Oh Chahyun, Lee Minwook, Hong Boohwi, Song Byong-Sop, Yun Sangwon, Kwon Sanghun, Ko Youngkwon, Lee Sun Yeul, Noh Chan
Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon 35015, Korea.
Department of Anesthesiology and Pain Medicine, College of Medicine, Chungnam National University, Daejeon 34134, Korea.
J Clin Med. 2022 Mar 23;11(7):1772. doi: 10.3390/jcm11071772.
(1) Background: Prolonged neck flexion is thought to cause harmful loading on the cervical spine. Along with the degenerative process, cervical alignment tends to change toward lordotic curvature. The association between cervical alignment and cervical spondylosis remains unclear. (2) Methods: Three raters retrospectively assessed cervical radiographies of outpatients at a tertiary center in 2019 using degenerative cervical spondylosis score (DCS score; a newly developed scoring system), C2-7 absolute rotational angle (ARA), and C2-7 sagittal vertical axis (SVA). (3) Results: A total of 561 patients were included in the analysis. Multiple regression analysis with adjustments for age and sex revealed that C2-7 ARA, rather than SVA, was a significant parameter for degenerative spondylosis. The interaction between age and C2-7 ARA was significant, indicating that the increase in DCS score with increasing age was more pronounced in patients with kyphotic cervical alignment. The direct effect of age on DCS score was 0.349 (95% CI 0.319 to 0.380, p < 0.001) and the proportion of the mediation effect of C2-7 ARA was −0.125 (p < 0.001). (4) Conclusions: C2-7 ARA was significantly associated with DCS after adjustment for both age and sex. Subjects with more kyphotic cervical alignment showed a greater correlation between increased DCS score and older age.
(1) 背景：长时间低头被认为会对颈椎造成有害负荷。随着退变过程，颈椎排列往往会向生理前凸弯曲改变。颈椎排列与颈椎病之间的关联仍不明确。(2) 方法：2019年，三名评估者使用退变型颈椎病评分（DCS评分；一种新开发的评分系统）、C2 - 7绝对旋转角度（ARA）和C2 - 7矢状垂直轴（SVA），对一家三级中心门诊患者的颈椎X光片进行回顾性评估。(3) 结果：共有561名患者纳入分析。经年龄和性别调整的多元回归分析显示，C2 - 7 ARA而非SVA是退变型颈椎病的一个重要参数。年龄与C2 - 7 ARA之间的相互作用显著，表明在颈椎后凸排列的患者中，随着年龄增长DCS评分的增加更为明显。年龄对DCS评分的直接效应为0.349（95%置信区间0.319至0.380，p < 0.001），C2 - 7 ARA的中介效应比例为 - 0.125（p < 0.001）。(4) 结论：经年龄和性别调整后，C2 - 7 ARA与DCS显著相关。颈椎后凸排列越明显的受试者，DCS评分增加与年龄增长之间的相关性越大。
