Analysis of Parameters That Can Predict the Cervical Sagittal Vertical Axis in Cervical Fusion Surgery.
World Neurosurg
; 164: e1071-e1077, 2022 08.
Article
en En
| MEDLINE
| ID: mdl-35636665
ABSTRACT
OBJECTIVE:
The absolute value of the cervical sagittal parameters cannot be guaranteed with certainty on all follow-up cervical radiographs. With the assumption that neck posture changes can occur at any time at each follow-up radiographic session, we examined whether the sagittal parameters change meaningfully and identified the factors most closely related to the C2-C7 sagittal vertical axis (SVA).METHODS:
We enrolled 200 patients who had undergone either anterior cervical fusion (n = 100) or posterior cervical fusion (n = 100). The craniovertebral angle (CVA), mandible angle (MA), occipital slope (Os), C2 slope (C2s), C7 slope (C7s), and C2-C7 SVA were measured on 2 different follow-up radiographs after surgery. The C2-C7 angle (C2-C7A) and changes (Δ) in the sagittal parameters between the 2 radiographs were then calculated.RESULTS:
The ΔC2s and ΔCVA showed a very strong correlation with the ΔC2-C7 SVA (r = |0.70-0.93|). An independent t test showed a statistically significant difference for multiple sagittal parameters (i.e., ΔMA, ΔOs, ΔC2s, ΔC7s, and ΔCVA) between the large and small ΔC2-C7 SVA groups. In contrast, the change in the C2-C7A was without statistical significance. A stepwise multivariate regression analysis revealed a high adjusted R2 value (0.841) between the ΔC2-C7 SVA and 2 parameters (standardized coefficient ΔCVA, -0.563; ΔC2s, -0.398).CONCLUSIONS:
During cervical fusion surgery, the CVA was the most predictable parameter reflecting the C2-C7 SVA in various analyses. The upper cervical parameters (Os and C2s) provided more explanatory power regarding the C2-C7 SVA changes than did the lower cervical parameter (C7s) or the presence of cervical lordosis (C2-C7A).Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Fusión Vertebral
/
Lordosis
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Año:
2022
Tipo del documento:
Article