Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
Spine (Phila Pa 1976). 2013 Mar 15;38(6):484-9. doi: 10.1097/BRS.0b013e318273a1c0.
Prospective radiographical analysis of cranial center of mass (CCOM), C2, and C7 plumb lines in young and elderly asymptomatic individuals.
To establish a normal range for craniosagittal balance for both young and elderly asymptomatic individuals.
Global sagittal balance must account for the position of the head in relation to the spine and pelvis. The C7 plumb line defines thoracolumbar sagittal balance and has been shown to have significant impact on patient outcomes. However, the C7 plumb line fails to take into consideration the position of the head in relation to the pelvis.
A total of 100 asymptomatic 20- to 40-year-old patients and 100 asymptomatic 60- to 80-year-old patients were enrolled. Standing plain radiographs of 14 × 36 in were obtained. CCOM, C2, and C7 plumb lines were drawn and measured from the superoposterior endplate of S1.
A total of 78 asymptomatic 20- to 40-year-old patients and 62 asymptomatic 60- to 80-year-old patients had adequate radiographs. The mean plumb line values in the 20- to 40-year-old patients and 60- to 80-year-old patients, respectively, were as follows; CCOM 9.0 mm (SD, 31.5 mm) and 41.2 mm (SD, 35.7 mm); C2 -2.7 mm (SD, 32.7 mm) and 32.1 mm (SD, 33.6 mm); and C7 -16.4 mm (SD, 31.5 mm) and 10.6 mm (SD, 27.8 mm). One-way analysis of variance and Student t tests confirmed that these mean plumb line values were significantly different between young and elderly patients (P < 0.001). The change at each level over time was highly correlated with the other levels (r > 0.97; P < 0.001) as did the degree of change between groups (r > 0.90, P < 0.001).
Spinopelvic alignment in conjunction with CCOM has increased our understanding of spinal balance by including the head and may better represent true global spinal balance. CCOM is an easily measured parameter by using the nasion-inion technique.
对年轻和老年无症状个体的颅重（CCOM）、C2 和 C7 铅垂线进行前瞻性影像学分析。
为年轻和老年无症状个体建立颅矢状平衡的正常范围。
整体矢状平衡必须考虑头部相对于脊柱和骨盆的位置。C7 铅垂线定义了胸腰椎矢状平衡，并且已显示对患者结局有重大影响。然而，C7 铅垂线未能考虑头部相对于骨盆的位置。
共纳入 100 名无症状的 20-40 岁患者和 100 名无症状的 60-80 岁患者。获得 14×36 英寸的站立位平片。从 S1 的上后终板绘制并测量 CCOM、C2 和 C7 铅垂线。
共有 78 名无症状的 20-40 岁患者和 62 名无症状的 60-80 岁患者的 X 线片足够。20-40 岁患者和 60-80 岁患者的平均铅垂线值分别为：CCOM 9.0 毫米（标准差，31.5 毫米）和 41.2 毫米（标准差，35.7 毫米）；C2 -2.7 毫米（标准差，32.7 毫米）和 32.1 毫米（标准差，33.6 毫米）；和 C7 -16.4 毫米（标准差，31.5 毫米）和 10.6 毫米（标准差，27.8 毫米）。单因素方差分析和学生 t 检验证实，这些平均铅垂线值在年轻和老年患者之间存在显著差异（P <0.001）。随着时间的推移，每个水平的变化与其他水平高度相关（r >0.97；P <0.001），组间变化程度也高度相关（r >0.90，P <0.001）。
脊柱骨盆排列与 CCOM 相结合，通过包含头部增加了我们对脊柱平衡的理解，并且可能更好地代表真正的整体脊柱平衡。CCOM 是通过使用鼻根-枕骨技术测量的一个容易测量的参数。
