Tamai Koji, Grisdela Phillip, Romanu Joshua, Paholpak Permsak, Nakamura Hiroaki, Wang Jeffrey C, Buser Zorica
Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Department of Orthopedics, Osaka City University Graduate School of Medicine, Osaka, Japan.
Clin Spine Surg. 2019 May;32(4):E206-E213. doi: 10.1097/BSD.0000000000000789.
This is a retrospective analysis of kinematic magnetic resonance images (kMRI).
To assess the association of cervical paraspinal muscle with cervical sagittal balance and degenerative spinal disorders.
Although the effects of spinal disorders and cervical imbalance on patient's symptoms have been well described, the relationship of the cervical muscle quality and volume to cervical imbalance or spinal disorders is not well established.
In total, 100 kMRI taken in a neutral weight-bearing position were analyzed. The adjusted cross-sectional area ratio (aCSA ratio: the value of muscle CSA divided by the vertebral CSA) and fat infiltration ratio of the transversospinalis muscles at C4 and C7 vertebral levels were measured using axial slice of kMRI. The correlation with cervical balance parameters [Oc-C2 angle, C2-C7 angle, C7-T1 angle, C7 slope, T1 slope, cranial tilt, cervical tilt, thoracic inlet angle (TIA), and neck tilt] and cervical degenerative disorders (disk degeneration, Modic change, and spondylolisthesis) were evaluated.
The aCSA ratio at C4 correlated with C2-C7 angle (r=0.267), C7 slope (r=0.207), T1 slope (r=0.221), disk degeneration at C3-4, C4-5, C5-6 (r=-0.234, -0.313, -0.262) and spondylolisthesis at C3 (anterior: r=-0.206, posterior: r=-0.249). The aCSA ratio at C7 correlated with disk degeneration at C3-4, C4-5, C5-6, C6-7 (r=-0.209, -0.294, -0.239, -0.209). The fat infiltration ratio at C4 correlated with TIA (r=0.306) and neck tilt (r=0.353), likewise the ratio at C7 correlated with TIA (r=0.270) and neck tilt (r=0.405). All correlations above were statistically significant with P<0.05.
The paraspinal muscle volume showed significant relationship with the cervical balance parameters and disk degeneration. While, paraspinal muscle quality related to the thoracic inlet parameters. Our findings can be an important step to develop the knowledge of the association between cervical muscle and cervical degenerative disorders, as well as the sagittal balance of the cervical spine.
Level III.
这是一项对动态磁共振成像（kMRI）的回顾性分析。
评估颈旁肌肉与颈椎矢状面平衡及脊柱退行性疾病之间的关联。
尽管脊柱疾病和颈椎失衡对患者症状的影响已有详细描述，但颈肌质量和体积与颈椎失衡或脊柱疾病之间的关系尚未明确确立。
总共分析了100例在中立负重位拍摄的kMRI。使用kMRI的轴位切片测量C4和C7椎体水平横突棘肌的调整后横截面积比（aCSA比：肌肉CSA值除以椎体CSA值）和脂肪浸润率。评估其与颈椎平衡参数[枕骨-C2角、C2-C7角、C7-T1角、C7斜率、T1斜率、头颅倾斜、颈椎倾斜、胸廓入口角（TIA）和颈部倾斜]以及颈椎退行性疾病（椎间盘退变、Modic改变和椎体滑脱）的相关性。
C4处的aCSA比与C2-C7角（r = 0.267）、C7斜率（r = 0.207）、T1斜率（r = 0.221）、C3-4、C4-5、C5-6节段的椎间盘退变（r = -0.234、-0.313、-0.262）以及C3节段的椎体滑脱（向前：r = -0.206，向后：r = -0.249）相关。C7处的aCSA比与C3-4\、C4-5、C5-6、C6-7节段的椎间盘退变（r = -0.209、-0.294、-0.239、-0.209）相关。C4处的脂肪浸润率与TIA（r = 0.306）和颈部倾斜（r = 0.353）相关，同样，C7处的脂肪浸润率与TIA（r = 0.270）和颈部倾斜（r = 0.405）相关。上述所有相关性均具有统计学意义，P<0.05。
椎旁肌体积与颈椎平衡参数和椎间盘退变显示出显著关系。而椎旁肌质量与胸廓入口参数相关。我们的研究结果可能是增进对颈肌与颈椎退行性疾病以及颈椎矢状面平衡之间关联认识的重要一步。
三级。
