Zhu Shuaiqi, Zhao Chong, Wu Yonghao, Liu Chenjun, Liu Haiying
Department of Spinal Surgery, Peking University People's Hospital, Beijing, China.
Global Spine J. 2025 Jul 2:21925682251357011. doi: 10.1177/21925682251357011.
Study DesignRetrospective study.ObjectivesTo investigate the prevalence of cervical kyphosis, identify factors influencing cervical sagittal alignment and analyze its relationship with spino-pelvic parameters in asymptomatic children and adolescents.Methods410 asymptomatic children and adolescents aged 4-18 years were included. Cervical sagittal alignment types and radiographic parameters were measured in the full-length spine X-ray. Three groups were assigned according to Toyama method: lordotic group, straight and sigmoid group, kyphotic group. Participants were stratified by gender and age, and differences in spinal parameters were analyzed. To determine factors influencing cervical sagittal alignment, a multinomial logistic regression was conducted.ResultsAmong the 410 participants, 119 (29.0%) were classified as lordotic, 170 (41.5%) as straight, 5 (1.2%) as sigmoid, and 116 (28.3%) as kyphotic of the cervical sagittal alignment. Females exhibited a higher prevalence of kyphosis compared to males (35.8% vs 19.0%). Furthermore, kyphosis prevalence increased with age, from 0% in the 4-6-year-old group to 39.2% in the 16-18-year-old group. Strong positive correlations were observed between T1 slope and C2-C7 Cobb angle (r = 0.667, < 0.01), as well as between lumbar lordosis and sacral slope (r = 0.758, < 0.01). Age and C2-C7 Cobb angle were identified as predictors of cervical sagittal alignment via multinomial logistic regression analysis.ConclusionsThis study revealed that cervical kyphosis prevalence was comparable to lordosis in asymptomatic pediatric population, which challenged the traditional view of kyphosis as pathological. Additionally, cervical sagittal alignment showed significant gender- and age-related differences. These findings contribute to understanding pediatric cervical morphology and refining surgical strategies.
研究设计
回顾性研究。
目的
调查无症状儿童和青少年颈椎后凸的患病率，确定影响颈椎矢状面排列的因素，并分析其与脊柱-骨盆参数的关系。
方法
纳入410名4-18岁无症状儿童和青少年。在全脊柱X线片上测量颈椎矢状面排列类型和影像学参数。根据富山方法分为三组：前凸组、直型和S型组、后凸组。参与者按性别和年龄分层，分析脊柱参数的差异。为确定影响颈椎矢状面排列的因素，进行多项逻辑回归分析。
结果
在410名参与者中，119名（29.0%）颈椎矢状面排列为前凸，170名（41.5%）为直型，5名（1.2%）为S型，116名（28.3%）为后凸。女性后凸患病率高于男性（35.8%对19.0%）。此外，后凸患病率随年龄增加，从4-6岁组的0%增至16-18岁组的39.2%。观察到T1斜率与C2-C7 Cobb角之间存在强正相关（r = 0.667，<0.01），腰椎前凸与骶骨斜率之间也存在强正相关（r = 0.758，<0.01）。通过多项逻辑回归分析确定年龄和C2-C7 Cobb角为颈椎矢状面排列的预测因素。
结论
本研究表明，在无症状儿童人群中颈椎后凸患病率与前凸相当，这挑战了将后凸视为病理性的传统观点。此外，颈椎矢状面排列存在显著的性别和年龄差异。这些发现有助于理解儿童颈椎形态并完善手术策略。
