Abstract
ABSTRACT Objective: To compare the cervical sagittal balance in groups of patients submitted to lateral radiographs of the cervical segment, with the upper limbs in two different positions. Methods: This is a cross-sectional, quantitative, prospective, descriptive study using radiographic analysis of 100 adult individuals, aged between 20 and 70 years. Two lateral radiographs were taken of each patient, one image with the upper limbs crossed over the trunk (flexed elbows) and the other with the upper limbs elevated in front (extended elbows). All patients answered a questionnaire about age, sex, presence of pain in the cervical spine, as well as degree of pain based on the Likert scale. The radiographic parameters evaluated were the COBB angle (Cobb), thoracic inlet angle (TIA), T1 slope, neck tilt and distance from the center of gravity (COG) of the skull to C7 (COG-C7) with the elbows in extension (Ext) and flexion (Flex). A p-value of less than 0.05 was considered a statistically significant difference. Results: Sixty patients were female (60%) and forty were male (40%). The data analysis obtained showed statistical significance in Cobb Flex vs. Cobb Ext (p = 0.000), TIA Flex vs. TIA Ext (p = 0.000), T1 Flex vs. T1 Ext (p = 0.000), Neck tilt Flex vs. Neck tilt Ext (p = 0.000), and COG-C7 Flex vs. COG-C7 Ext (p = 0.000). Conclusion: There was statistical significance in relation to the positioning of the upper limbs in the lateral radiographs, yielding higher values in the angulations with the limbs raised towards the front (extended elbows). Level of evidence II; Prospective Comparative Study.
Highlights
Human postures have been described by anatomists, such as Staffels, Delmas, and Bonne
Two lateral radiographs were taken of each patient, one image with the upper limbs crossed over the trunk and the other with the upper limbs elevated in front
There was statistical significance in relation to the positioning of the upper limbs in the lateral radiographs, yielding higher values in the angulations with the limbs raised towards the front
Summary
Human postures have been described by anatomists, such as Staffels, Delmas, and Bonne. Sagittal balance is based on the alignment between the vertebral segments.[2,3,4] It is a parameter evaluated by means of physical and radiographic examinations, being important in the study of spinal diseases, especially in the planning and indication of surgical treatment. The importance of the sagittal balance of the cervical segment and the fact that its deformity is associated with pain, functional disability, and even with the severity of cervical myelopathy have been demonstrated.[4]
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