7 angle in cervical sagittal alignment. The Spine Journal : Official Journal of the North American Spine Society, 17(5), 622-626. https://doi.org/10.1016/j.spinee.2016.11.007

Matsubayashi Y, et al. C7 Sagittal Vertical Axis Is the Determinant of the C5-C7 Angle in Cervical Sagittal Alignment. Spine J. 2017;17(5):622-626. PubMed PMID: 27871819.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - C7 sagittal vertical axis is the determinant of the C5-C7 angle in cervical sagittal alignment. AU - Matsubayashi,Yoshitaka, AU - Chikuda,Hirotaka, AU - Oshima,Yasushi, AU - Taniguchi,Yuki, AU - Fujimoto,Yoh, AU - Shimizu,Takachika, AU - Tanaka,Sakae, Y1 - 2016/11/15/ PY - 2016/04/15/received PY - 2016/10/07/revised PY - 2016/11/09/accepted PY - 2016/11/23/pubmed PY - 2017/6/1/medline PY - 2016/11/23/entrez KW - C5–C7 angleC7 sagittal vertical axis KW - Cervical lordosis KW - Cervical sagittal alignment KW - Cervical spine KW - Scoliosis SP - 622 EP - 626 JF - The spine journal : official journal of the North American Spine Society JO - Spine J VL - 17 IS - 5 N2 - BACKGROUND CONTEXT: Previous studies have indicated that the T1 slope correlates with cervical lordosis. In contrast, the specific impact of the C7 sagittal vertical axis (C7SVA) on cervical lordosis remains unknown. PURPOSE: This study aimed to investigate the specific role of C7SVA in cervical lordosis. STUDY DESIGN/SETTING: This was a retrospective radiographic study. PATIENT SAMPLE: Forty-eight consecutive patients who underwent lateral standing radiography of the entire spine were retrospectively reviewed. OUTCOME MEASURES: Radiographic parameters included occipito (Oc)-C7, Oc-C2, C2-C7, C2-C4, and C5-C7 angles; T1 slope; C7SVA; T1 pelvic angle (TPA); pelvic incidence; pelvic tilt; and sacral slope. METHODS: The radiographs of 96 consecutive patients who underwent lateral standing radiography of the entire spine in June 2015 in our hospital were retrospectively reviewed. Patients having cervical deformities, having undergone cervical fusion, and under 18 years of age were excluded. A total of 48 Asian patients (14 men and 34 women; mean age, 54.6 years) were eligible. Pathologies included scoliosis, myelopathy, thoracolumbar deformity, and spondylosis. Spearman rank correlation coefficients were used to examine correlations between the parameters. The relationship between C5-C7 lordosis and the radiographic parameters was calculated using the forward stepwise multivariate regression analysis. The authors do not have financial associations relevant to this article. RESULTS: C7SVA correlated with the Oc-C7 (r=0.42) and C2-C7 (r=0.50) angles. However, the correlation coefficient was smaller than that between the T1 slope and Oc-C7 (r=0.83) or C2-C7 (r=0.76) angles. When the C2-C7 angle was divided into C2-C4 and C5-C7 angles, C7SVA correlated with the C5-C7 (r=0.63) angle but not with the C2-C4 angle. The correlation coefficient between the C5-C7 angle and C7SVA was higher than that between the C5-C7 angle and T1 slope (r=0.53) or the C5-C7 angle and TPA (r=0.60). Using radiographic parameters and age, multiple regression analysis revealed that only C7SVA affected the C5-C7 angle. CONCLUSIONS: C7SVA was the only radiographic parameter that affected the C5-C7 angle. Both T1 slope and C7SVA are key to the shape of the cervical sagittal alignment. The results of this study can be a starting point to improve our understanding of cervical sagittal alignment. SN - 1878-1632 UR - https://www.unboundmedicine.com/medline/citation/27871819/C7_sagittal_vertical_axis_is_the_determinant_of_the_C5_C7_angle_in_cervical_sagittal_alignment_ DB - PRIME DP - Unbound Medicine ER -