Lee Sang Hun, Hyun Seung-Jae, Jain Amit
Department of Orthopaedic Surgery, Johns Hopkins University, School of Medicine, Baltimore, MD, USA.
Department of Neurological Surgery, Seoul National University College of Medicine, Seoul, Korea.
Neurospine. 2020 Sep;17(3):478-496. doi: 10.14245/ns.2040392.196. Epub 2020 Sep 30.
Cervical alignment as a concept has come to the forefront for spine deformity research in the last decade. Studies on cervical sagittal alignment started from normative data, and expanded into correlation with global sagittal balance, prognosis of various conditions, outcomes of surgery, definition and classification of cervical deformity, and prediction of targets for ideal cervical reconstruction. Despite the recent robust research efforts, the definition of normal cervical sagittal alignment and cervical spine deformity continues to elude us. Further, many studies continue to view cervical alignment as a continuation of thoracolumbar deformity and do not take into account biomechanical features unique to the cervical spine that may influence cervical alignment, such as the importance of musculature connecting cranium-cervical-thoracic spine and upper extremities. In this article, we aim to summarize the relevant literature on cervical sagittal alignment, discuss key results, and list potential future direction for research using the '5W1H' framework; "WHO" are related?, "WHY" important?, "WHAT" to evaluate and "WHAT" is normal?, "HOW" to evaluate?, "WHEN" to apply sagittal balance?, and "WHERE" to go in the future?
在过去十年中，颈椎排列作为一个概念已成为脊柱畸形研究的前沿领域。关于颈椎矢状面排列的研究始于正常数据，并扩展到与整体矢状面平衡的相关性、各种病症的预后、手术结果、颈椎畸形的定义和分类以及理想颈椎重建目标的预测。尽管最近进行了大量的研究工作，但正常颈椎矢状面排列和颈椎畸形的定义仍然难以确定。此外，许多研究继续将颈椎排列视为胸腰椎畸形的延续，而没有考虑到可能影响颈椎排列的颈椎独特生物力学特征，例如连接颅骨 - 颈椎 - 胸椎和上肢的肌肉组织的重要性。在本文中，我们旨在总结关于颈椎矢状面排列的相关文献，讨论关键结果，并使用“5W1H”框架列出潜在的未来研究方向；“WHO”与之相关？“WHY”重要？“WHAT”进行评估以及“WHAT”是正常的？“HOW”进行评估？“WHEN”应用矢状面平衡？以及未来“WHERE”发展？
