Abstract
BackgroundNot a large number of previous studies have reported the normal sagittal balance of the cervical spine and physiological cervical lordosis (CL) has not been clearly defined yet.MethodsThis was a prospective radiological analysis of asymptomatic subjects. The following cervical sagittal parameters were measured: CL, thoracic inlet angle (TIA), T1 slope (T1S), neck tilt (NT), and C2–7 sagittal vertical axis (C2–7 SVA). The Pearson correlation test was calculated, and the stepwise multiple regression analysis was conducted by using the CL (dependent variable) and the other cervical sagittal parameters (independent variables) to determine the best sets of predictors. A paired sample t test was conducted between the predicted and measured values.ResultsThe mean age of 307 participants was 24.54 + 3.07. The mean CL, TIA, T1S, NT, and C2–C7 SVA was 17.11° ± 6.31°, 67.87° ± 7.78°, 25.84° ± 5.36°, 42.53° ± 6.68°, and 14.60 ± 8.20 mm, respectively. The formula was established as follows: CL = 0.762 × T1S − 0.392 × C2–C7 SVA + 0.25 × TIA − 13.795 (R = 0.812, R2 = 0.660) (stepwise multiple regression) and CL = 0.417 × TIA − 11.193 (R = 0.514, R2 = 0.264) (simple linear regression). There was no statistical difference between the predicted CL and the measured CL (t = 0.034, P = 0.973).ConclusionsThere was a significant correlation between CL and other cervical sagittal parameters, including TIA, T1S, NT, and C2–C7 SVA in asymptomatic Chinese population. The results of this study may serve as a normal reference value for the study of asymptomatic population.
Highlights
Not a large number of previous studies have reported the normal sagittal balance of the cervical spine and physiological cervical lordosis (CL) has not been clearly defined yet
For the human body always tends to obtain a stable posture at the minimum energy expenditure when standing and walking, it is critical to maintaining the sagittal balance of the spine [1]
CL was significantly correlated with T1 slope (T1S), C2–C7 sagittal vertical axis (SVA), and thoracic inlet angle (TIA) (P < 0.05), while CL was not correlated with neck tilt (NT) (P = 0.762)
Summary
Not a large number of previous studies have reported the normal sagittal balance of the cervical spine and physiological cervical lordosis (CL) has not been clearly defined yet. The spine has a certain physiological curvature in the sagittal plane. For the human body always tends to obtain a stable posture at the minimum energy expenditure when standing and walking, it is critical to maintaining the sagittal balance of the spine [1]. Any deviations from the normal alignment of the mass of the head would result in a biomechanical imbalance of the cervical spine and an increase in muscular energy expenditure, and bringing a variety of disorders and complications. The results of this study may serve as a normal reference value of ideal CL for the evaluation of sagittal balance or planning of a fusion angle in the cervical spine
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