Peculiarities of changes in the sagittal balance of the cervical spine in cervicobrachial syndrome

Abstract

Objective. To analyze clinical manifestations of cervicobrachial syndrome and identify their relationship with sagittal imbalance using data of MRI and radiological examination.Material and Methods. Clinical manifestations of cervicobrachial syndrome associated with degenerative changes in the spine were studied in 22 patients. Clinical examination, radiography of the cervical spine, electroneuromyography of the upper extremities, and MRI study were performed. The intensity of the pain syndrome was assessed by VAS, and the quality of life – by the NDI questionnaire. The sagittal balance of the cervical spine was evaluated according to the following characteristics: angle of T1 slope, atlantoaxial (C1–C2) angle, degree of shift of the center of gravity of C2–C7, and Cobb angle.Results. The pain intensity in cervicobrachial syndrome correlates with sagittal balance changes in the C2–C7 Cobb angle (r = 0.656; p < 0.05), the angle of T1 vertebra slope (r = 0.520; p < 0.05), and in the degree of shift of the center of gravity of C2–C7 (r = 0.756; p < 0.02). Differences between MRI and radiological results of the sagittal balance measurement are not significant (p < 0.04).Conclusion. The study of the sagittal balance can be included in the algorithm for diagnosing osteochondrosis of the cervical spine. The MRI, along with spondylography, can be used to assess the state of sagittal balance. Understanding the identified relationships can help in determining the program of etiopathogenetic treatment of patients with cervicobrachial syndrome with obligatory including the sagittal balance correction in the program.