Neuroscience Research Center, Shahid Beheshti University of Medical Sciences, Arabi Ave, Daneshjoo Blvd, Velenjak, 19839-63113, Tehran, Iran.
School of Medicine, Capital Medical University, Beijing, China.
Eur Spine J. 2021 Jun;30(6):1411-1439. doi: 10.1007/s00586-021-06825-0. Epub 2021 Mar 27.
The purpose of this systematic review and meta-analysis was to compare the cervical sagittal parameters between patients with cervical spine disorder and asymptomatic controls.
Two independent authors systematically searched online databases including Pubmed, Scopus, Cochrane library, and Web of Science up to June 2020. Cervical sagittal balance parameters, such as T1 slope, cervical SVA (cSVA), and spine cranial angle (SCA), were compared between the cervical spine in healthy, symptomatic, and pre-operative participants. Where possible, we pooled data using random-effects meta-analysis, by CMA software. Heterogeneity and publication bias were assessed using the I-squared statistic and funnel plots, respectively.
A total of 102 studies, comprising 13,802 cases (52.7% female), were included in this meta-analysis. We used the Newcastle-Ottawa Scale (NOS) to evaluate the quality of studies included in this review. Funnel plot and Begg's test did not indicate obvious publication bias. The pooled analysis reveals that the mean (SD) values were: T1 slope (degree), 24.5 (0.98), 25.7 (0.99), 25.4 (0.34); cSVA (mm), 18.7 (1.76), 22.7 (0.66), 22.4 (0.68) for healthy population, symptomatic, and pre-operative assessment, respectively. The mean value of the SCA (degree) was 79.5 (3.55) and 75.6 (10.3) for healthy and symptomatic groups, respectively. Statistical differences were observed between the groups (all P values < 0.001).
The findings showed that the T1 slope and the cSVA were significantly lower among patients with cervical spine disorder compared to controls and higher for the SCA. Further well-conducted studies are needed to complement our findings.
本系统评价和荟萃分析的目的是比较颈椎疾病患者与无症状对照者的颈椎矢状参数。
两位独立作者系统地检索了在线数据库，包括 Pubmed、Scopus、Cochrane 图书馆和 Web of Science，检索时间截至 2020 年 6 月。比较了健康、有症状和术前参与者颈椎的颈椎矢状平衡参数，如 T1 斜率、颈椎 SVA（cSVA）和脊柱颅角（SCA）。在可能的情况下，我们使用 CMA 软件对数据进行了随机效应荟萃分析。使用 I 平方统计量和漏斗图分别评估异质性和发表偏倚。
共有 102 项研究，包括 13802 例（52.7%为女性），纳入本荟萃分析。我们使用纽卡斯尔-渥太华量表（NOS）来评估本综述纳入研究的质量。漏斗图和 Begg 检验均未表明存在明显的发表偏倚。汇总分析显示，平均值（标准差）分别为：T1 斜率（度），24.5（0.98），25.7（0.99），25.4（0.34）；cSVA（mm），18.7（1.76），22.7（0.66），22.4（0.68）分别为健康人群、有症状人群和术前评估人群。SCA（度）的平均值分别为 79.5（3.55）和 75.6（10.3）分别为健康组和有症状组。组间差异有统计学意义（均 P 值<0.001）。
研究结果表明，与对照组相比，颈椎疾病患者的 T1 斜率和 cSVA 明显较低，而 SCA 较高。需要进一步进行良好设计的研究来补充我们的发现。
