Zuckerman Scott L, Sardar Zeeshan M, Lai Christopher S, Marciano Gerard F, Kerolus Mena G, Buchanan Ian A, Ha Alex S, Cerpa Meghan, Kelly Michael P, Bourret Stéphane, Hasegawa Kazuhiro, Wong Hee-Kit, Liu Gabriel, Hey Hwee Weng Dennis, Riahi Hend, Le Huec Jean-Charles, Lenke Lawrence G
Department of Orthopedic Surgery, Columbia University Medical Center, The Och Spine Hospital at New York Presbyterian, New York, USA.
Department of Orthopaedic Surgery, Washington University, St. Louis, MO, USA.
Eur Spine J. 2021 Dec;30(12):3639-3646. doi: 10.1007/s00586-021-06873-6. Epub 2021 May 19.
In a population of asymptomatic volunteers across 5 countries, we sought to: (a) establish normative values of the Odontoid-Central Sacral Vertical Line (OD-CSVL) across patient factors, and (b) assess correlations of OD-CSVL with other radiographic parameters.
A prospective, cross-sectional study of asymptomatic adult volunteers, ages 18-80 years, were enrolled across 5 countries (France, Japan, Singapore, Tunisia, United States) forming the Multi-Ethnic Alignment Normative Study (MEANS) cohort. Included volunteers had no known spinal disorder(s), no significant neck/back pain (VAS ≤ 2; ODI ≤ 20), and no significant scoliosis (Cobb ≤ 20°). Radiographic measurements included commonly used coronal alignment parameters (mm) and angles (°). OD-CSVL was defined as the difference between the odontoid plumb line (line from the tip of the odontoid vertically down) and the CSVL (vertical line from the center of the sacrum). Chi-square, student's t tests, Kruskal-Wallis, Wilcoxon rank-sum, linear regression, and Pearson's correlation were used with significance at p < 0.05.
467 volunteers were included with normative OD-CSVL values by age decade, gender, BMI, and country. Mean ± SD OD-CSVL was 8.3 mm ± 6.5 mm and 31 (6.6%) volunteers were almost perfectly aligned (OD-CSVL < 1 mm). A linear relationship was seen between OD-CSVL with both age (p < 0.001) and BMI (p = 0.015). Significant variation was seen between OD-CSVL and 5 different ethnicities (p = 0.004). OD-CSVL correlated best with other coronal radiographic parameters, C7-CSVL (r = 0.743, p < 0.001), OD-knee (r = 0.230, p < 0.001), CAM-knee (r = 0.612, p < 0.001), and regional TL cobb angle (r = 0.4214, p = 0.005).
Among asymptomatic volunteers, increased OD-CSVL was significantly associated with increased age, increased BMI, and ethnicity, but not gender. OD-CSVL correlated strongest with C7-CSVL, TL cobb angle, OD-knee, and CAM-knee. OD-CSVL. These results support further study of OD-CSVL in symptomatic adult spine deformity patients.
在5个国家的无症状志愿者群体中，我们试图：(a) 确定不同患者因素下齿突-骶骨中心垂直线（OD-CSVL）的正常值，以及 (b) 评估OD-CSVL与其他影像学参数的相关性。
对年龄在18 - 80岁的无症状成年志愿者进行一项前瞻性横断面研究，这些志愿者来自5个国家（法国、日本、新加坡、突尼斯、美国），组成了多民族对齐规范研究（MEANS）队列。纳入的志愿者没有已知的脊柱疾病，没有明显的颈部/背部疼痛（视觉模拟评分法[VAS]≤2；脊柱功能障碍指数[ODI]≤20），也没有明显的脊柱侧弯（Cobb角≤20°）。影像学测量包括常用的冠状面排列参数（毫米）和角度（度）。OD-CSVL被定义为齿突垂线（从齿突尖端垂直向下的线）与CSVL（从骶骨中心垂直向下的线）之间的差值。使用卡方检验、学生t检验、Kruskal-Wallis检验、Wilcoxon秩和检验、线性回归和Pearson相关性分析，显著性水平为p < 0.05。
纳入了467名志愿者，根据年龄十年、性别、体重指数（BMI）和国家得出了OD-CSVL的正常值。OD-CSVL的平均值±标准差为8.3毫米±6.5毫米，31名（6.6%）志愿者几乎完全对齐（OD-CSVL < 1毫米）。OD-CSVL与年龄（p < 0.001）和BMI（p = 0.015）之间均呈现线性关系。OD-CSVL在5个不同种族之间存在显著差异（p = 0.004）。OD-CSVL与其他冠状面影像学参数的相关性最佳，C7-CSVL（r = 0.743，p < 0.001）、OD-膝（r = 0.230，p < 0.001）、CAM-膝（r = 0.612，p < 0.001）以及胸腰段Cobb角（r = 0.4214，p = 0.005）。
在无症状志愿者中，OD-CSVL增加与年龄增长、BMI增加和种族显著相关，但与性别无关。OD-CSVL与C7-CSVL、胸腰段Cobb角、OD-膝和CAM-膝的相关性最强。这些结果支持在有症状的成年脊柱畸形患者中进一步研究OD-CSVL。
