J Korean Neurosurg Soc.  2021 Sep;64(5):784-790. 10.3340/jkns.2020.0320.

Physiologic Cervical Alignment Change between Cervical Spine X-ray and Computed Tomography

Affiliations
  • 1Department of Neurosurgery, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
  • 2Department of Neurosurgery, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

Abstract


Objective
: The purpose of this study was to investigate the correlations among various radiological parameters used to determine cervical alignment from cervical spine radiographs (X-CS) and cervical spine computed tomography (CT-CS), both within and between modalities.
Methods
: This study included 168 patients (≤60 years old) without a definite whole spine deformity who underwent CT-CS and X-CS. We measured occipital slope (O-s), C1 slope, C2 slope, C7 slope, sella turcica - C7 sagittal vertical axis (StC7-SVA), spinocranial angle, T1 slope, and C27-SVA. We calculated the O-C2 angle, O-C7 angle, and C2-7 angle from the measured parameters and conducted correlation analyses among multiple parameters.
Results
: The intrinsic correlation features among multiple cervical parameters were very similar for both X-CS and CT-CS. The two SVA parameters (C27-SVA and StC7-SVA) were mainly influenced by the upper cervical slope parameters (r=|0.13–0.74|) rather than the lower slope cervical parameters (r=|0.08–0.13|). The correlation between X-CS and CT-CS for each radiological parameter was statistically significant (r=0.26–0.44) except for O-s (r=0.10) and StC7-SVA (r=0.11).
Conclusion
: The correlation patterns within X-CS and CT-CS were very similar in this study. The correlation between X-ray and CT was statistically significant for most radiological parameters, and the correlation score increased when the horizontal gaze was consistently maintained. The lower cervical parameters were not statistically associated with translation-related parameters (C2-7 SVA and StC7-SVA). Therefore, the upper cervical segment may be a better predictor for determining head and neck translation.

Keyword

Cervical spine alignment; X-ray; Computed tomography

Figure

  • Fig. 1. The measured cervical parameters in this study; occipital slope, C1-slope, C2-slope, C7-slope, T1-slope, C2-C7-sagital vertical axis (C27-SVA), sella turcia-C7 sagittal vertical axis (StC7-SVA) and spino-cranial angle.


Reference

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