Sherekar S K, Yadav Y R, Basoor A S, Baghel Arvind, Adam Nelson
Neurosurgery Unit, NSCB Medical College, Jabalpur, Madhya Pradesh, India.
Neurol India. 2006 Sep;54(3):264-7. doi: 10.4103/0028-3886.27149.
The alignment of upper and lower cervical spine is presumed to be closely interrelated and the knowledge of this is mandatory when performing occipito-cervical and upper cervical fusions. The aim of this study was to establish standard values for upper and lower cervical spine alignment in the Indian population.
Five hundred eighteen asymptomatic volunteers (261 males and 257 females) between 12 and 80 years of age underwent lateral radiography with their neck in the neutral position. Angles for occipital to 2nd cervical (Oc-C2), 1st to 2nd cervical (C1-C2) and sagittal alignment of 2nd to 7th cervical vertebrae (C2-C7) were measured. Statistical analyses were performed using a statistical package SPSS 10 for windows and the students 't' test.
The mean Oc-C2, C1-C2 and C2--C7 angles were 14.66+9.5 degrees , 25.6+7.9 degrees and 16.8+12.7 degrees in male, while same angles in female were 15.59+8.26 degrees, 26.9+6.8 degrees and 9.11+10.4 degrees respectively. Weak statistically significant negative correlation was observed between the measured angles of the upper (Oc-C2 and C1-C2) and lower (C2-C7) cervical spines, which means if the lordosis of the occiput and upper cervical spine increases (if the Oc-C2 angle increases), the alignment of lower cervical spine becomes kyphotic and vice versa. This negative correlation was stronger between the Oc-C2 and C2-C7 angles than between the C1-C2 and C2-C7 angles.
Relationship between alignment of the upper and the lower cervical spine should be taken into consideration when performing cervical fusion.
上下颈椎的排列被认为密切相关，在进行枕颈和上颈椎融合时，了解这一点是必不可少的。本研究的目的是确定印度人群上下颈椎排列的标准值。
518名年龄在12至80岁之间的无症状志愿者（261名男性和257名女性）在颈部处于中立位时进行了侧位X线摄影。测量了枕骨至第2颈椎（Oc-C2）、第1至第2颈椎（C1-C2）以及第2至第7颈椎（C2-C7）矢状面排列的角度。使用Windows版统计软件包SPSS 10和学生t检验进行统计分析。
男性的平均Oc-C2、C1-C2和C2-C7角度分别为14.66±9.5度、25.6±7.9度和16.8±12.7度，而女性的相同角度分别为15.59±8.26度、26.9±6.8度和9.11±10.4度。在上颈椎（Oc-C2和C1-C2）和下颈椎（C2-C7）的测量角度之间观察到弱的统计学显著负相关，这意味着如果枕骨和上颈椎的前凸增加（如果Oc-C2角度增加），下颈椎的排列会变成后凸，反之亦然。Oc-C2与C2-C7角度之间的这种负相关性比C1-C2与C2-C7角度之间更强。
进行颈椎融合时应考虑上下颈椎排列之间的关系。
