van Santbrink Esther, Schuermans Valérie, van de Goor Ank, de Bie Rob, Boselie Toon, van Santbrink Henk, Smeets Anouk
Dept. Of Neurosurgery, Maastricht University Medical Centre, Maastricht, The Netherlands; Dept. Of Neurosurgery, Zuyderland Medical Centre, Heerlen, The Netherlands; CAPHRI Institute for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
Dept. Of Neurosurgery, Maastricht University Medical Centre, Maastricht, The Netherlands; Dept. Of Neurosurgery, Zuyderland Medical Centre, Heerlen, The Netherlands; CAPHRI Institute for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
Spine J. 2025 Aug;25(8):1751-1761. doi: 10.1016/j.spinee.2025.01.037. Epub 2025 Jan 29.
Cervical sagittal balance parameters are an important aid in surgical decision-making and influence outcome in cervical spine surgery. In current literature, the normative values of these parameters vary highly within and between patients. This variability might be attributed to body posture.
The primary aim is to review the literature on the influence of body posture, including studies that compare sitting or standing positions possibly varying in arm positions, on cervical alignment measured in the sagittal plane on X-rays.
A systematic review was performed.
PubMed, Embase, Cochrane Library, Web of Science, and CINAHL were systematically searched for articles published up to and including May 2024. The primary outcome was variability in cervical alignment in the sagittal plane as measured in altering body postures on X-rays. Quality of the included articles was assessed with the QUADAS-2 tool.
Out of 17,628 screened articles, 8 were eligible for inclusion. Articles were excluded based on irrelevant outcomes (n=10,372), duplicates (n=4,315), wrong study design (n=1,462), or the influence of body posture was not described (n=612). Overall cervical alignment ranged from 33.3° lordosis to 3.5° kyphosis. In all studies, statistically significant differences in T1 Slope (T1S), C2C7 Sagittal Vertical Axis (SVA), McGregor Slope (McGS), or C7 SVA were observed with respect to body posture. The observed differences between postures for cervical alignment ranged from 1° to 16.6°.
Body posture significantly influences cervical alignment values measured in the sagittal plane on X-rays. Studies investigating this influence are scarce and vary highly in investigated body postures. Standardization of body posture is imperative to enable optimal comparison of cervical sagittal balance parameters within and between patients, but also between studies. Moreover, the high variability observed raises questions about the comparability of measured values in previously published studies.
颈椎矢状面平衡参数是手术决策的重要辅助指标，并影响颈椎手术的结果。在当前文献中，这些参数的规范值在患者内部和患者之间差异很大。这种变异性可能归因于身体姿势。
主要目的是回顾关于身体姿势影响的文献，包括比较坐姿或站姿（手臂位置可能不同）对X线矢状面颈椎排列测量影响的研究。
进行了一项系统评价。
系统检索了截至2024年5月（包括5月）在PubMed、Embase、Cochrane图书馆、科学网和CINAHL上发表的文章。主要结局是在X线下改变身体姿势时矢状面颈椎排列的变异性。使用QUADAS - 2工具评估纳入文章的质量。
在17628篇筛选的文章中，有8篇符合纳入标准。排除的文章基于不相关的结局（n = 10372）、重复（n = 4315）、错误的研究设计（n = 1462）或未描述身体姿势的影响（n = 612）。整体颈椎排列范围从33.3°前凸到3.5°后凸。在所有研究中，观察到T1斜率（T1S）、C2C7矢状垂直轴（SVA）、麦格雷戈斜率（McGS）或C7 SVA在身体姿势方面存在统计学显著差异。观察到的姿势间颈椎排列差异范围为1°至16.6°。
身体姿势显著影响X线矢状面测量的颈椎排列值。研究这种影响的研究很少，并且所研究的身体姿势差异很大。身体姿势的标准化对于在患者内部和患者之间以及研究之间实现颈椎矢状面平衡参数的最佳比较至关重要。此外，观察到的高变异性引发了对先前发表研究中测量值可比性的质疑。
