Zhang Lilong, Cheng Zhaojun, Cui Zijian, Ren Zhishuai, Peng Bing, Zhang Xueli
No.1 Department of Spine Surgery, Tianjin Union Medical Center, Tianjin, 300121, P.R.China.
No.1 Department of Spine Surgery, Tianjin Union Medical Center, Tianjin, 300121, P.R.China;Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2017 Apr 15;31(4):451-454. doi: 10.7507/1002-1892.201610119.
To analyse the correlation between cervical sagittal parameters of cervical spondylotic myelopathy in different sagittal curvature so as to find out representative cervical sagittal alignment parameters by measuring on MRI.
A retrospective analysis was made on the clinical data of 88 patients with cervical spondylotic myelopathy between July 2015 and January 2016. The C -C Cobb angle, T slope (T S), and C -C sagittal vertical axis (C -C SVA) were measured on T2-weight MRI. According to C -C Cobb angle, the patients were divided into lordosis group (≥10° Cobb angle, 48 cases) and straightened group (0-10° Cobb angle, 40 cases). Intraclass correlation coefficient (ICC) was used for the reliability of measured data, Pearson correlation analysis for correlation between cervical sagittal parameters.
ICC was 0.858-0.946, indicating good consistency of measurement parameters. The C -C Cobb angle, T S, and C -C SVA were (5.6±2.4)°, (22.2±6.7)°, and (10.2±5.4) mm in straightened group, and were (20.1±8.2)°, (23.4±8.9)°, and (8.2±4.6) mm in lordosis group respectively. There was no correlation between the 3 parameters in straighten group ( =0.100, =0.510 for T S and C -C Cobb angle; =-0.100, =0.500 for T S and C -C SVA; =0.080, =0.610 for C -C Cobb angle and C -C SVA). There was positive correlation between T S and C -C Cobb angle ( =0.540, =0.000), negative correlation between T S and C -C SVA ( =-0.450, =0.001), and no correlation between C -C Cobb angle and C -C SVA ( =-0.003, =0.980).
For cervical spondylotic myelopathy in patients with cervical lordosis, only T S measurement on MRI can be used as the main parameter to judge the sagittal curvature, but in patients with straightened cervical Cobb angle, measurements of T S, C -C Cobb angle, and C -C SVA should be taken for the comprehensive evaluation of cervical sagittal curvature.
分析不同矢状面曲度的脊髓型颈椎病患者颈椎矢状面参数之间的相关性,通过磁共振成像(MRI)测量找出具有代表性的颈椎矢状面排列参数。
回顾性分析2015年7月至2016年1月期间88例脊髓型颈椎病患者的临床资料。在T2加权MRI上测量C2-C7 Cobb角、T1斜率(TS)和C2-C7矢状垂直轴(C2-C7 SVA)。根据C2-C7 Cobb角,将患者分为前凸组(Cobb角≥10°,48例)和变直组(Cobb角0-10°,40例)。组内相关系数(ICC)用于测量数据的可靠性,Pearson相关分析用于颈椎矢状面参数之间的相关性。
ICC为0.858-0.946,表明测量参数具有良好的一致性。变直组的C2-C7 Cobb角、TS和C2-C7 SVA分别为(5.6±2.4)°、(22.2±6.7)°和(10.2±5.4)mm,前凸组分别为(20.1±8.2)°、(23.4±8.9)°和(8.2±4.6)mm。变直组中这3个参数之间无相关性(TS与C2-C7 Cobb角,r = 0.100,P = 0.510;TS与C2-C7 SVA,r = -0.100,P = 0.500;C2-C7 Cobb角与C2-C7 SVA,r = 0.080,P = 0.610)。TS与C2-C7 Cobb角呈正相关(r = 0.540,P = 0.000),TS与C2-C7 SVA呈负相关(r = -0.450,P = 0.001),C2-C7 Cobb角与C2-C7 SVA无相关性(r = -0.003,P = 0.980)。
对于颈椎前凸的脊髓型颈椎病患者,MRI上仅测量TS可作为判断矢状面曲度的主要参数,但对于颈椎Cobb角变直的患者,应测量TS、C2-C7 Cobb角和C2-C7 SVA以综合评估颈椎矢状面曲度。