Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Spine Unit 2, University Victor Segalen, 33079, Bordeaux, France.
Eur Spine J. 2019 Oct;28(10):2319-2324. doi: 10.1007/s00586-019-06117-8. Epub 2019 Aug 23.
Previous studies have shown poor health-related outcomes among patients with spinal sagittal malalignment of the thoracolumbar or spinopelvic region, and less interest has been paid to the relationship between cervical sagittal balance and functional outcome of the patients. This study aims to compare the cervical sagittal parameters between patients with non-specific neck pain and asymptomatic controls.
Twenty-five patients (21 females/4 males) with non-specific neck pain and 25 age-, sex- and BMI-matched controls (18 females/7 males) participated in the study. Using a standard lateral cervical radiography, the Cobb angle between occiput-C2, C1-C2, C1-C7 and C2-C7 as well as the thoracic inlet angle (TIA) and C7 and T1 slope angles was measured. Also the spine cranial angle (SCA) and the C2-SVA (sacral vertical axis) and C1-SVA were measured. The primary outcome measure of the study was comparison of the sagittal balance variables between the patients and the healthy controls. Secondary outcome measures were correlation between pain intensity of the patients in neck pain group and their demographic and radiographic findings. Data analysis was performed using independent sample T test and Pearson's correlation for primary and secondary outcome measurements, respectively.
There was no difference in cervical lordosis curvature (measured by C2-C7 and C1-C7 lordosis angle) between patients with non-specific NP and healthy controls (P value = 0.45 and 0.37, respectively). We found that T1 slope angle was significantly (P value = 0.02) lower in patients with neck pain.
Our findings showed that the slope of the upper endplate of T1 vertebrae body (T1 slope) is significantly lower among patients with non-specific neck pain compared to controls. A compensatory mechanism to bring the center of head gravity back to the spinal axis might be the possible explanation for this difference. These slides can be retrieved under Electronic Supplementary Material.
先前的研究表明，胸腰椎或脊柱骨盆区域矢状位失平衡的患者健康相关结局较差，而对颈椎矢状位平衡与患者功能结局的关系关注较少。本研究旨在比较非特异性颈痛患者与无症状对照者的颈椎矢状参数。
25 例非特异性颈痛患者（21 例女性/4 例男性）和 25 例年龄、性别和 BMI 匹配的对照者（18 例女性/7 例男性）参与了研究。使用标准侧位颈椎 X 线片，测量枕骨-C2、C1-C2、C1-C7 和 C2-C7 的 Cobb 角以及胸入口角（TIA）和 C7 及 T1 斜率角。还测量了脊柱颅角（SCA）和 C2-SVA（骶骨垂直轴）和 C1-SVA。本研究的主要结局测量指标是比较患者与健康对照组的矢状平衡变量。次要结局测量指标是颈痛组患者的疼痛强度与他们的人口统计学和影像学发现之间的相关性。分别使用独立样本 T 检验和 Pearson 相关分析进行主要和次要结局测量的数据分析。
非特异性 NP 患者与健康对照者的颈椎前凸曲率（通过 C2-C7 和 C1-C7 前凸角测量）无差异（P 值分别为 0.45 和 0.37）。我们发现颈痛患者 T1 斜率角明显较低（P 值=0.02）。
我们的研究结果表明，与对照组相比，非特异性颈痛患者 T1 椎体上终板斜率（T1 斜率）显著降低。一种将头重心重回到脊柱轴的代偿机制可能是这种差异的可能解释。这些幻灯片可以在电子补充材料中检索。
