Changes In Cervical Alignment Research Articles

アメリカンフットボール選手における頚椎椎体の形態の経時的検討

The purpose of this study is to investigate the degenerative change of the cervical spine in American football (AF) players. The subjects were 27 collegiate AF players who had an annual radiological examination of the cervical spine. X-ray films of the lateral view were read by digital scanner and the anterior and posterior height of each spine (C 3-C 6) was measured. The subjects were divided into two groups based on experience of AF in high school (inexperienced and experienced) or the position played (lines and backs) .Although the anterior height did not change from the first grade to fourth grade, the posterior height of C 4, C 5 and C6 significantly increased (P <0.05) . The experienced group showed a faster increase in the rate of posterior height than the inexperienced group. Also, the backs group showed a faster increase in the rate of posterior height than the lines group. The increased posterior height, which sometimes includes bony spur, results in kyphotic change of cervical alignment and impingement of the cervical nerve root. The faster growth rate in experienced or backs groups suggests that higher mechanical stress to the cervical spine and younger start of AF caused degeneration.

Expansive laminoplasty by sagittal splitting of the spinous process for cervical myelopathy: correlation of clinical results with morphological changes in the cervical spine.

Morphological changes in the cervical spine were evaluated using radiography in 140 patients with cervical myelopathy who underwent expansive laminoplasty by sagittal splitting of the spinous process. We assessed the influence of these observed changes on the postoperative clinical results. The mean follow-up period was 33 +/- 19 months. Intervertebral body union occurred in 18%, and interlaminal union in 80% of the patients. The factors influencing the bony union in these were not identified. Bony union did not significantly influence the clinical results. There were changes in cervical alignment in 29 (21%) patients after the operation. Correlation between the spinal curvature and the clinical results was the strongest for the sigmoid-type curvature. The number of patients in whom preoperative ROM was maintained was only 8 (7%). The range of cervical spine motion decreased by approximately 50%, and there was no correlation with the clinical results. The surgical method described in the current study for compression myelopathy was associated with postoperative morphological changes and decreased ROM in the cervical spine, but nonetheless provided good postoperative results unless extreme morphological abnormalities occurred. This surgical technique was safe and gave satisfactory results in patients with preoperative morphological abnormalities in the cervical spine.

頚椎後縦靭帯骨化症患者における脊柱管拡大術後の脊柱アライメントの変化

We evaluated changes in cervical alignment after laminoplasty using biomechanical method. Twenty-four patients with cervical ossification of the posterior longitudinal ligament were analyzed. The postoperative “A” value was useful for estimating postoperative malalignment. The frequency of decrease in the “A” value was less in OPLL than in CSM.

頚椎症に対する頚部脊柱管拡大術の検討

We studied 69 patients with cervical spondylotic myelopathy, and 33 patients with cervical ossification of the posterior longitudinal ligament with a mean age of 65.5 years and an average follow-up period of 4 years and 5 months. Clinical results were evaluated using the JOA score for cervical myelopathy and recovery rates using Hirabayashi's method. The overall mean recovery rate was 58%. There was no significant difference between recovery rate and age, duration of symptoms or preoperative JOA score.Moreover, we radiographically investigated changes in cervical alignment and rate of enlargement, antero-posterior movement, and instability in 50 cases.